Sunday, September 29, 2013

Dialogue on Twitter with CTNHS

Dialogue on Twitter with CTNHS

I'm not the only one who has realised that CTNHS have frequently resorted to dirty tricks. Lately, some Cure members and supporters have moderated their tone in an apparent wakening to the effect of their prickly reaction to anyone who disagrees with anything they say (no matter how reasonably they make their point). 
Gabriel Scally was the recipient of CTNHS ire recently, with thuggish cheerleader Gary Walker in the forefront:


  1. Please provide the evidence that ever used the term "minister for murder"! Appalling abuse.

  2. It was about the unpleasant campaign denigrating You're respected enough to change the whole tone
  3. I apologise if you thought I was implying you personally hurled such abuse. A civilised debate is sorely needed.
  4. Almost perfect but you still make your apology by accusing of misunderstanding you. It's not her fault at all.

  5. Disappointing sophistry. If I've learnt one thing from N Ireland it is that anger & hurt must be transcended.


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  6. Just a simple apology for accusing someone of something they didn't do would suffice. Why so hard
  7. "I apologise IF YOU didn't understand" is not an apology.Do Labour activists know the word sorry?
  8. Gosh! But that's not what I wrote. I'm sorry for touching raw nerves. I do try not to.


Gabriel is making a perfectly point and perfectly reasonable apology, but it's not enough for rottweiler Gary Walker. It speaks volumes that the epithet "Labour activist" is considered such an insult by him, and that he considers that anyone who disagrees with CTNHS must be a Labour activist. 
 Next Gabriel tries to find out from Julie Bailey (famous advocate for transparency):


  1. I'm told that you supported abolition of National Patient Safety Agency. I thought that abolition was an error, was I wrong?
  2. . fascinated to see what JB's response will be

  3. It will be ignored John - you should know by now that the hard questions's are ignored.

  4. It's a reasonable question so I am sure will want to put the true position on the record.
  5. I'm very cautious of the people I talk with & I suggest u r too! Didn't realise u had asked a question, hav a look later

  6. I think the more open dialogue the better. Hopefully we can move on to the changes we need now to improve patient safety & care.


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  7. . JB is very prone to ad hominem arguments and highly personal attacks on her opponents eg her campaign against Diana Smith
  8. CTNHS talk 2 any 1 about patient safety but we don't engage with those who been proven to hurt & have no empathy with victims


Of course there are some people with which it is impossible to have a civilized conversation, and if Julie Bailey refused to engage with people like that, that would be completely understandable. But the people she attacks are simply those that disagree with her. This blatant exclusion of her most effective opponents amounts to a complete avoidance of genuine dialogue and debate.

Gabriel Scally has already comment on JB's evasiveness:

It would be very disappointing if someone who criticises secrecy and evasion wouldn't answer as simple a question.

Despite this being an apparently simple question to answer, JB's response so far has been:

  1. I'm told that you supported abolition of National Patient Safety Agency. I thought that abolition was an error, was I wrong?
  2. Lets wait & see, did think what great help they were 2 staff/patients at MSFT! But irony is lost 4 those blinded by ideology

  3. So did you support the Goverment's abolition of the NPSA?


We await a straight answer.
Update: Julie Bailey has still not responded


Seems I'm not going to get a straight answer from on whether she supported the abolition of National Safety Agency.

Further update:


  1. I thought I'd answered but I sense ur another 1 of those labour activist with a nasty streak & dodgy mates & I'm too busy 4 u

  2. All I asked was whether or not you had supported the abolition of the NPSA. Surely all you need to say is 'Yes' or 'No'?

Julie Bailey, unwilling to answer a simple question about whether or not she supported the closure of the National Patient Safety Agency (I'm told that she actively lobbied for it):

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  2. I asked once and she said she approved; in fact NPSA had obstructed some cases.
  3. I was genuinely aghast at this, as NPSA is a core part of the current medical 'core medical training'
  4. The main problem Hunt and campaigners have is that the Health and Social Care Act ABOLISHED NPSA.
  5. Approved of its abolition that is, Gabriel.
  6. I can't understand how supporting abolition of NPSA is compatible with caring about avoidable deaths in the



Monday, September 23, 2013

Mid Staffs and professional regulatory bodies

Mid Staffs and professional regulatory bodies

Today it was announced that the General Medical Council (GMC) was dropping the investigation into doctors that had been implicated in poor care at Mid Staffs FT. The television news featured Prime Minister commenting that the GMC and Nursing and Midwifery Council (NMC) had difficult questions to answer. Unless this was previously filmed footage, his comments were oddly ill-informed - he commented that nobody had been struck off (whereas three nurses have been struck off). 

Just as politicians shouldn't comment on the judicial process, they shouldn't comment on a quasi-judicial process. The GMC and NMC are accountable to the Council for Healthcare Regulatory Excellence. Their decisions are also subject to judicial review. Just like the criminal justice system, professional regulatory processes must be immune from political pressure. 

Whatever the temptations to respond to public outcry by overriding procedure, possibly in an attempt to 'uphold public confidence', and despite the oft-repeated phrase from the case of Bolton v Law Society that “the reputation of the profession is more important than the fortunes of any individual member", the GMC and NMC should not sacrifice professionals on the altar of public opinion. However frustrating it may be for patients and relatives, in a collective enterprise like healthcare it can be impossible to pin blame on one individual. So the failure to censure or sanction any doctors should not be automatically labelled as a failure of regulation. A witch-hunt might be momentarily satisfying, but it will not achieve the desired improvements. 

Monday, September 2, 2013

Clinical negligence and the GMC and NMC

Clinical negligence and the GMC and NMC

I have seen many patients or relatives who are baffled as to why the GMC or NMC do not necessarily get involved when there has been a compensation pay-out related to clinical negligence. In some cases, their bewilderment is justified, but in many cases they misunderstand both the implications of clinical negligence and the role of the these professional regulatory bodies.

The tort of clinical negligence requires in short the proof of a failure to meet the duty of care which has caused an injury. This does not entail that any individual was failing in their professional duty as such. Further, where a simple error is the cause of the injury, this is not something that requires censure by the GMC or NMC. This does not preclude local action, which is the first resort for complainants. This route has been emphasized by both the GMC and NMC as the number of complaints per annum has increased.

Errors of judgment are inevitable where difficult decisions are being made on a daily basis. Lord Denning was of the opinion that doctors should not be liable for "errors of clinical judgment". Later jurists have not been so deferential to the medical profession, applying the same principles as other torts. The way to achieve openness and improvement of healthcare is not by increasing the sanctions for clinical negligence, but by routinizing the investigation of clinical negligence.