GMC Abuse: A personal account of the General Medical Council's abuse of its position.

A Patient's Story of Cosmetic Surgery and the General Medical Council (GMC)

5th December 2002 - Dr David Veale's letter to me -

I understand you are very angry with me for referring you to Mr Nasser, and I shall explain my actions once more:

I advised you not to have cosmetic surgery, and I referred you to Mr Nasser for an OPINION. I did not say that you must have a rhinoplasty with Mr Nasser: this was entirely between you and Mr Nasser.

I rarely refer patients to cosmetic surgeons, but you were at the time extremely distressed, desperate and determined to have the surgery. There was a possibility of you committing suicide.

My rationale for referring you to Mr Nasser was that he is a reputable surgeon in the UK. I quote from my letter to you dated 22nd September 2000: "He specialises in rhinoplasty. He is also an NHS surgeon and is not attached to any cowboy clinic that will just want to grab your money." He also teaches other surgeons. You may have a view about his surgical technique, but I am NOT a specialist in this area and would not know the difference between the technique adopted by the surgeon in the USA and the one in the UK.

It seems that it would have been far easier for me not to refer you to anyone and that you would have found your own surgeon. We will never know whether the surgeon you might have found at this time would have produced a better result for you. I have learnt from you that in future, when I am confronted with a case similar to yours, I will not refer to any cosmetic surgeon and I will leave patients to the vagaries of the cosmetic surgery jungle. At least I won't then be blamed when patients feel things have gone wrong.

I am genuinely sorry for you and recognise that you are very distressed and handicapped. I feel unable to assist you further. ... All I can say is that the large majority of patients with this condition do accept it, can be helped by treatment and are generally grateful for the improvement in the quality of their life. I recognise, however, that I can't help you, and that whatever I say to try and explain why I referred you to Mr Nasser is not going to satisfy you. An independent body (the General Medical Council, which consists of both doctors and lay persons) agreed that there was no cause for concern in my conduct and, as far as I am concerned, the matter is now closed. You are, of course, at liberty of pursuing other legal channels.

5th August 2004 - Dr Chai Patel's letter to me -

Thank you for your recent email raising the issue of your treatment at The Priory Hospital North London in the year 2000. I am aware that the Hospital Director, David Cole, investigated your complaint at the time and a small refund was offered and accepted by your father who was the payer. [*For the reader's information: I tried to obtain the refund money for my father.]

You then initiated the complaint again in 2002 with Lorraine Ahern who, on investigation, found that the complaint had been dealt with previously and was concluded as far as the hospital was concerned. I am sorry that you obviously feel differently and are unhappy with the way both Lorraine Ahern and David Cole had conducted this matter.

I am also aware that you initiated proceedings at the GMC against Dr Veale relating to the same matters and that the GMC screener decided there was no need for a full investigation. If I understand you correctly you have recently won compensation from Mr Nasser for the manner in which he carried out a rhinoplasty, and now wish to pursue Priory for compensation because it was Dr Veale who referred you to Mr Nasser.

I have received your medical notes and correspondence. I note particularly Dr Veale's letter to you of 22nd September 2000 in which he recommends Mr Nasser but also reminds you of his advice "that you are likely to be dissatisfied with such an operation". I have found no evidence in the records I have seen to substantiate your other allegations about your treatment in Priory between 15th and 19th September 2000.

I cannot see any grounds for a further refund on the basis of my investigation and I understand that you do not wish to have your complaint reopened with a full investigation. However, for your information, I enclose a copy of Priory's complaints procedure in case you decide you wish to take it further.

6th August 2004 - My reply to Dr Chai Patel -

In response to your letter:

1. I do not consider a brief review of my hospital records to be an investigation. Neither Mr Cole, Ms Ahern, Professor Thompson, or you, have taken into account my personal experience - an experience which inevitably goes undocumented in the pen-pushing formalities passed-off as records of my hospital stay. The negligible refund my father accepted from Mr Cole was done under extremely stressful circumstances for both my father and myself and does not represent an accurate reflection of the suffering resulting from Priory. I question the sincerity of your use of the word "sorry", in the context of my dissatisfaction with the "investigation" of the hospital directors; despite retaining an unquestioning faith in their judgment.

2. You mention briefly: "If I understand you correctly you have won compensation from Mr Nasser". I fail to see why there should be any doubt as to you understanding this fact as it was made very clear in my email to you. The success of my Chicago operation disproves Dr Veale's claim that I would be "likely to be dissatisfied with such an operation"; however, I consider it unscrupulous that you are willing to completely gloss-over that Mr Nasser was recommended to me by Dr Veale with merely an empty acknowledgement of this fact - in effect ignoring the acute flaw in Dr Veale's clinical judgment which created the opportunity for me to be a victim of negligence. The GMC have a reputation for failing to protect patients and I consider it your duty to me as a patient to balance their track-record with the screeners' rejection of my complaint - particularly in light of the settlement. As I mentioned, a letter being sent from my expert-witness surgeon should legally compel them to investigate what probably amounts to an assault by Mr Nasser on myself and most likely numerous others.

3. Your dismissal of my other complaints concerning the standard of care I received in the hospital amounts to a rejection of your duty to ensure that standards are enforced. The hospital staff are free to neglect their duty, from the experiences of myself as well as other Priory patients I have had contact with, because they have nobody to answer to - as evidenced in the total lack of rigour by Priory in dealing with complaints. [Incidentally, for the reader: I am not some kind of serial complainer. I didn't even want to mention my negative experience with a few aspects of some of the Priory staff when trying to get a refund from Priory. (Although one nurse, Sarah from South Africa, I got on very well with. Please email me if you ever read this, Sarah. I owe you an apology. Or perhaps it's a bit late for that...) I tried to get a refund without having to state my case in detail and go through a complaints maze, but Professor Chris Thompson insisted on me stating it in detail and in writing - apparently so that he could then draft a refusal for Chai Patel to sign.]

4. Your claim that you "can't see any grounds for a further refund" displays the intrinsic flaw in your leadership philosophy. To quote you from a source published online: "I don't see why we should not talk to the government about healthcare in the same way as people talk to them about providing telecoms services." The reason why there should be significant differences in the approaches to providing these two contrasting services is that healthcare is a human commodity, dealing in areas of morality and compassion. That Priory is in a relatively secure position relating to legal liability for compensation over the errors of judgment in my patient treatment - not least because you were lucky enough for me to leave before Mr Nasser saw me at the hospital - does not absolve you of these ethical duties. The concept of right and wrong is not exclusively defined by legislation. The human cost to myself and my family as a result of Priory is immense. The fact that you are unwilling to discuss this situation with me personally, let alone refund the money Priory were paid, further highlights a ruthless corporate policy completely at odds with the role of a healthcare organisation.

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11/3/06 - My email to the House of Lords Commission -

Dear House of Lords Appointments Commission,

As a former patient at The Priory, I oppose Dr Chai Patel's appointment to this unelected, political honours tier of government.

I do not intend to address his Labour donations. However, as a result of my experience with Priory I followed closely the coverage of his involvement with Lynde House and contacted one of the complainants to hear her experience first hand. The GMC Fitness to Practise hearing against Dr Patel failed on a technicality but the evidence and witnesses attesting to systemic neglect at Lynde House simply cannot be ignored. There ought to be no doubt that while trading on his title as a doctor, in business dealings with government, Dr Patel also bore ultimate responsibility for addressing any neglect of the vulnerable elderly residents in his care home.

I mention my experience with Dr Patel and Priory on my website: . I also link a series of articles relating to the Dr Patel case. A couple of the statements from Dr Patel's side are that the protestors are a "small unrepresentative group" ("Priory Clinic boss cleared"), and that: "More attention should be paid to the True Friends of Lynde House." ("Former chief executive says he is relieved 'terrible ordeal' is over")

There was also denial at Priory, under Dr Patel's management, when I tried to address my concerns over the treatment I received. It was clear that this approach was sanctioned from the top - through the management culture, if not expressly. I have records substantiating this, including an email from the Priory Hospital North London manager (Lorraine Ahern) to Priory Head Office, recommending that they refuse a refund for my patient treatment and (I quote) "close the loop". As the Priory managers - up to and including Dr Patel, who wrote to refuse the refund - knew that I had struggled with suicidal ideation this phrase has a particularly callous resonance.

Most people recognise a fundamental test of civilized society to be how well it treats its most vulnerable members. The characterisation of the Lynde House complainants as a "small unrepresentative group" by Dr Patel's spokesperson is incompatible with this principle. A culture of denial among those tasked with governing society leads to its betrayal no matter how much they claim to serve it.

Dame Janet Smith on the Shipman Report's GMC findings -

"I have concluded there has not yet been the change of culture within the GMC that will ensure that patient protection is given the priority it deserves."

"I have grave reservations about the willingness and ability of the GMC as presently constituted to change its ways."

"In short, I am not convinced that the leopard has changed its spots or ever will."

Articles proceeding from Dame Janet Smith's deeply critical report (published at the start of 2005) -

http://tinyurl.com/d7jbua "Shipman row hits doctors' watchdog"
http://tinyurl.com/ckytyr "GMC 'slated' over Shipman case"
http://tinyurl.com/dbpygo "GMC acted in interests of doctors"
http://tinyurl.com/co5gv2 "The GMC: expediency before principle"
http://tinyurl.com/5hzas "Shipman report demands GMC reform"
http://tinyurl.com/co5vwz "'Patients must be protected'"
http://tinyurl.com/c66cd9 "Doctors given last chance to put house in order"
http://tinyurl.com/ddn64v "Doctors call for abolition of GMC"
http://tinyurl.com/cpkfg2 "Doctors 'are looking after their own'"
http://tinyurl.com/cb2d3h "Where is the political will to save us from bad doctors?"
http://tinyurl.com/csxb8v "Dame Janet's disappointments"
http://tinyurl.com/cro7c8 "Chairwoman of Shipman inquiry protests at lack of action"
http://tinyurl.com/cdejam "Progress 'too slow' after Shipman"
http://tinyurl.com/hhfy7 "Good doctors, safer patients: Proposals to strengthen the system to assure and improve the performance of doctors and to protect the safety of patients"
http://tinyurl.com/c55vdo "GMC 'should disband'"
http://tinyurl.com/d3x2qe "Calls for GMC to be scrapped to restore public confidence"
http://tinyurl.com/ybzjjc "A remedy for the soul of medicine"
http://tinyurl.com/wrsfa "Success relies on winning hearts and minds"

The Shipman Report -

http://www.the-shipman-inquiry.org.uk/home.asp

Further articles relating to the GMC -

http://tinyurl.com/2qxz4y "GMC should be scrapped completely ... It is a totally inbred situation."
http://tinyurl.com/c4467p "Time to end self regulation"
http://tinyurl.com/cdjyxd "GMC knew of fears over baby expert"
http://www.sallyclark.org.uk/ Sally Clark
http://tinyurl.com/c2mags "NHS action on rogue doctors urged"
http://tinyurl.com/cxnj4x "Consultants attack 'arrogant' GMC"
http://tinyurl.com/canlny "Would GMC dismiss a complaint against Guantanamo doctor?"
http://tinyurl.com/y8ds8e "GMC mishandled father's complaint"
http://tinyurl.com/2ed7nt "GMC told of Neale complaint"
http://tinyurl.com/5kc874 "Medical manslaughter"
http://tinyurl.com/2qlvyg "The General Medical Council - a Personal View"
http://tinyurl.com/58w8k6 "Three doctors and a GMC prosecution"
http://tinyurl.com/dmr8hv "Security blunders let 4 fake docs get NHS jobs"
http://tinyurl.com/dmy8ug "Medical negligence : Robbie Powell update"

Consistency in action:

http://www.gmc-uk.org/concerns/hearings_and_decisions/ftp/20081028_ftp_panel_hall.asp

The GMC's Expert Witness Guidance - clearly they didn't follow their own guidelines when instructing Devine -

http://www.gmc-uk.org/guidance/ethical_guidance/expert_witness_guidance.asp

An article written by the GMC President, Professor Catto -

http://tinyurl.com/3m9rc7 "Professionalism: pompous, pretentious and outmoded?"

His response to the Shipman Report:

http://tinyurl.com/56bl22 "Catto hits out at 'misguided' Dame Janet"

A comment by him in 2006: "I also believe passionately in fairness, both to patients and to doctors. At a minimum, processes and procedures should be fair, objective, transparent and free from unfair discrimination."

His parting shot, not remotely crass:

http://tinyurl.com/cyoh8f "'I have loved every minute of it. Whatever damage I have done to the GMC and maybe the health service will be in the past,' he says with a smile."

The CV of the GMC Screener who rejected my complaint:

http://tinyurl.com/79bom7 "In my professional life I have pursued actions that are fair, just, transparent, open, discrimination free and are patient centred."

Articles relating to The Priory Hospital and Dr Chai Patel -

http://snipurl.com/nyan "Crony makes a killing from NHS"
http://tinyurl.com/d6ctjb "The business bonus"
http://tinyurl.com/c5tafj "The Priory, rest home for troubled stars, is accused of 'cynical commercialism'"
http://tinyurl.com/cdbgpd "The highway from hell"
http://tinyurl.com/cq6gka "Dear Weekend"
http://tinyurl.com/dmecfe "Group therapy: I still howl at the memory"
http://tinyurl.com/dxbrzl "Chai Patel, Westminster Health Care"
http://tinyurl.com/cnc7y3 "The Lynde House Relatives Support Group"
http://tinyurl.com/c4r546 "Labour health guru accused of care home neglect"
http://tinyurl.com/cvsr7h "Priory boss accused of misconduct over elderly care"
http://tinyurl.com/cq7br7 "A home unfit for heroes"
http://tinyurl.com/dcgql2 "Don't bet your life on healthcare shares"
http://tinyurl.com/cmr6ov "Humiliation of a New Labour guru"
http://tinyurl.com/d383vw "Priory boss wins injunction against watchdog"
http://snipurl.com/o028 "Priory Clinic boss cleared"
http://snipurl.com/ny9q "Dutch bank swoops on Priory celebrity clinics in 875m deal"
http://tinyurl.com/conz58 "Former chief executive says he is relieved 'terrible ordeal' is over"
http://tinyurl.com/c9g4zv "MPs diagnose trouble over peerage for Labour’s donor doctor"
http://tinyurl.com/czuha3 "Watchdog warns Blair off ennobling Labour donors"
http://tinyurl.com/c3vahh "Priory boss 'anger' over peerage"
http://tinyurl.com/29xhj9 "This murky system can't go on: I'm breaking ranks"
http://tinyurl.com/34ffor "No need to be Chai"
http://tinyurl.com/zc93r "Police seek charges by showing loans were 'donations in disguise'"
http://tinyurl.com/yekx58 "Labour says it has proof party donors wanted secrecy"
http://tinyurl.com/wldhl "Honours papers detail block on Labour donors"

Never Mind the Forelocks - The concept of deference should be consigned to history -

http://tinyurl.com/2curmv

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Solace

The following quotes by Jean Baudrillard - an expert on simulacra (http://tinyurl.co.uk/97dz ) - provided me with some solace. They are reproduced as a secondary point of interest to the main purpose of the site as stated on the Home page.

''To be a mirror, but a two-way mirror: to see others from behind the screen of one's own persona.''

''Isn't the photogenic smile a defensive mask, a way of playing dead to escape the predator?''

''A whirl of idiotic events amasses around distraught souls, just as flesh and fat amass around a scar.''

''We are real only by chance, and immortal without knowing it.''

''Our consciousness being a kind of mirror, it follows that we appear to ourselves only symmetrically altered, like the image in a mirror. Everything which passes through consciousness must therefore be corrected and inverted for the true effigy (the essential, paradisiac form) to appear. This is part of the illusion of the world, whose trajectory can be corrected only by a supplementary artifice. We have to undo this with a mental turnabout, with the simulation of an inverted image - showing us as we shall never actually appear to ourselves.
Hence, the betrothed at a Pakistani wedding together enter a room in which there is a mirror. They look at each other only in the mirror. In this way, each sees the other as they are in paradise - that is to say, as they are really, in the transformed, essential image eternity provides of them, and not as they originally appear.''

''The photographer dreams of a hyperborean light, of a rarefied atmosphere in which things take on the exactness they might have in the void. It is also a phantasm of the mind to see an idea, a word or an entire sentence stand out with absolute clarity, with only the flickering which comes from distance - just like the world, which is there too in its entirety, but in a veiled dimension, with just a few fragments emerging from it, touched by actual grace.''

"Nothing in man's nature can induce him into that irrational, excessive act of taking power or of making war except the mask, the figure of the mask, in whose shade he can take up the challenge of a world of truth of which we shall never know, and which is therefore fundamentally a thing of artifice. It is the mask which makes sacrifice possible, which allows us to make war, the mask alone which enables us to engage in politics."

"There is nothing left to protect us from the scene of the real. Nothing left to protect us from the obscenity of the virtual (of information, transparency, etc.). We are no longer the actors of the real but the double agents of the virtual."

"The finest physical and mental exercise: wandering around an unknown town in a certain quality of light. Secret circulation, the virginity of the (nonetheless corrupt) signs of the metropolis, the surprise of the architecture, tiredness, all the senses on the alert, one's body buoyed up by walking, a trance-like state in which all the mechanisms of intuition function at great speed. Catching the town as it emerges, before it has come on stage, leaving the people in abeyance, and their language, which seems oddly familair to the foreigner...Then the landmarks awaken from their slumber, meaning is roused, here and there, in fragmentary fashion. But the phase of emergence itself is delicious. Yet, the end has already come. Weariness wins out over the trance."

"Only one way of looking at things produces a supreme sense of understanding and that is a completely controlled form of delirium or simulation."

"The metro. A man gets on - by his glances, gestures and movements, he carves out a space for himself and protects it. From that space, he sets his actions to those of the neighbouring, approximate molecules. He becomes the centre of a physical pressure, sniffs out hostile vibrations and emanations, or friendly ones, on the verge of panic. He joins up with others out of fear. He innervates his whole body with a calcualted indifference, wraps himself in a superficial reverie, created only to keep others at a distance. He deciphers nothing, protects himself from the crossfire of everyone's gazes and sets his own as a backhand down the line, staring at a particular face at the back of the carriage until the very lightness of his stare stirs others in their sleep. When the train accelerates or brakes, all the bodies are thrown in the same direction, like the shoals of fish which change diection simultaneaously. The marvellous underwater lethargy of the metro, the self-defence of the capillary systems, the cruel play of vague thoughts - all while waiting for the stop at Faidherbe-Chaligny."

"Cards, that virtual money, protect us from the vulgarity of cash. But money itself, that artifact of value, protects us from the vulgarity of the commodity. And the commodity, that artifact of desire, protects us from the vulgarity of human relations. In this way, we are marvellously protected."

"When you think of the incredible neurotic complexity of millions of scattered individuals and the exponential sum of all these problems, you are aware that the psychical pollution of the planet is far greater than the biological or technological pollution. This certainly was not the case at Tautavel or Cro-Magnon. The short, fierce nature of life provided an automatic regulation. Today we have exchanged primary cannibalism for psychical cannibalism. We have moved into the stage of virtual cruelty."

"We should be amazed not that there is so much chaos and violence, but that there is so little and everything functions so well. Given the level of aggression of every car driver, the frailties of the equipment and the mad scramble of the traffic, it's a miracle thousands aren't killed every day, a miracle we only rarely slaughter each other and only a few of these disastrous possibilities come to fruition. When you see the immense bureaucratic chaos, the number of absurd decisions, the universal fraud and squandering of our civic virtues, you can only be amazed by the daily miracle of this machine which, somehow or other, keeps on going, dragging its detritus along in its orbit. Apart from a few episodic breakdowns (no more frequent, ultimately, than earth tremors), it's as though an invisible hand managed to teleonomize all this mess, to normalize this anomie. This is perhaps the same miracle as the one which prevents everyone from succumbing daily to the idea of death or to suicidal melancholia."

Copyright Jean Baudrillard's "Cool Memories" series, Verso.
http://www.versobooks.com/

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A Patient's Story of Cosmetic Surgery and the General Medical Council (GMC)