Bristol

The request was refused by General Medical Council.

Dear General Medical Council,

BACKGROUND

In December 2010 the Department of Health Professional Standards Unit raised the following questions/comments of public interest in response to a briefing it received from University Hospitals Bristol NHS Foundation Trust (via the Strategic Health Authority NHS South West) prior to publication of a report commissioned by the Trust.

“The briefing note raises more questions than it answers not least because it appears to be UHB Chief Execs own interpretation of the report. Some of the comments seem to perpetuate the rivalry between the two organisations.”

“The briefing note does mention specific findings about the failings/behaviour of the medical directors and other staff. Do you know whether local disciplinary or remedial action was undertaken as a result of this, for any of the individuals concerned? Or has the Trust/SHA raised this with the GMC or other regulatory bodies?”

“We would also query the line to take that “there is no serious concern about the diagnostic quality of histopathology services”. The culture that appears to have pervaded the service at UHB individuals refused to take account of peer reviews etc. This forms part of the professional performance of each individual clinician at UHB, and as such did cause a problem in the diagnostic quality of the service. Whilst we note that many of the senior clinicians involved have since moved on, we did wonder how many original staff were still present at both UHB and North Bristol and to what extent this culture may be prevalent while senior posts are being filled. Is the SHA aware of whether UHB has involved the National Clinical Assessment Service (NCAS) at all, in order to assess any individual(s)?“

THE FOIA REQUEST

1. Please provide information held by the GMC relating to the following:

a. Whether or not local disciplinary or remedial action was undertaken as a result of the inquiry for for any of the individuals concerned (medical directors and other staff)

b. Whether or not the Trust/SHA raised the issues with the GMC.

c. Whether or not any individuals who are registered with the GMC were assessed by the National Clinical Assessment Service in the light of "the problem of the quality of the diagnostic service".

Yours faithfully,

Mrs D Havercroft

FOI, General Medical Council

Dear Mrs Havercroft

Your information request F13/5656/EH

Thank you for your email of 14 August 2013 asking for information under
the Freedom of Information Act 2000 (FOIA).

We will consider your request and give you the information as soon as we
can, normally within the 20 working-day limit set by the FOIA.

Please note that there may be some information which we cannot release to
you under the FOIA. If this is the case, we will let you know why and
state the relevant exemptions given in the FOIA. We will also give you
information about how to appeal our decision.

I have allocated your request to Elizabeth Hiley. If you have any
questions, please contact her on 0161 923 6314 or email
[1][email address].

Yours sincerely

Sadie Jones

Information Assistant

[2][email address]

0161 250 6889

 

General Medical Council

3 Hardman Street

Manchester

M3 3AW

 

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Elizabeth Hiley (0161 923 6314), General Medical Council

1 Attachment

Dear Mrs Havercroft

Please find attached our response to your request below.

Yours sincerely

Elizabeth Hiley
Information Access Officer
Tel no: 0161 923 6314
Email: [email address]

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Dear General Medical Council,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of General Medical Council's handling of my FOI request 'Bristol'.

I request an internal review of your decision please:

1. You claim exemption under Section 40(5)(b)(i) of the FOIA. You contend that provision of the information requested would cause substantial and unwarranted distress to data subjects. I challenge your decision on the following grounds:

a. Provision of the information requested does not require you to provide me with individuals' personal data.

b. Your claim for exemption is outweighed by the volume of personal data already in the public domain. This personal data of the individuals, concerning what the Department of Health described as “the problem in the diagnostic quality of the (histopathology) service” is already in the public domain here:

http://www.uhbristol.nhs.uk/files/nhs-ub...

The personal data of Medical Directors is presented throughout the report. The personal data of the individuals about whom the Department of Health asked whether they had been assessed by the National Clinical Assessment Service is located as follows:

Pages 58 to 62 inclusive, paragraphs 2.42 to 2.60 inclusive.

Annexe 4(i) Pages 2 to 17 inclusive.

Annexe 6, Pages 5 to 6 inclusive.

Annexe 7, Pages 250 to 258 inclusive.

The identity of those individuals still working in Bristol is in the public domain here:

http://www.uhbristol.nhs.uk/for-clinicia...

c. I challenge your position that the conditions in Schedule 2 of the DPA are not met. The condition of Schedule 2 (6) (1) is met, namely that the processing is necessary for the purposes of legitimate interests pursued by third parties to whom the data should be disclosed. These third parties are patients. Under the provisions of the NHS 2013/14 Choice Framework they have a right to choose who carries out specialist tests if they need them. This means that they have a right to know whether histopathologists and other staff implicated in what the Department of Health described as the “problem in the diagnostic quality of the service” have been assessed by the National Clinical Assessment service and subjected to appropriate remedial and/or disciplinary action in order that patients can make an informed choice as to whether to allow these members of staff to carry out specialist tests on their tissue or whether to ask for it to be referred to other specialists and maybe other cities.

Patients have the right not be subjected to the substantial damage and distress of not knowing whether the problem of the quality of the diagnostic service provided by certain individuals has been resolved with assistance of the National Clinical Assessment Service. This overrides the data protection rights of these individuals. As NHS employees they are subject to published governance rules as set out in the NHS Code of Conduct/Accountability which says:

Accountability – everything done by those who work in the NHS must be able to stand the test of parliamentary scrutiny, public judgements on propriety and professional codes of conduct.

Openness – there should be sufficient transparency about NHS activities to promote confidence between the NHS organisation and its staff, patients and the public.

Provision to the public of the information requested is entirely consistent with the obligations of these NHS staff to be accountable and open.

2. You claim exemption under Section 31(3) of the FOIA and believe that confirming or denying whether this information is held would be likely to prejudice your regulatory function.

You say that you believe that to confirm or deny would discourage individuals or organisations from raising concerns or cooperating with an investigation if they know that information about their communication with you may be made publicly available.

These arguments cannot be applied to Bristol because the individuals and organisations involved failed to raise any concerns with the GMC. It was left to Dr Phil Hammond to tell the GMC about them in 2009. I have written evidence, seen by the GMC, that doctors claimed to be “scared” to raise their concerns with it about what some regarded as a “dangerous” histopathology service. It is the GMC's relationship with the doctors it regulates which has been prejudicial to effective regulation in Bristol, not requests for information under the FOIA.

The exemption you claim is subject to the Public Interest test. This has not been applied. The grounds for disclosing the information in the public interest is set out in paragraphs 1 a) to c) inclusive above.

In addition people living in the Bristol area are tired of its health scandals. It is in the public interest for the GMC to provide evidence to show whether or not the National Clinical Assessment Service has been brought in to assist with resolving individual and team performance problems. If it has this will provide some reassurance to the public. If it hasn't the public needs to know so that it can hold Bristol NHS organisations and regulators to account to explain why NCAS has not looked at Bristol histopathology.

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/b...

Yours faithfully,

Mrs D Havercroft

Courtney Brucato (0161 923 6692), General Medical Council

Our Ref: F13/5656/EH

Dear Mrs Havercroft

Thank you for your email below. This will receive my attention in line with our comments and complaints procedure for information requests. This sets a target response time of 20 working days. I will endeavour to respond to you within this timeframe.

If you have any further queries in the meantime, please let me know.

Yours sincerely

Courtney Brucato
Information Access Officer
General Medical Council

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Courtney Brucato (0161 923 6692), General Medical Council

1 Attachment

Our Ref: F13/5656/EH

Dear Mrs Havercroft,

Please find attached our response to your internal review. If you have any questions please let me know.

Yours sincerely,

Courtney Brucato
Information Access Officer
General Medical Council

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Dear Courtney Brucato (0161 923 6692),

This is not a request for further review, simply a reply which I wish to put in the public domain:

I have received some of the information I requested in a. and b. from other sources.

This leaves the matter of the GMC's refusal to state if it holds any information as to whether any individuals implicated in the issue of the diagnostic quality of the service (the Department of Health's words) have been assessed by the National Clinical Assessment Service (NCAS).

You say "I believe that if we confirmed if any complaints have been made about doctors named in
the December 2010 Report for University Hospitals Bristol there is potential that a member of the public could identify the doctors concerned."

The outstanding request for information is not asking if any complaints have been made about doctors. As stated above I now have information which answers that to some extent. It is requesting any information held by the GMC as to whether any individuals have been assessed by NCAS.

Information is in the public domain which shows that the Department Health recognised that there were problems with the professional performance of some individuals who can easily be identified in the Inquiry Report.

Contrary to the GMC's claim that providing the information requested is likely to have an adverse impact on its fitness to practise function, the opposite is true. Given that the GMC's stated purpose is to "protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine", it is reasonable for the public to see evidence that it actually does what it says.

Consequently the GMC's refusal to state whether it has any information as to whether NCAS assessed any Bristol individuals leaves the public with considerable uncertainty as to whether it is still at risk of being exposed to problems with the diagnostic quality of the service provided by the doctors, who are easily identifiable.

If the individuals have been assessed by NCAS, provision of this information to the public would provide welcome reassurance. However since such reassurance is not forthcoming, individual members of the public will have to form their own conclusions about the safety of doctors concerned when making healthcare choices.

In your response you say "I also consider it relevant to note paragraph 35 in the recent First Tier Tribunal
decision EA/2012/0262" and then quote a paragraph containing my personal data.

Use of my personal data is governed by the Data Protection Act 1998. Data Protection Principle 1 states that personal data must not be used in ways that have unjustified adverse effects on the individuals concerned. I consider that your use of my personal data as described above, when you have provided no reasoning for your statement, is deliberately intended to have an adverse effect on me.

Consequently I request that you explain your logic and reasoning as to exactly why you consider a paragraph in a First Tier Tribunal decision as in any way relevant to this FOIA request.

I suggest you reply to this request by post because the What Do They Know website is for FOIA and this has now become a Data Protection matter.

Yours sincerely,

Mrs D Havercroft

Julian Graves (0161 923 6351), General Medical Council

Dear Mrs Havercroft

Ms Brucato has referred your email to me for consideration. I will respond, as you suggest, to the correspondence address we hold for you.

Yours sincerely

Julian Graves

Julian Graves
Information Access Manager
General Medical Council
3 Hardman Street
Manchester
M3 3AW
 
Tel. no: 0161 923 6351
Email: [email address]

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