Racism and Fitness to Practice complaints to the GMC

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

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The request was partially successful.

Dear General Medical Council,

#BlackLivesMatter

There have been multiple admissions of racism in the GMC including Fitness to Practice processes. The base data and correct initial questions do not appear to have been asked or properly gathered, when exploring concerns in discourses and GMC related research. As this related data is not available and far too often nothing is done too. Can I make the following request:

In the last 3 years, Please provide (ideally as a simple table):
1. The ethnicity of complainants if available against
2. The ethnicity of defendants if available (no names please)
3. Whether there was further investigation or curtailment, or a finding against the doctor
4. Of those doctors with a finding/erasure, the ethnicity of the prosecution
5. Only of those investigated, the route of their initial complaint i.e. was it by Responsible Officer, direct to the GMC by website/letter, or via another body / court /
health process, GMC-liaison-backdoor service and Rule 12.

I am aware information may not be available and, in this case, if partial information is available please provide with blank information in other areas. If no information is available, then omit. I am aware data is likely to be incomplete and this is acceptable.

Separately for the last 3 years
6. The ethnicity of the decision makers as a group
7. The ethnicity of the investigator if present (as a group)
8. The Ethnicity of the GMC Management as a group
9. The Ethnicity of the GMC MPTS division as a group, if available

I would like to make a clarification in relation to the above, having read some of your other FOI non-minimised 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. They are often in junior positions and the system issues are ignored by design. Please do not provide any names or GMC numbers of doctors or staff. The reason I ask for group information, is so punitive action is not subsequently taken which is inline with GDPR, integrity and confidentiality principle as well as data minimisation. We can all be part of the change which includes following the outcomes detailed in https://www.gmc-uk.org/-/media/documents...

I am happy for you to make changes to the request as reasonable. If unclear, please ask your colleague Mr McCoig-Lees who has my personal contact details. If the above more specific and narrower request is still too long, please omit Question 6,7,8,9 as that is unlikely to be a simple data extraction.

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
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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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FOI, General Medical Council

Dear Dr Ali,

Your information request – IR1-2727801914

Thank you for your email dated 28 June, in which you ask for the below:

 

In the last 3 years, Please provide (ideally as a simple table):

1.         The ethnicity of complainants if available against

2.         The ethnicity of defendants if available (no names please)

3.         Whether there was further investigation or curtailment, or a
finding against the doctor

4.         Of those doctors with a finding/erasure, the ethnicity of the
prosecution

5.         Only of those investigated, the route of their initial
complaint i.e. was it by Responsible Officer, direct to the GMC by
website/letter, or via another body / court / health process,
GMC-liaison-backdoor service and Rule 12.

              

Separately for the last 3 years

6.         The ethnicity of the decision makers as a group

7.         The ethnicity of the investigator if present (as a group)

8.    The Ethnicity of the GMC Management as a group

9.    The Ethnicity of the GMC MPTS division as a group, if available

 

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

Simon Willis 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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Simon Willis (0161 923 6310), General Medical Council

Dear Dr Ali,

 

Thank you for your email of 28 June 2020.

 

There are aspects of your request which require clarification and we would
be grateful if you could address the following:

 

• The GMC do not have powers to ‘prosecute’. We can however take action
where it appears that a doctor's fitness to practise may be impaired.
Please therefore provide further information about question 4.

 

• Please clarify what you mean by “a finding”

 

• Please clarify what you mean by “curtailment”

 

Once we hear from you, we will proceed with your request.

 

In the meantime, please note that your request may exceed the cost limit
in accordance with section 12 of the FOIA.  To give you an idea on the
number of files that would need to be reviewed, there were 7,405
complaints in 2018 and further 7,417 in 2019. There were over 1,900
investigations in each of these two years.

 

Yours sincerely,

 

GMC

 

 

 

From: FOI
Sent: 29 June 2020 15:50
To: '[FOI #673127 email]'
<[FOI #673127 email]>
Subject: RE: Freedom of Information request - Racism and Fitness to
Practice complaints to the GMC

 

Dear Dr Ali,

Your information request – IR1-2727801914

Thank you for your email dated 28 June, in which you ask for the below:

 

In the last 3 years, Please provide (ideally as a simple table):

1.         The ethnicity of complainants if available against

2.         The ethnicity of defendants if available (no names please)

3.         Whether there was further investigation or curtailment, or a
finding against the doctor

4.         Of those doctors with a finding/erasure, the ethnicity of the
prosecution

5.         Only of those investigated, the route of their initial
complaint i.e. was it by Responsible Officer, direct to the GMC by
website/letter, or via another body / court / health process,
GMC-liaison-backdoor service and Rule 12.

              

Separately for the last 3 years

6.         The ethnicity of the decision makers as a group

7.         The ethnicity of the investigator if present (as a group)

8.    The Ethnicity of the GMC Management as a group

9.    The Ethnicity of the GMC MPTS division as a group, if available

 

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

Simon Willis 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

 

[2][email address]

General Medical Council

3 Hardman Street

Manchester

M3 3AW

 

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Dear Simon Willis (0161 923 6310),

The GMC FTP process-with-themselves at an MPTS is quasi-legal, the MPTS is independent yet fully funded by the GMC, the defendant is the doctor, and the prosecution is seen as the GMC appointed/paid barrister or solicitor. I see what you mean but here Prosecutor (badly worded but you can put 'accuser' or ' GMC decision maker' or 'doctor-basher' but might read too literal) it refers to this GMC person involved (i.e. GMC barrister/solicitor) or at the early stage, it is the investigator or complaint handler! The Ethnicity of this GMC person refers to exactly that, and where there are multiple people involved it should refer to the last person whom is normally the Barrister. If it helps you can use another word to describe this GMC person. If you would like examples of names of your staff, please give me a telephone call via your colleague (see previous correspondence and last similar request which I have been asked to be more specific and resubmit). I hope this provides clarification.

Regarding, clarify what you mean by “a finding” and ‘curtailment.’ I am happy for you to clarify ‘finding’ and ‘curtailment’ given how you have written your response and would ask if really needed, to look at a dictionary or consider what this means to a common person. In essence anything that is not-guilty of an accusation and results in sanctions, suspension or erasure. It may help you to look at https://www.mpts-uk.org/hearings-and-dec... Obviously with the GMC FTP process it is multi-stage and I am happy for your to alter the questions or words if needed.

Yours sincerely,

Dr S. Ali

Simon Willis (0161 923 6310), General Medical Council

1 Attachment

Dear Dr Ali,

Please find attached response to your request of 28 June 2020.

Yours sincerely,

GMC

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 Simon Willis (0161 923 6310),

I am not seeking the breakdown of 20,000 complaints, I hope this is clear as the above also states I explicitly do not want you to list personal information of the large number you have. I am fully aware, the GMC have collated the results and some data extraction is possible without going back to original submissions, manually as the GMC and or MPTS, has already processed the data. This is the second request, having refined the request to reduce time and allow automatic collation of processed data.

You again ask for clarification, this time ethnicity for “ethnicity… as a group.” This is the number of any particular ethnic group tallied up. Please see a dictionary for definition of words or use common sense. Please see government census or the following site on what an ethnic groups are https://www.ethnicity-facts-figures.serv... alternatively speak with your HR department. I am aware you already collect this information and there are publishing of different groups already publically available. These particular small group tallies, can be done in batches – hence the wording to save on time and ensure the work can be done within the stipulations. As the GMC is also a registered charity, if you would like extra-funding from doctors please let me know and I will seek to arrange via crowd-funding.

I am not finding your actions at all helpful. As your actions, continue to bring an organisation that is seen as racist into doubt and are not consistent with Dame Marx’s words. I would remind you, the previous responses are publically available on https://www.whatdotheyknow.com/request/r... Further as the GMC both self-regulates and believes they are the profession, under Section 1 of the Medical Act, this continues to not promote or maintain the public confidence in the medical profession; I thus request an internal review on the GMC refusal.

Yours sincerely,

Dr S. Ali

FOI, General Medical Council

Dear Dr Ali,

 

Your appeal request: IR1-2755827315

Thank you for your email dated 27 July.

We will be considering your email under our comments and complaints
procedure. This sets 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 [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

 

[2][email address]

General Medical Council

3 Hardman Street

Manchester

M3 3AW

 

 

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Dear Lauren Barrowcliffe,

I thought I would chase the internal review outcome. Please provide the outcome if it has been done. I note previous responses to others which are less than ideal.

You acknowledged my email 27 July and states a target response time of 20 working days. Given the pandemic I have waited at least 40 working days before chasing this.

Yours sincerely,

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

Dear Dr Ali,

Thank you for your email. I have discussed this with Julian Graves who is dealing with your review. Apologies for the delay in responding to you, Your review will be priorities and we will get back to you as soon as possible.

Kind regards

Lauren Barrowcliffe
Information Access Team Assistant

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

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Julian Graves (0161 923 6351), General Medical Council

1 Attachment

Dear Dr Ali

Please find attached my internal review 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 Julian Graves (0161 923 6351),

My original request was 18 June and there is a link provided to this. The second request was the 28 June.
I requested an Internal review under FOI processes and not an appeal, which appears what was done despite Lauren Barrowcliffe stating it will be considered under your comments and complaints procedure (section 45 code of practice). I note the name given to your file. The response appears with passive-aggressive wording and an aversion set nature of a considered response. I would remind you of:
1. Your responses clearly highlights you have some of the information requested. I clearly disagree with your interpretation of my request reasoning. I provide a lengthy clarification below
2. That although the GMC is a public body it is wholly financed from subscriptions from doctors and not the public purse. I realise what I am saying is very similar to the relationship of the GMC and MPTS which is seen as frequently misused as it undermines any real independence. You point out the cost of such a request but given the financing has never been public money; I have offered to arrange further finances from our profession to meet the cost of a request which would obviously need to be refined and set out objectively but really is it needed - see below.
3. This is not really a forum for debate, just information that should be in the public domain.

I am a fully registered doctor with the GMC whom given circumstances is in the unique position to ask much needed questions, that cannot be brushed off under the dining room table. My request, was borne out of an email from Dame Marx of the GMC, to doctors, it has sought out simple missing information regarding relationship between ethnicity and Fitness to practice investigation process. This may be considered as bias or a confounder or causal, but that is not for you or me, to decide.

I believe it was clear I am not asking you to link information especially having spoken to your colleague. Thus the following is not appropriate for you to interpret “My interpretation of your request is that you are looking to link the data obtained with each question to the remainder – i.e. the impact of the ethnicity of each group on the outcome of the complaint - so providing you with tables for each question in isolation would not meet your requirements. I’m sure you will inform me if I have misinterpreted your requirements.” Normally with such passive-aggressive passages would mean a person does not call you out, which I do, as I just want simple standardised information. However I will re-quote the first paragraph of my original request and one of the last comments in the related responses:
“There have been multiple admissions of racism in the GMC including Fitness to Practice processes. The base data and correct initial questions do not appear to have been asked or properly gathered, when exploring concerns in discourses and GMC related research. As this related data is not available and far too often nothing is done too. Can I make the following request:” ….
“….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 am looking for initial raw data. Your response seems fixated on making links, maybe you should observe your medical colleagues and reflect on what is the purpose of true investigation.

Anyway, your colleague and you highlight, both you have the processed data for
1. Ethnicity of 30% of complainants ---- so provide this
2. Ethnicity of defendants – you highlight SOMEP report table 31, which uses 3 ethnicity groups
3. Ignore (I agree with your colleague this is too complicated and costly)
4. Ethnicity of GMC prosecutors/barristers/solicitors where there was suspension/erasure/conditions which obviously is not readily held but are small numbers, it does not take a rocket scientist to give a snapshot. This is as a group, thus you do not go into every case one by one which is more of a subversion of the request! But if you would like to list all their names as the GMC has a habit of doing that for doctors (not staff), then you are welcome to, as that would also mean less processing and maybe cost saving.
5. Only of those investigated, the route of their initial complaint, you highlight table 5 SOMEP – Thank you, it seems the best I will get.

I would highlight from my original request “I am aware information may not be available and, in this case, if partial information is available please provide with blank information in other areas. If no information is available, then omit. I am aware data is likely to be incomplete and this is acceptable.” I have clearly stated it is acceptable to provide the data of what is available.

You quote to me information available in data tables within the State of Medical Education and Practice in the UK (SOMEP) report for 2019 which you give a link with a typo that goes to spam website, maybe it should be https://www.gmc-uk.org/about/what-we-do-...
I telephoned your colleague to save embarrassment.
I am sill not sure whether you grasp I was asking for a simple small data table not 100 odd tables or 20,000-line single table.

I believe it is entirely reasonable to ask for information for Item 1 and for you to consider a variation of item 4 with a snapshot, which will not take several thousand hours but a few hours of talking at most. Given how much I get paid an hour, the work will easily be done at a third of your allotted fee and I am prepared to arrange payment of extortionate wages if that is how the GMC is run. I am aware rather than using ethnicity in the ‘census’ sense which most doctors are use to - as that is what we use in primary and secondary care; the GMC appears to use only 3 ethnicity groups: BME, white and other = which is fine.

May be the best way forward would be for you to contact your line manager, the GMC's 'strategic equality diversity and inclusion forum' or contact Dame Marx, and ask her for a response. I would remind you from my original request regarding the expected GMC refusal, your response does go against this quote from her:
“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."”

Yours sincerely,

Dr S. Ali

FOI, General Medical Council

Dear Dr Ali,

 

Thank you for your email dated 9 October which you sent directly to Julian
Graves. Please can you confirm that you are happy for us to communicate
with you via this email address in relation to the new request?

 

Yours sincerely

 

Lauren Barrowcliffe
Information Access Team Assistant

 

[1][email address]

General Medical Council

3 Hardman Street

Manchester

M3 3AW

 

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

Dear FOI,

Thank you for your email. Your colleague and you, have not asked me to make a formal new request., Number three.

There is no new request for me. The previous email correspondence was under the FOI internal review process after a delay of over 40 days. I have requested provision of the information that is stated as available for #1 and made a compromise for #4 which may or may not be accepted. If this is not possible, then I have suggested an appropriate escalation avenue. This is open public correspondence and dialogue clearly shows to any decent person this is not information you want to provide but to use your own words, you need to be humble.

Yours sincerely,

Dr S. 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

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

Sadie Jones (0161 250 6889), General Medical Council

1 Attachment

Dear Dr Ali

Your information access request - IR1-2827968221

Thank you for your email dated 9 October. I’ve considered the requests
made at question 1 and 4 under the Freedom of Information Act 2000 (FOIA).

1.Ethnicity of 30% of complainants ---- so provide this

The below table provides you with the number of complainants who were
members of the public from between the 1 January 2015 and 01 October 2020
broken down by ethnicity.

Ethnic Number of %
Origin Complainants Complainants
Asian or 805 2.3%
Asian
British
Black or 340 1.0%
Black
British
Mixed 231 0.7%
Not stated 293 0.8%
Other 192 0.6%
Ethnic
Groups
White 7318 21.2%
Unspecified 25383 73.4%
Grand Total 34562 100.0%

Please note from this data that although we do have a field for ethnicity
data on our complaints form, this is not compulsory and we do not hold
this information for 74.2% of complainants from members of the public.

4.Ethnicity of GMC prosecutors/barristers/solicitors where there was
suspension/erasure/conditions which obviously is not readily held but are
small numbers, it does not take a rocket scientist to give a snapshot.
This is as a group, thus you do not go into every case one by one which is
more of a subversion of the request! But if you would like to list all
their names as the GMC has a habit of doing that for doctors (not staff),
then you are welcome to, as that would also mean less processing and maybe
cost saving.

Please see the below table with the ethnicity breakdown of the GMC legal
team. Please note that our legal team includes a in house solicitors, and
variety of administration roles.

+------------------------------------------------------------------------+
|Ethnic Origin |Number of Staff |% of Staff |
|-------------------------+--------------------------+-------------------|
|Asian or Asian British |16 |10.2% |
|-------------------------+--------------------------+-------------------|
|Black or Black British |3 or less |Under 2% |
|-------------------------+--------------------------+-------------------|
|Mixed |5 |3.2% |
|-------------------------+--------------------------+-------------------|
|Not stated |5 |3.2% |
|-------------------------+--------------------------+-------------------|
|Other Ethnic Groups |3 or less |Under 2% |
|-------------------------+--------------------------+-------------------|
|White |127 |80.9% |
|-------------------------+--------------------------+-------------------|
|Unspecified |0 |0% |
|-------------------------+--------------------------+-------------------|
|Grand total |157 |100% |
+------------------------------------------------------------------------+

You will see that I have withheld the exact numbers and percentages  for
‘Black or Black British’ and ‘Other Ethnic Groups’, this is because it
would breach data protection legislation to give this to you. I’ve given
details of the exemption under the FOIA which applies below.

 

The exemption

 

Section 40(2), by virtue of section 40(3A)(a)

 

This exemption applies where the information is the personal data of a
third party and where releasing the information would breach any of the
principles relating to the processing of personal data listed at Article 5
of the General Data Protection Regulation (GDPR). In this instance
disclosure would breach the first principle, which requires the processing
of information to be lawful, fair and transparent. I do not believe that
any of the legal bases for processing listed at Article 6, or any of the
conditions for processing special category data listed Article 9 of the
GDPR, are met and therefore giving you the information would be unlawful.

Your right to appeal

I'm sorry I couldn’t provide all the information you requested. If you
would like to appeal this decision please set out your reasons in writing
to [1][GMC request email]. Please note that we will only usually consider
appeals received within 40 working days of our response. You can also
appeal to the [2]Information Commissioner, the regulator of the FOIA and
DPA.

Yours sincerely

Sadie Jones

Information Access Officer

[3][email address]

0161 250 6889

 

General Medical Council

3 Hardman Street

Manchester

M3 3AW

 

[4][IMG]

 

--------------------------------------------------------------------------

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Dear Sadie Jones (0161 250 6889) and colleagues,

Thank you for the delayed provision of limited information for item 1, which was the purpose of the second request having discussed the first request.

Regarding item 4, clearly Article 6 (f) legitimate interest applies, given earlier GMC statement. However I do not have an objection to any refusal as long as it is stated but we do see it as hypocrisy. As doctors are not happy about the release of their names with personal details/events without freely given consent but you apply Public Interest. Similarly this applies more so to GMC staff.

Thank you again for the information, now in the public domain.

Yours sincerely,

Dr Ali