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The way I see it

Plea bargaining at the General Medical Council

Authors:  Peter Wilmshurst 

Publication date:  06 May 2011

The GMC has a history of informal arrangements with

senior academics, argues Peter Wilmshurst

In his article on proposed amendments to the General

Medical Council’s procedures on fitness to practise Mr
Truby suggested that the use of plea bargaining would be
an innovation.[1] In fact the GMC already uses plea
bargaining and similar informal arrangements. I believe
that plea bargaining is used when the council wishes to
prevent or limit public exposure of misconduct by senior
academics. Its use obscures inequitable treatment of
different groups of doctors.

I reported Peter Collins to the GMC because, for a number

of years, he had claimed to have a qualification that he had
not been awarded.[2] I supplied the GMC with copies of
three of his successful applications for senior registrar,
senior lecturer, and honorary consultant posts and his
entry in the Good Doctor Guide, in which he made false
claims about his qualifications. I also provided the GMC
with a copy of the letter sent by the chairman of the board
of governors of his institution warning the whistleblower
concerned that his career was likely to suffer unless he
dropped the complaint. The GMC informed me that
Professor Collins had admitted that he claimed to have
qualifications that he did not have. He promised not to do
it again. So the GMC did not take him to a hearing, and
there was no public exposure of his misconduct.

I checked the adjudications of the GMC for a few years

before and after they dealt with my complaint about
Professor Collins. I found seven cases where the GMC held
public hearings for doctors who claimed qualifications that
they had not been awarded. Most had made a single false
claim. Three (Rashid Rhalife-Rahme, Seth Atardo, and
Ashoka Prasad) were erased from the medical register.

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Three (Afolabi Ogunlesi, Abu Shafi, and Ashutosh Jain) were ×

suspended from the register. One (Sahmin Pandor) was
reprimanded. They differed from Professor Collins in
seniority and ethnicity. His misconduct has not prevented
him from subsequently being awarded a national clinical
excellence award. That required him to complete a form
stating his qualifications and contribution “over and
above,” and for his institution to supply a supporting
citation.

I have serious concerns about the inequitable treatment of

miscreant senior academics by the GMC and by other arms
of the medical establishment in comparison with the
treatment of less eminent miscreants. Some seem to be
treated better than blameless doctors. They are certainly
treated better than whistleblowers.

The GMC found that Richard Eastell failed to correct before

publication a false statement that all authors had access to
the data used for an article of which he was the lead
author.[3] In fact only the trial sponsor had access to the
full data.[4] Many people believe the paper to now be
discredited. Despite an adverse finding by the GMC,
Professor Eastell retained his national clinical excellence
award. British medicine is disgraced by the fact that the
whistleblower, Aubrey Blumsohn, is now unemployed.

The GMC found Timothy Peters guilty of serious

professional misconduct because he was aware that one
of his research fellows had falsified research on which
Professor Peters was a coauthor but that he had taken
insufficient steps either to prevent further falsification of
research or to ensure that, where such research had been
published, timely retractions of it were made.[5] In
addition, Professor Peters failed in his duty to bring this to
the attention of the GMC.[5] He was given a severe
reprimand. Yet he retained his A plus merit award. The
career of the whistleblower suffered.

I believe that the proposed amendments to the processes

at the GMC will allow it to make even more cosy private
arrangements to protect senior academics from the
sanctions their conduct would attract if they were less
senior. It is a travesty that even unfavourable adjudications
by the GMC are insufficient to prevent some of these
people holding national clinical excellence awards, while
whistleblowers continue to suffer for reporting
misconduct.[4]

Competing interests: I have a silver national clinical

excellence award but my application for a gold award was
rejected. Unlike most whistleblowers I still have a job in the

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NHS. ×
References
1. Truby A. Fitness to practise? BMJ  2011;342:91-2 (BMJ
Careers  , 17 Mar, [Link] ).
2. Wilmshurst P. Dishonesty in medical research. Med Leg J
2007;75:3-12.
3. Eastell R, Barton I, Hannon RA, Chines A, Garnero P, Delmas
PD. Relationship of early changes in bone resorption to the
reduction in fracture risk with residronate. J Bone Miner
Res  2003;18:1051-6.
4. Dyer C. Aubrey Blumsohn: academic who took on industry.
BMJ   2010;240:b5293.
5. Wilmshurst P. Institutional corruption in medicine. BMJ
2002;325:1232-5.

Peter Wilmshurst consultant cardiologist Royal

Shrewsbury Hospital, Shrewsbury, UK

peter.wilmshurst@tiscali.co.uk

Cite this as BMJ Careers ; doi: 

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Response from the GMC
19/05/2011 Niall Dickson
Peter Wilmshurst's view of the GMC's fitness to practise procedures does not represent an
accurate picture. Plea-bargaining has never been used at the GMC and we have made it very
clear that we are not proposing it would be used under the new system; we will put forward
the sanction necessary to protect the public and if the doctor refuses to accept this then the
case will proceed to a hearing. We do not think it is necessary to proceed with a full public
hearing that is stressful for all parties when a doctor agrees to accept the sanction proposed
by the GMC. This is not a means of agreeing sanctions in secret - all of the charges put
before the doctor and any outcome will still be made public, including on our website. Dr
Wilmshurst's suggestion that we treat any doctors differently, according to their name,
ethnicity or position, is also incorrect. All doctors who appear before the GMC under fitness
to practise procedures are treated equally. There is no evidence of bias in the way cases are
handled or the decisions made towards any groups of doctors. We regularly conduct audits
of our fitness to practise procedures to ensure that cases are handled in a way that is
transparent, consistent, fair and appropriate. An audit by King's College London in 2007 also
found that our decisions were sound, consistent and appropriate, and we will commission a
new independent audit next year to ensure this is still the case. Niall Dickson, Chief Executive
of the General Medical Council

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