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March’s medical law news

Anger at 20-year-old case & worrying data for the GPhC

Each month, the team at Medic Assistance Scheme finds articles and stories from the past few weeks that will help medical practitioners to stay on top of fitness to practise trends in their profession. If you have concerns relating to anything you’ve read on our website, contact us today.

Anger at Hyponotraemia Inquiry doctor’s voluntary removal from the register

Source: BBC News (1/3/2019)

The GMC has expressed disappointment at the MPTS’s decision to let Dr Robert Quinn remove himself from the medical register following the high-profile Hyponotraemia Inquiry. The inquiry was the latest stage in a case that has lasted for almost two decades, investigating the deaths of five children in the Royal Belfast hospital for sick children in 2000.

In a case involving hundreds of witnesses, thousands of pages of evidence and 50 lawyers, Dr Quinn was able to end the professional investigation against him by voluntarily removing himself from the register. His lawyer said that he had been retired since 2006. In a statement, the GMC expressed its disappointment at the outcome, saying, “We felt it was in the public interest for these allegations to be heard by the Tribunal in an open and transparent way.” However, the regulator did disclose that several other doctors remained under investigation.

Our take

The GMC’s response to the decision of the MPTS is indicative of the purpose they feel a fitness to practise investigation should serve. It was not enough that Dr Quinn should be removed from the register; they were more concerned with the public perception of the inquiry and its impact on the wider profession. We know that family members of the children involved in the case have also expressed anger at the result, so it is unsurprising that the GMC is disappointed.

The MPTS’s acceptance of Dr Quinn’s voluntary removal indicates that they were less concerned with public perception than with reaching the right outcome for the doctor. With Dr Quinn retiring over a decade ago, it is unclear what sanction the MPTS could have given other than erasure. Dr Quinn’s voluntary removal expedited the process and allowed the tribunal service to avoid sinking further time and resources into the case when doing so would only lead to the same result.

Dishonest nurse struck-off despite spotless record

Source: Cambridgeshire Live (26/3/2019)

A nurse has been struck off the NMC’s register after dishonestly claiming expenses from the Peterborough and Stamford Hospitals NHS Foundation Trust between October 2014 and July 2015. Charlotte Nykoluk claimed travel expenses for a course that she didn’t attend, staying at home during the time in which she was paid to be at an ultrasound course at the University of Hertfordshire. Ms Nykoluk then maintained her dishonesty over the following months in an attempt to hide her actions from the Trust.

Following the discovery of her actions, Ms Nykoluk was referred for a fitness to practise investigation. Despite an unblemished record over the previous 10 years and the NMC’s recognition that her actions were unlikely to cause harm to patients, Ms Nykoluk was struck off because of a lack of insight. In a quote, a spokesperson for the NMC said: “It was mindful of the panel’s findings on impairment, specifically that her insight was limited, and she failed to show recognition of the impact her actions had on the Trust and the wider reputation of the nursing profession.”

Our take

Ms Nykoluk’s case is another example of the importance of insight in fitness to practise cases. Where the regulator has determined that fitness to practise has been impaired, the practitioner’s ability to demonstrate insight regarding the consequences of their actions is often a key factor in the severity of any sanctions. Ms Nykolouk’s sanctions were determined thanks to her lack of insight following a sustained period of dishonesty, which will have indicated to the NMC that there was a risk of further dishonesty occurring in the future.

This case further demonstrates the view of a regulator when a registrant has not just acted dishonestly, but has sustained the period of dishonesty by attempting to cover their tracks. Dishonesty to this extent will usually result in a nurse being struck off. For a more favourable outcome, the professional under investigation should seek to show the NMC that they are fully aware of the impact of their actions and that they will take steps to ensure that something similar will not happen in the future.

Concerning data regarding discrimination in GPhC fitness to practise decisions

Source: The Pharmaceutical Journal (7/3/2019)

Data gathered between 1st January 2016 and 31st December 2018 has revealed that 47% of pharmacists who have been suspended or removed from the GPhC’s register were black, Asian or of an ethnic minority (BAME). However, it is possible that the actual percentage is higher. When removing pharmacists whose ethnicity is undisclosed, the number rises to 57%.

Commentators are concerned by these results, given that 45% of GPhC-registered pharmacists identify as BAME. This suggests that a disproportionate number are being struck off following fitness to practise investigations. In response, the GPhC has promised to conduct an equality impact assessment of its fitness to practise processes in 2019.

Our take

An equality review of the GPhC’s fitness to practise processes appears to be an appropriate response to the data. If the percentage of BAME pharmacists being struck off is as disproportionately large as it appears to be, the GPhC would do well to identify the cause. As the article mentions, it’s unclear at this stage where the core inequality lies. Is it in the percentage of BAME pharmacists referred for fitness to practise investigations, or is it in the investigation process itself?

Once the root cause has been identified, the GPhC will be able to take steps to address it, though this is likely to be a lengthy process. In the meantime, anyone facing a GPhC investigation will benefit from expert representation to ensure that their case reaches the best possible conclusion.

Related services

The Medic Assistance Scheme’s lawyers can help medical professionals in many of the areas referred to in these news topics. See below for the services that relate to March’s stories:

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