The General Medical Council (GMC) Is Worse Than Useless

When doctors are believed to have erred, the ultimate complaints procedure is the General Medical Council (GMC), an organisation which regulates doctors and is supposed to protect patients from bad doctors. The GMC decides whether or not they are fit to practise. And it lays down rules and guidelines detailing how they should practise and how they should treat their patients.

But if the GMC really exists to protect the health of patients and the integrity and reputation of the medical profession (and, if it does not, then why does it exist?) then in my view it has failed both doctors and patients.

Here are ten ways in which I believe that the GMC has failed patients and doctors:

1. The GMC does nothing to limit the enormous control the drug companies have over medical education. The GMC has stood by while the medical profession has been taken over by an industry. As I wrote in The Medicine Men in 1976, `a profession which takes its instructions from an industry can no longer call itself a profession'. A GMC which truly cared about professional standards would punish doctors who, while practising medicine, develop over-close links with drug companies. Doctors and drug companies have (or should have) completely different aims.

2. The GMC allows doctors to overprescribe drugs such as antibiotics and tranquillisers without publishing adequate guidelines and without punishing the thousands of doctors who recklessly overprescribe. The overprescribing of tranquillisers has led to the biggest addiction problem in Britain. The overprescribing of antibiotics has contributed to the incidence of antibiotic resistant infections in hospitals.

3. The GMC does nothing to ensure that doctors only provide patients with the best possible advice. After a GP was reported to have `prescribed' meat for his patients, I made a formal complaint about him to the GMC on the grounds that meat is a recognised cause of cancer. (The scientific evidence for this is published in my book Food for Thought and on this website). Despite the existence of this evidence the GMC refused to take any action against the GP.

4. The GMC has made no criticism of the way the NHS (the main source of health care in Britain) is mismanaged by politicians and administrators. There is little or no point in the GMC admonishing doctors for breaches of medical etiquette when the environment in which they work is dangerously and criminally inadequate. It is simply not good enough for the GMC to say that the medical environment in which doctors operate is not its concern. That is akin to a GP treating patients poisoned by a pollutant and doing nothing to eradicate the pollutant on the grounds that it isn't his responsibility. If the GMC is to be taken seriously it must tackle serious issues.

5. The GMC has done nothing to prevent doctors taking advantage of the existence of two different health systems (the NHS and private care) in order to make money. Thousands of British doctors work both for the NHS and for their own interests. Many of them deliberately make their NHS waiting lists long so that they can attract more private patients. It is improper and unethical for doctors who work for the NHS to offer private care to the same pool of patients. The GMC should interfere and stop this abuse.

6. The GMC should do more to prevent the abuse of minority groups of patients, such as those who are mentally ill and those who are elderly. Doctors who withhold treatment and allow patients to die just because they are old (a common practice in NHS hospitals) are not punished by the GMC. They should be. By refusing to acknowledge the existence of this problem, and by refusing to do anything about it, the GMC is ignoring the needs of patients and abandoning its own fundamental responsibility.

7. The GMC should punish doctors who work in hospitals which have higher than average levels of antibiotic-resistant infection. Many British hospitals are dirty. This is why antibiotic-resistant infections are higher in Britain than almost anywhere else in the world. Neither administrators nor nurses will take responsibility for this tragic state of affairs and so doctors must. The GMC should question and monitor doctors whose hospitals are dirty or which have a high incidence of MRSA infection, and should punish those doctors who do not insist that the appropriate changes are made in cleaning and nursing practices. It seems to me that the GMC doesn't much care if doctors kill their patients wholesale as long as they don't sleep with them retail.

8. The GMC should make it clear that medical confidentiality is of primary importance to the integrity of the doctor-patient relationship. Any doctor who is guilty of a breach of medical confidentiality should be struck off the medical register. You can't be a little bit confidential any more than you can be a little bit pregnant. Doctors should be instructed not to share confidential information with social workers, policemen, politicians, bureaucrats or anyone else who isn't directly concerned with the health of the patient concerned. Politicians and judges who attempt to overrule the principle of medical confidentiality should be advised that the GMC will not accept interference in this area. But instead of promoting the importance of confidentiality the GMC seems to have fallen over backwards to ensure that confidentiality becomes a thing of the past. In September 2009, the GMC told doctors that they should share a range of confidential information with the `authorities'. Alarmed by this I sent this letter to the GMC:

`I was surprised to hear that you have decided that in future I should break my Hippocratic Oath and tell the police if I treat a victim of a gun or knife crime. I was equally startled by your assertion that I can tell relatives about diagnoses of genetic disease and should tell social services if patients harm themselves. These are appalling decisions which seem designed to destroy the very principle of confidentiality. Confidentiality is like pregnancy: it doesn't come in degrees. The doctor's primary responsibility must be to the patient he is treating and not to the public. When I qualified as a doctor I took the Hippocratic Oath. Who gave the GMC the right to decide that I should now break that solemn Oath?
      These are appalling decisions (which seem to me to be politically motivated and contrary to Article 9 of the Human Rights Act) and no thinking doctor should obey them.
      Although I am fully registered (and intend to remain registered and licensed) I will not obey your instruction to disobey the Hippocratic Oath and, indeed, I do not believe you have the moral right to demand that I do.'

Over a month later I received a reply (written on the 29th October) someone called Jane O'Brien, Assistant Director, Standards and Fitness to Practise Directorate. She told me:

`We agree that doctors' first concern should be the patients they treat, and that a relationship of confidentiality is a key part of forming a relationship of trust in which the patient can receive good care. However, we do not see the duty of confidentiality (as) an absolute'.

So, the GMC believes it is possible to be a little bit pregnant. The bureaucrats at the GMC clearly don't realise that nothing a doctor tells the Government (or a State employee such as a policeman, tax inspector, local council employee, doctor, nurse or social worker) will be treated as confidential. The Government will either sell the information or lose it.

9. The GMC should look carefully at some of the more bizarre medical fashions. For example, it is surely wrong that surgeons should remove the breasts of healthy women or should perform operations on patients suffering from nothing more than obesity caused by overeating. And the Government's enthusiasm for vaccination does not seem to be entirely supported by convincing scientific evidence. Currently fashionable vaccination programmes may do more harm than good. Doctors who advocate or promote vaccination programmes should be investigated by the GMC.

10. The GMC should make a clear statement about how medical research should be conducted. For example, the evidence clearly proves that reliance on animal experiments is one of the factors responsible for the current endemic of drug-induced disease. One in six patients in hospital is there because he or she has been made ill by a doctor. This is unacceptable. The Department of Health has been quite unable to produce any evidence supporting the use of animal experiments in medical research. The GMC should make it clear that drugs should be properly tested before being made available for general prescribing and that animal testing has no place in the development process for new drugs. Doctors who support or advocate animal testing should be investigated by the GMC.

11. The GMC should have spoken up when the Government accepted EU laws about doctors' working hours. The General Medical Council, which is supposed to spend its huge income preserving medical standards, should have realised the effect that reduced working weeks would have on patient care. However, the GMC, which was once a rather lumbering but reasonably reliable organisation run by the medical profession to maintain a register of all doctors and to dish out punishments to the bad ones, has become a political toy. It is, it seems to me, of no practical value to patients or doctors but of enormous practical value to politicians and bureaucrats. The GMC's main role today seems to be to create ever more complex rules and regulations to keep its bureaucrats busy and to justify its vast overheads. (Like many quangos and quango-like organisations the GMC also likes raising money, which it needs to pay the vast salaries of all the administrators it has acquired to help it raise more money. There are licence fees and registration fees and there will soon be revalidation fees and fees for doctors who want to go to the lavatory.) The GMC staff must realise that the EU's rules have devastated the quality of medical care in Britain. It could have said so and insisted that the Government reject the absurd EU legislation. But not an eyebrow or a voice has been raised in protest. The bottom line is that the GMC is a multi-million pound money making machine with plush offices in central London. And that's about it. I believe it is self-serving and far too pro-establishment and that for all the good it does for patients and doctors it could be replaced by a single clerk equipped with a computer and a website. The GMC is a rich and hugely successful licensing body which seems to me to exist to collect money rather than to protect patients or defend the interests of doctors or, heavens above, to improve medical standards. It is out of touch with reality and completely fails to understand the extent of the iatrogenesis problem.

The GMC will pillory and strike off a doctor found guilty of kissing, groping or propositioning a willing patient. But killing patients is fine, especially if they're old. The GMC launches investigations and then makes judgements. These are chiselled in stone. It is absurd (and, surely, questionable legally) to have a single body launching an investigation and then making a judgement. Patients and doctors deserve (and need) much better than an organisation which, like so many quangos, now seems to exist only to exist; a support agency for the unholy trinity of State, drug industry and medical establishment.

Today, the General Medical Council gives a false sense of security and leadership: it is far worse than useless. I believe that without it, many of the problems I have outlined would be tackled and put right.

Copyright Vernon Coleman 2012 Taken from Do Doctors And Nurses Kill More People Than Cancer? by Vernon Coleman. This book is published by EMJ Books. For details of how to purchase a copy please visit the shop on this website.