The correspondence by the late Dr DS in 2008. Letter to the Disability Rights Commission To the Disability Rights Commission, As a psychiatrist I am writing to express my strong concerns regarding the General Medical Councils approach towards doctor-patients who suffer from mental illness. I believe that their actions in these cases contravene the Disability Discrimination Act and as such are illegal. I have been made aware of the following:- 1. Doctors who suffer from relapsing remitting conditions, for example bipolar affective disorder, are being prevented from working for protracted lengths of time (months-years) during periods when the doctor is fully well and able to function at work. 2. Doctors are called to GMC court hearings during which they are expected to justify behaviour that occurred when unwell and which is totally unrelated to their medical practice. 3. Doctors are expected to attend these hearings even when they are acutely unwell and would not be considered fit to plead in criminal proceedings. 4. Doctors are approached by the GMC by letters addressed to acute psychiatric wards while they are inpatients. 5. Doctors have been assessed by GMC appointed examiners for fitness to practice whilst acutely unwell and admitted formally under section 3 of the Mental health Act 1983 (i.e. sectioned). The consequences of these actions are that doctors who suffer from mental illness are being forced to leave the medical profession. In addition I am aware of a number of doctors who have completed suicide whilst undergoing GMC health procedures. I believe that the GMC procedures are an example of discrimination towards mental illness at the highest level within the medical profession. I have contacted the Royal College of Psychiatrists expressing my concerns. I would ask for your urgent advice and assistance in addressing these issues. Many Thanks Dr DS MRCPsych Dr DS committed suicide in 2008. The Royal College of Psychiatrists as well as the Disability Rights Commission were made aware of this. No action was taken. This is the correspondence between DS and Graeme Catto, the then President of the GMC. Letter from Debraj to Graeme Catto ___________________________________________ Dear Sir Graeme, I write to express my grave concerns regarding discrimination by the GMC against doctors with mental health difficulties. I was appalled to hear a GMC lawyer state at a recent hearing that all doctors who have a diagnosis of bipolar affective disorder have impaired fitness to practice. The said doctor was found to have impaired FTP purely on the basis of their diagnosis. There has never been any patient complaint or indeed contact as when unwell this doctor has been off work. The indicative sanctions document allows these grossly discriminatory and offensive decisions to be taken because of the catch all phrase regarding relapsing and remitting conditions. This statement would allow for any health condition (including the common cold) to result in a GMC finding of impaired FTP. In fact what appears to happen is that those doctors diagnosed with mental illness are targeted using this clause. In addition I was shocked by the adversarial attitude of the lawyer and the intimidating nature of the hearing. It was worse than a criminal court when in fact the only offense that had been committed was to have a mental illness I am also aware that FTP assessments have been carried out on acute psychiatric inpatient wards. I find it difficult to believe that the GMC would request FTP assessments on a doctor who was admitted to CCU. The GMC pursues doctors relentlessly when they are unwell and doctors are called to hearings when they would not be considered fit to plead. All of the above tells me that the GMC acts with shocking ignorance and prejudice towards doctors with mental illness. Obviously this must reflect the attitude of those at the highest levels in the medical profession towards psychiatric illness and people who suffer from this. I do not believe that the general public would find this reassuring. GMC medical supervision is in fact a farce and provides no protection for patients or support for the doctor. Quite the contrary in fact. The GMC published death rates of doctors subject to supervision for health which were unacceptably high. A number of these (if not all) have been suicides. I would therefore suggest that GMC procedures and supervision endangers doctors health. I believe that in fact the GMC is acting in breach of the Disability Discrimination Act and therefore acting illegally. I and others would happily challenge this in a court of law. However I felt that out of courtesy I would make you aware of my concerns regarding the behavior of your organization. Yours sincerely Dr DS MRCPsych Catto's Reply Dear Dr Shepherd Thank you for your email to the President, Sir Graeme Catto, about doctors with mental health problems. I have been asked to reply. I was concerned to learn that you think we are in breach of the Disability Discrimination Act. We are committed to ensuring our processes and procedures are fair, objective, transparent and free from unlawful discrimination. We have published our Equality Scheme, which demonstrates how we fulfill our obligations under relevant equality legislation, including the Disability Discrimination Act 2005. A copy of our Equality Scheme is on our website at http://www.gmc-uk.org/about/equality_scheme/index.asp Our procedures for dealing with sick doctors are generally held in high regard. We have a statutory duty to act where a doctor's fitness to practise is called into question because of their physical or mental health and although our overriding responsibility is to ensure that no patient is placed at risk we try,wherever possible, to rehabilitate the doctor, although this may not be possible depending on the nature of the doctor's illness and his or her level of insight. We may require a doctor to undergo a health assessment. The assessment takes the form of an examination carried out by two doctors,normally psychiatrists.Those doctors then provide a report on whether the doctor is fit to practise either generally or in a limited way plus any recommendations about the management of the doctor's case. The reports are considered by two case examiners, one medical and one lay, together with any other information about the doctor's fitness to practise. The options open to the case examiners are to conclude the case with no action, to agree undertakings with the doctor, or to refer the case to a Fitness toPractise Panel. Sometimes doctors refuse to undergo assessment or to co-operate with the assessment process. Where this happens the case is referred to a Fitness to Practise Panel to consider whether the doctor's fitness to practise is impaired and, if so, whether any action need to be taken against his registration. Where matters relating to a doctor's health are considered by a Fitness to Practise Panel, the panel meets in private. The panel is normally assisted by a specialist adviser, usually a psychiatrist, whose role is to advise on the medical issues. The doctor is invited to attend but it for the doctor to decide whether or not to be present. We recognise that some doctors may be unable to attend because of their health condition and although the panel may proceed in the doctor's absence, subject to satisfying itself that the doctor has been served notice of the hearing, every effort is made to ensure that the hearing is fair to all concerned, that is the doctor, patients and the wider public interest. The important points to bear in mind are that each doctor's case is considered separately, a large number of doctors, including some with bipolar affective disorder, do not have impaired fitness to practise and are able to practise unsupervised but in other cases it may be necessary torestrict or suspend the doctor's registration. I hope this clarifies the position. Yours sincerely Graziella Oragano Head of Panel Development Team