Racism and complaints to the GMC

S. Ali made this Freedom of Information request to General Medical Council

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The request was refused by General Medical Council.

Dear General Medical Council,

Dame Clare Marx, Chair of the General Medical Council highlighted this week to doctors, an admission of racism within the GMC and health system, in verbatim:

"GMC research has shown that BME doctors’ experience of medicine can be sharply different to that of their white colleagues. As our Fair to Refer? report highlighted, some doctors are treated differently, some feel less able to raise concerns, and some are not provided with the feedback or support they need. These same issues also pervade education and training environments. We see that racism and other forms of discrimination still exist in medicine, as in so many walks of life. That is why we have been working, not only in the GMC, but across the system to facilitate change.

Addressing these entrenched issues requires focus and commitment. We will need to be humble about what we don’t know and decisive in implementing solutions. The Black Lives Matter movement serves as a reminder that this is urgent. We can all be part of the change. All of us in medicine share that responsibility."

In relation to this and possibly to aide the strategic equality diversity and inclusion forum openly in public. Please can you highlight with a breakdown of Fitness to Practice (FTP) complaints:
1. the ethnicity of complainants against
2. ethnicity defendants,
3. the ethnicity of the decision maker and
4. ethnicity of the investigator if present,
5. Whether there was action taken against the doctor (ideally as yes or no)

IF available also highlight: the route of their complaint i.e. was it by Responsible Officer, direct to the GMC by website/letter, or via another body / court / health process. If possible, please break this down per year for the last 5 years when data has been been gathered or, as for as far back in historical records as possible i.e. to 2001. Just be simple please if possible, just produce one or two tables from information already available or easily collatable.

I hope you will be humble and not difficult with this FOI request, if you have any queries please contact Dame Marx within the GMC or the above GMC internal forum.

Yours faithfully,

Dr S. Ali

FOI, General Medical Council

Thank you for getting in touch. Please note this is an automated email.

 

Unfortunately, due to the current pandemic outbreak we are operating at
reduced capacity. It may therefore take us longer to respond to your
correspondence. We apologise for any inconvenience caused but we’ll get
back to you as soon as we can with a further acknowledgement.

 

In the meantime, if you want any further information about the GMC, please
visit our website.

 

Thank you

 

Information access team

General Medical Council

Email: [GMC request email]

Telephone: 0161 923 6365

Working with doctors Working for patients

The General Medical Council helps to protect patients and improve medical
education and practice in the UK by setting standards for students and
doctors. We support them in achieving (and exceeding) those standards, and
take action when they are not met.

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Dear General Medical Council,

Thank you for your acknowledgements and it is understandable and okay for their to be a delay.

I would like to make a clarification in relation to the above, having read some of your other FOI disclosures. Names of individual doctors are considered by our profession as personal data, and are information relating to living identifiable individuals, as defined by the Data Protection Act 1998. Please do not provide any names or GMC numbers of doctors or staff. We can all be part of the change which includes following the outcomes detailed in https://www.gmc-uk.org/-/media/documents...

Yours faithfully,

Dr S. Ali

FOI, General Medical Council

Thank you for getting in touch. Please note this is an automated email.

 

Unfortunately, due to the current pandemic outbreak we are operating at
reduced capacity. It may therefore take us longer to respond to your
correspondence. We apologise for any inconvenience caused but we’ll get
back to you as soon as we can with a further acknowledgement.

 

In the meantime, if you want any further information about the GMC, please
visit our website.

 

Thank you

 

Information access team

General Medical Council

Email: [GMC request email]

Telephone: 0161 923 6365

Working with doctors Working for patients

The General Medical Council helps to protect patients and improve medical
education and practice in the UK by setting standards for students and
doctors. We support them in achieving (and exceeding) those standards, and
take action when they are not met.

show quoted sections

FOI, General Medical Council

1 Attachment

Dear Dr Ali,

 

Your information request – IR1-2719116226

Thank you for your emails dated 18 June, in which you ask for the below:

 

o The ethnicity of complainants
o The ethnicity of defendants,
o The ethnicity of the decision maker and
o The ethnicity of the investigator if present,
o Whether there was action taken against the doctor (ideally as yes or
no)
o The route of their complaint i.e. was it by Responsible Officer,
direct to the GMC by website/letter, or via another body / court /
health process.

 

Broken down per year for the last 5 years where data has been gathered or,
as for as far back in historical records as possible i.e. to 2001 with o
names of GMC numbers or doctors or staff

 

How we will consider your request

We’re going to consider your request under the Freedom of Information Act
2000 (FOIA). The FOIA gives us 20 working days to respond, but we’ll come
back to you as soon as we can.

 

Who to contact

Matt McCoig-Lees will be handling your request. If you have any questions
you can contact him via email at [1][email address].

 

Unfortunately, due to the pandemic outbreak we are currently operating at
reduced capacity. It may therefore take us longer to respond to your
request. We apologise for any inconvenience caused.

 

Yours sincerely

 

Lauren Barrowcliffe

Information Access Team Assistant

 

[email address]

General Medical Council

3 Hardman Street

Manchester

M3 3AW

 

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Matthew McCoig-Lees (0161 923 6579), General Medical Council

1 Attachment

Dear Dr Ali

 

I write further to previous correspondence with a response under the
Freedom of Information Act 2000.

 

I am applying an exemption to your request in full because of the amount
of work it would take to process. Under the FOIA there is an exemption for
requests where it would cost the public authority more than £450 to
process- equivalent to two and half days’ work.

 

Our current electronic database was introduced around 2006. Even if I took
the start date for your request as 2006, not all of the data you have
requested is extractable by automation. I would have to go through each
complaint received to obtain the data you requested. 

 

For example just for 2018, our data explorer app shows there were 7405
complaints. If it took just 1 minute to manually look at each case to
manually obtain the data that cannot be electronically extracted (and it
may take substantially longer), it would take over 123 hours  to  obtain
the information you requested. Based on an hourly rate of £25 per hour
(which is set by the Freedom of Information (Fees and Appropriate Limit)
Regulations 2004 ) this would cost us over £3000 just for that year. The
total cost of your request would therefore cost us significantly in excess
of the ‘appropriate limit’ to process.

 

The exemption

 

Under the FOIA, the specific exemption which we believe applies is at
section 12. This states that we are not required to comply with a request
if we estimate that the cost of doing so would exceed the appropriate
limit.

 

Advice and Assistance

 

We are obliged to offer you advice and assistance to make a request which
would not attract a costs exemption.

 

I should explain that we do not have full data on the ethnicity of
complainants as they do not all provide it to us. Nor do we have full
information for doctors. We also may not have ethnicity data on former GMC
staff if they left the organisation some time ago. Current staff may also
not have provided the organisation with this information.

 

We have lots of information about  the FTP process and ethnicity in the
public domain. You referenced our fair to refer report. You may well have
read it but if not, the link to it is [1]here. There may be other research
we have carried out which is interesting to you as well, for example our
[2]work on the fairness of decisions to refer doctors to the MPTS Interim
Orders Tribunal, [3]Understanding employers’ referrals, [4]An analysis of
doctors erased or suspended, and an analysis of [5]our decision making in
Fitness to Practice Procedures.

 

You might also find our reports on the [6]state of medical education and
practice useful. In particular the [7]data tables for this years report,
specifically tables 31, 39, 47, 55, 62, 66, 70, 73, 75-6, 82 and 89.

 

If after considering this information, you would like anything else please
let me know and I’ll be happy to help.  We may be able to provide further
information on doctor ethnicity, investigation outcomes and the route by
which the complaint was made.

 

 

---

Kind Regards

 

Matt

 

Matthew McCoig-Lees

Information Access Officer

Information Access Team

General Medical Council

3 Hardman Street

Manchester

M3 3AW

Email: [8][email address]

Website: [9]www.gmc-uk.org

Tel: 0161 923 6579

 

[10]Coronavirus email footer_artwork_5-01 REWORK

 

From: FOI
Sent: 19 June 2020 14:52
To: '[FOI #671473 email]'
<[FOI #671473 email]>
Subject: RE: Freedom of Information request - Racism and complaints to the
GMC

 

Dear Dr Ali,

 

Your information request – IR1-2719116226

Thank you for your emails dated 18 June, in which you ask for the below:

 

o The ethnicity of complainants
o The ethnicity of defendants,
o The ethnicity of the decision maker and
o The ethnicity of the investigator if present,
o Whether there was action taken against the doctor (ideally as yes or
no)
o The route of their complaint i.e. was it by Responsible Officer,
direct to the GMC by website/letter, or via another body / court /
health process.

 

Broken down per year for the last 5 years where data has been gathered or,
as for as far back in historical records as possible i.e. to 2001 with o
names of GMC numbers or doctors or staff

 

How we will consider your request

We’re going to consider your request under the Freedom of Information Act
2000 (FOIA). The FOIA gives us 20 working days to respond, but we’ll come
back to you as soon as we can.

 

Who to contact

Matt McCoig-Lees will be handling your request. If you have any questions
you can contact him via email at [11][email address].

 

Unfortunately, due to the pandemic outbreak we are currently operating at
reduced capacity. It may therefore take us longer to respond to your
request. We apologise for any inconvenience caused.

 

Yours sincerely

 

Lauren Barrowcliffe

Information Access Team Assistant

 

[12][email address]

General Medical Council

3 Hardman Street

Manchester

M3 3AW

 

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Dear Matthew McCoig-Lees (0161 923 6579),

Thank you for the reply and explanation that any information provided would have been missing information but also to manually extract missing information it would cost too much. I would have expected some data analysis on this already completed but I guess I am wrong. I can understand and accept that the manual work is too onerous. However the electronic extraction you mention does not sound like it would take that long. Obviously you will not be able to supply all data and that is acceptable.

Having experienced how shambolically poor communication within the large and uncoordinated GMC is (with false accusations originating from the GMC), may be you may wish to contact Dame Marx or the GMC 'strategic equality diversity and inclusion forum.' If it is acceptable to them, then there is nothing I would add.

Yours sincerely,

Dr S. Ali

Matthew McCoig-Lees (0161 923 6579), General Medical Council

Dear Dr Ali

Thank you for your email. We have done some data analysis and these can be seen in the links within my previous response. You have to click show quoted sections and you will be able to see the analysis which has been done, to which I refer.

---
Kind Regards

Matt

Matthew McCoig-Lees
Information Access Officer
Information Access Team
General Medical Council
3 Hardman Street
Manchester
M3 3AW
Email: [email address]
Website: www.gmc-uk.org
Tel: 0161 923 6579

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Dear Mr McCoig-Lees and Ms Barrowcliffe,

Thank you for your quick reply. I had given thought before responding as well as re-read some of the quotes from your CEO, Mr Massey 2018 from GPonline ‘‘But we do know that there is an over-representation of BME doctors that have been complained about and we want to know more about what is driving this, as well as whether there is an under representation of other doctors…’ Although I am fully aware GMC guidelines unfortunately do not apply to their own staff (hypocrisy of your seniors), this request is not personal to you, to explain:

It is to fill in the obvious voids given the GMC Duty of Candour and umpteenth admission by the GMC of Racism within the GMC (which does include the financially dependent MPTS). To highlight medical dogma, ‘without proper investigation, despite a diagnosis, you cannot often expect to cure or re-sect a complex disease.’

I have read the links, which do not provide the information sought. I also considered other documents from the GMC and PSA. The above GMC documents such as ‘Review of decision making in our fitness to practice procedures’ sits at odds with data from the GMC and the reasons why the two prominent GMC employees made the above obvious statements. Similar concerns have been present for decades which continues to bring harm to the reputation of our profession and the ongoing inability of non-medics to regulate it. I am aware of possible repercussions of this request but I have little to lose and in a situation where I can highlight injustices of the GMC. Some of the GMC documents are interesting although a little tangential (unsure if it is by design) but I did found other tables more relevant than those quoted for ‘[7] data tables for this years report.’
Given that the email yesterday, I was responding to states ‘If after considering this information, you would like anything else please let me know and I’ll be happy to help. We may be able to provide further information on doctor ethnicity, investigation outcomes and the route by which the complaint was made.’
I thus would ask if you can re-read my last reply.

Warmest Regards,

Dr S. Ali

Matthew McCoig-Lees (0161 923 6579), General Medical Council

Dear Dr Ali

Thank you for your email of 25 June. I have also re read your email of 24 June.

I accept that the information I provided links to does not contain all the information you requested. I am glad that at least some of it was somewhat helpful. I have also explained why I cannot fulfil the request you made, noting that there may be more information we are able to provide on doctor ethnicity, investigation outcomes and the route by which the complaint was made. However you have not specified what, if any information you would like. I need you to make a specific request which I can then consider. Until you do that I am unable to assist further. Time specific requests (for example for data in the last 3 full years) are less likely to attract a Section 12 costs exemption than ones which do not. Narrower requests are also less likely to attract the exemption. Alternatively, I have provided you with the information needed to appeal my decision which you are also at liberty to do.

---
Kind Regards

Matt

Matthew McCoig-Lees
Information Access Officer
Information Access Team
General Medical Council
3 Hardman Street
Manchester
M3 3AW
Email: [email address]
Website: www.gmc-uk.org
Tel: 0161 923 6579

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Dear General Medical Council,

This/there was a repeated request having had previous advice on refining the request.

In relation to Section 12, I note that you did not include a calculation or explanation of the costs involved in providing the information, given other projects and changes at the GMC which may also reduce costs. It would be useful if you could do so, to allow me to understand how best to reframe my request and not exceed the cost limit, or arrange payment of costs.

As I am sure you are aware, the FOI Act states that it is "the duty of a public authority to provide advice and assistance, so far as it would be reasonable to expect the authority to do so", and the ICO consider it best practice to provide "arguments or evidence" when applying this exemption.

Yours faithfully,

Dr Ali

FOI, General Medical Council

Thank you for getting in touch. Please note this is an automated email.

We’ll get back to you as soon as we can with a further acknowledgement.
You’ll usually hear from us on the next working day, but it might take a
little longer during busy periods.

In the meantime, if you want any further information about the GMC, please
visit our website.

Thank you

Information Access team

General Medical Council

Email: [GMC request email]

Working with doctors Working for patients

The General Medical Council helps to protect patients and improve medical
education and practice in the UK by setting standards for students and
doctors. We support them in achieving (and exceeding) those standards, and
take action when they are not met.

show quoted sections

FOI, General Medical Council

Dear S Ali,

Thank you for your email dated 24 June.

We will be considering your email as a Freedom of Information Act 2000 (FOIA) appeal. We have a target response time of 20 working days. We will endeavour to respond to you within this timeframe.

Julian Graves will be handling your request. If you have any questions you can contact him via email at [email address].

Yours sincerely

Lauren Barrowcliffe
Information Access Team Assistant

[email address]
General Medical Council
3 Hardman Street
Manchester
M3 3AW

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Dear FOI Ms Barrowcliffe,

Thank you for your email but the 20 working day response duration is not appropriate as my further email is a request for clarification of costs under Schedule 12. It is not a new request. However seeing the generic cut and paste responses and generally responding beyond 20 working days, I welcome your message but would prefer you turn off the auto-acknowledgements.

Yours sincerely,

Dr Ali

Dear FOI Ms Barrociffe and Mr Greaves,

Information request ongoing from 2020 – IR1-2719116226

As stated in my previous clarification reply, it is expected given your departments habitual poor performance a response would not be received in 20 working days, it is now 30 working days since I submitted my cost clarification, I highlight I have not had a reply. I would point out that it is over a year or 289 working days since the original submission of my refined request, with GMC input.

This request for information is to clarify the current statistics in relation to racism and complaints to the GMC. I find it utterly surprising given Dame Marx statements last year that the information has no already been collated. Although I myself have noticed a 100% refusal to investigate a complaint from an Asian or Black doctor if it is against a white doctor. In submitting multiple complaints, including at invitation of one of your investigators to show a complaint from an Asian doctor is not accepted, I know from direct experience that the GMC (not you personally) collect the information sought. Shockingly as I am discovering, it appears the threshold to investigate a complaint is almost non-existent if it is a complaint from a white-privileged doctor against an Asian or Black doctor even if it is not about medicine. The GMC non-medical triage/investigation personnel appear not-to-treat complaints or doctors equally and fairly, highlights why this request is in the public interest. Despite developments, to ironically quote Dame Marx, Chair of the GMC, stepping-back response from the GMC website, she said:
‘We know that many doctors feel discriminated against by the way in which referrals to the GMC are handled, and there remains much for us and others to do to change that.
‘But accepting a flawed tribunal judgment will not help achieve the aims we and others share to tackle inequalities where they exist in disciplinary proceedings for healthcare professionals.’

I have requested clarification of costs in relation to Section 12, although the subtlety here with the GMC being funded by UK doctors, i.e. I am already paying for the work that you do. As I am sure you are aware, the FOI Act states that it is "the duty of a public authority to provide advice and assistance, so far as it would be reasonable to expect the authority to do so", and the ICO consider it best practice to provide "arguments or evidence" when applying this exemption, your exemption Section 12 was incomplete whilst practically the work should already have been done and you should only be forwarding the information. Before doctors can challenge the inequality of joint GMC and MPTS disciplinary proceedings against doctors. To the point the GMC non-medics (including QCs) will deceive and discriminate to get a finding (as they are not subject to Fitness to Practice or expectation of honesty). It is important the earlier steps of the flawed and separate GMC FTP referral handling process by unqualified personnel that gives rise to discrimination has data available transparently. There are multiple flaws and they all need to be addressed without covering them up or amalgamating them. I would remind Ms Lauren Barrowcliffe I would like requests treated separately.

As I have reminded you the clarification for costs is late, I would appreciate a response.

Yours sincerely,

Dr Ali

Julian Graves (0161 923 6351), General Medical Council

Dear Dr Ali

Thank you for your email below.

I'm sorry for the delay in responding to your internal review request. This matter is receiving my attention and I will respond to you as soon as I possibly can.

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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Julian Graves (0161 923 6351), General Medical Council

1 Attachment

Dear Dr Ali

Further to our your email below please find attached my response.

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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Dear Mr Graves (0161 923 6351),

Thank you for your letter 13th September 2021 and your own chronology and belief despite delays this is an example of FOI best practice. Your reasoning appears that having stated cost limit exemption (to quote you) “… provided a full calculation of the work that would be involved in providing a response to you citing the data for 2018 as an example.” This would be fantastic but it appears I may be just blind, so please can you tell me these costs, as a one-line with a figure, I really cannot see this. Essentially, that is the current cost clarification request.
.
.
I apologise as may be I should have responded on the refined assisted SECOND request 28th June 2020 https://www.whatdotheyknow.com/request/r... and not this original FIRST request 18th June 2020 https://www.whatdotheyknow.com/request/r... I would clearly highlight I have found your colleagues conduct professional and do not have any concerns/grievance against him as an individual, he is commendable and I wish more of your colleagues could be like him.

I am unclear as to your ‘my emphasis’ on page two with the date 24 June 2021. I would point out to any normal person that it was a prompt response within days, as it was 24 June 2020. Contrary to your assertion ‘we heard nothing further from you in respect of this matter until your email sent on 24 June 2021 (my emphasis)...’ Moreso as the chronology is public and further (already accessed) event/contact data is available. It may be that you mean, my recent ‘prompted’ correspondence for costs. Well, then you really need to look at the related subsequent request, other events and see if similar information is already available to share. I do again apologies as the two requests although truncated and refined, are still similar.

I would rather not argue over individual points, as there is the apparent refusal to give costs estimates as overall your organisation again, does not want to provide transparent information for the subsequent and original FOI request given its connections. Given other requests by others, this appears to be a well-trodden path.

I again highlight I am satisfied with your colleagues response but not entirely satisfied as they missed out the actual cost. I hope you can quickly let me know the costs. This could prevent further escalation with these two linked requests.

Yours sincerely,

Dr Ali

Julian Graves (0161 923 6351), General Medical Council

Dear Dr Ali

Thank you for your email below.

In terms of the cost calculation Mr McCoig-Lees' response sent on 24 June 2020 contains the following paragraph:

For example just for 2018, our data explorer app shows there were 7405 complaints. If it took just 1 minute to manually look at each case to manually obtain the data that cannot be electronically extracted (and it may take substantially longer), it would take over 123 hours to obtain the information you requested. Based on an hourly rate of £25 per hour (which is set by the Freedom of Information (Fees and Appropriate Limit) Regulations 2004 ) this would cost us over £3000 just for that year. The total cost of your request would therefore cost us significantly in excess of the ‘appropriate limit’ to process.

You also queried the chronology I provided. If you review the chain of emails in the request here: https://www.whatdotheyknow.com/request/r... you'll note that Mr McCoig-Lees' email sent on 25 June 2020 is followed in the chain by your email sent on 24 June 2021 (I recorded this in bold in my previous email to highlight that it was almost a full calendar year between these two).

I hope that clarifies matters.

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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Dear Julian Graves (0161 923 6351),

Thank you or the response, but that was a dismissed example of creating 'new data' by going through every single complaint received manually, one by one. That is not the purpose of an FOI request although may be part of other works already done. Honestly with all the presentation of various complaint data by your colleagues and seniors, do you really think you have to go back to original electronic data and manually sift through them, one by one?

The data has been processed. Also, you may gather from the subsequent responses that the above is actually completely un-necessary hence at the time, my phone call to him and subsequent FOI request https://www.whatdotheyknow.com/request/r... which was still overall refused and shows that processed data is there! It is just confusing and difficult to understand (which may or may not be deliberate).

I would appreciate an actual costs for FOI requested not to create new data not requested.

Yours sincerely,

Dr Ali

S. Ali left an annotation ()

The reasoning for the bold text date, in the GMC response for request of costs under Section 12, appears that the ICO are now involved.

Possibly also looking for a Section 50 exemption whilst hiding the fact a subsequent-related FOI request has been made, showing ongoing communication, but with the GMC begrudging and unnecessarily slow in responding.

I hope this is helpful insight into future FOI requests and the need to not allow the GMC to take too much time in responding, plus need to give them regular reminders/prompts;- it appears a deliberate tactic related to Section 50. As the GMC can, like with a lot of things, use it against you (even using both sides of an argument separately).