Early morning, a column by Clare Gerada appeared in my twitter timeline. Gerada is an ex-chair of the Royal College of GPs so no fly by night. She campaigns (as part of a heavily, heavily NHS England funded gig ‘Practitioner Health’) about doctors’ mental health. This week there has been coverage of doctor suicides with some loose reporting of figures (there were 81 suicides not 430*). Gerada is trying to extend the Practitioner Health service beyond London.
I dunno. You can sit on either side of the fence, or on it. As is too often the case with the NHS following the dosh is an instructive exercise.
‘Sensible advice’ say some replies to Gerada’s column. ‘Best advice I’ve ever seen…’
The heading kind of made my eyes water. Those blooming tears. Still.
‘Do nothing… immediately.’ I can only now imagine this ‘luxury’ over the past five years. There is no space to ‘Do nothing… immediately‘ for families. We face years of unrelenting, unremitting fighting, policing, and uncovering. Pretty much every NHS related scandal is the outcome of persistent, committed and astonishing actions by families and their allies. Activity that allows no downtime in a grief drenched space.
‘Do nothing… immediately’
‘When a complaint lands on your desk…’ says Gerada. Deliberately disembodying the ‘complaint’ from the person making it. And the space in which it materialises.
The person (human) who probably never dreamed of making a ‘complaint’ to the NHS. I mean why would you? Why would any of us**? It’s a national institution. A treasure. Free healthcare at the point of delivery and all that…
How often do we actually make a complaint about stuff? About trains, airlines, education, retail outlets, telecoms, restaurants? Why would any of us want to make an official complaint against the NHS? What would make us feel driven do this? Complaints in any setting are important for improving service. Complaints in the NHS are crucial because they involve lives.
For Gerada the complaint isn’t delivered or received. It ‘lands’ on the workspace. Disconnected from action and intent. Allowing her to (brutally) focus solely on the practitioner.
‘Do nothing’, she advises. ‘If you can, take the rest of the day off.’ Take the rest of the day off…
‘Do not rant and rave…’ I still can’t understand why the assumed position of a medic would be to rant and ‘rave’ about a complaint. Getting a 3/5 mark on student evaluations is enough to cause some right old soul searching/scrutiny of our learning and teaching practice at work (even after 10 years). The idea we would leap straight to defence of our practice – to ranting and raving – is baffling.
‘Wait for the first waves of shock to pass…’ Still no consideration of the person or family who made the complaint. Of what they may be experiencing; their pain, distress, grief. The piece descends into a google translate type extract. Clunky. Missing meaning. Swerving on substance. With the odd hand grenade planted between platitudes: ‘At the earliest opportunity contact your medical defence organisation (even if the complaint is trivial)’.
In short, Gerada’s advice seems to be ignore the substance of the complaint, buggar off for the rest of day and get your legal defence ducks in line. She ends with ‘don’t suffer in silence and don’t take it personally’.
Wow. Just extraordinary ‘advice’.
She has previous on complaining.
And clearly remains obdurate on the subject. A road traffic accident… From last night.
What I don’t understand is why there remains little critical (in a good way) and open questioning of what is clearly shite and offensive advice by medics. It’s as if once harm has happened or been done, the drawbridge is raised and the profession becomes a pack.
Where is the thought, the reflection. Humility. Or challenge?
*This is in no way to dismiss, belittle or otherwise every health professional who has died.
** For the sake of transparency, I made a complaint to Southern Health NHS Trust when LB was in the unit. I said they didn’t listen to my concerns about his care. About 5 days before he drowned in the bath I was told it was not upheld.
mydaftlife 
Dr Geradai is correct complaints can kill. As a result of a complaint to my GP which was ignored for over 12 months I ended up being removed from the GP practice.. During that period I was a suffering from Post sepsis Syndrome, PTSD and other medical issues including possible heart problems.
Because of the stress caused by the refusal to accept my concerns , including two meetings with the practice where I was verbally abused by two of the partners, , I ended up seeking assistance from a mental health unit in Surrey who taught me C.B.T. and sent me on a course of pain management . After the course the unit referred me back to my GP who totally ignored the mental health issue I had on record at that time.
the practice eventually passed my complaint to the “Medical Defence Union” .who are now handling the case on their behalf.
This was after the NHS refused to consider my concerns about the practice and the local CCG, of whom my GP is an officer have also refused to consider my concerns.
In closing I would like to express my appreciation for the information about Dr. Gerarda who it appear is now one of the “medical mafia” helping to cover up for the problems created by doctors who have both drink and medical health problems who should not be in practice because they refuse to admit they made errors of judgement. which affected peoples lives.
I shall be sending a copy of this thread to the “Medical Defence Union” to demonstrate that indeed my GP practice and all four partners in it, conspired to follow Dr. Gerarda’s advice to the letter.
It is also a fact that NHS at every level invites ” compliments comments concerns and complaints” ( a.k.a. the 4 Cs ) The purpose alleged is so that staff within the NHS can learn from their complaints and improve the service. I am surprised that Dr Grerarda having held high office in the past does not now support this procedure which is so widely promoted these days
‘Complaints kill doctors’: wrong. It is lack of support by senior doctors and management, some of whom may use the complaint to undermine, if it suits them. Yes, ‘the drawbridge’ may be raised for others. I pointed this out to CG at the time (possibly on a different thread) & she ignored it.
Criticism of CG is likely to be muted because she is in a very powerful position, as is her husband Dr ‘Sir’ Simon Wessely. It is possible that SW might be questioned by a parliamentary committee into the PACE (MECFS) trial, if the current parliamentary investigation proceeds to one, or even under oath at a public enquiry. Writing about the untrustworthiness of complainants might help to prevent that. See also: https://drnmblog.wordpress.com/2018/05/23/how-drop-the-disorder-colludes-with-the-neoliberalism-it-claims-to-oppose/
I have emailed to you copies of responses from CG herself and contrasting responses from the BMA (impeccable) and the RCPsych (awful).
Dr MacFarlane, Many thanks for commenting on the patient v doctor problem which seems to be getting worse rather than better.
I approached my G.P. in January 2016 expressing concern that after two months intensive care after Sepsis I might be suffering for PTSD or Post Sepsis Syndrome as Iw as still having nightmares and flash backs.
. He stated that he knew nothing about mental health problems and would consult with the local CCG for information.. After a month went by I consulted the practice manager who advised me to “self refer” to an organisation called Think Action.
“Think action” gave me an 8 week course in CBT and pain management which was brilliant. . The following year 2017 I phoned them again over stress with my complaint against an NHS Trust and my G.P. I had four weeks talking therapy over the telephone which was also very helpful.
On each occasion following the course with Think Action they reported back on my mental state to my G.P Sadly my G.P chose to ignore that information and on August 8th. .2017 with out notice struck me off his register. I now have a much better group of G.P. at another surgery and wish I had changed over years ago. .
Whilst at your level of expertise there are obvious problems as recorded in the blog site, there can be no doubt that G.P.s in general do not know about mental health and indeed do not want to know about Mental Health .
My mother was a mental nurse and I remember from my youth in the 1950’s stories of her r coming home having locked patients up in padded cells because they wrecked the ward.. . Those days are gone and it is only in recent years that politicians have started to realize that the strains and pressures placed on people today is casing serious mental health problems at every level of society including the young.
Keep up the good work.
“G.P.s in general do not know about mental health and indeed do not want to know about Mental Health.” GPs???
You could make the same argument about some psychiatrists – like one at Sloven, who gave double hacksaw murderer Daniel Rosenthal unaccompanied leave – he absconded (what a surprise) putting the fear of God into the local community (including Mr & Mrs CRASH).
Later, a Judge ordered that he should be held at another Sloven unit – at a time when it had just been found not fit for purpose by the CQC! Sloven did not inform the Judge or the police of the situation.
Did Sloven fail to report this to the police because they get paid more for forensic patients? Surely not?
CRASH reported it to the police and was thanked for it by a charming DS on the phone. Read more at https://999crash.wordpress.com/2018/05/14/leder-and-leaders/ – bottom half of post.
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So incensed about Gerada’s views about complainants killing doctors that I ‘buggered off’ for the day; took an Alpaca for a walk; and then re-blogged Sara’s post with additional comment at: https://999crash.wordpress.com/2018/09/05/the-do-nothing-advice/.
Glad to see you took Gerarda’s advice and “buggered off ” for the day with an Alpaca. Went to CRASH site as advised, very interesting comments on that site.
It seems to me that the “problem” of doctors ( Both G.P>s and hospital doctors making mistakes and errors of judgement addressed by Dr. Gerada’s is more widespread than I first thought possible. Keep up the good work !
Dear Sara
Thank you for sharing your thoughts. I’ve tagged you in a response to a tweet by Prof Walshe from Manchester about this article.
It’s difficult to communicate effectively by tweet. May I email you about Dr Gerada’s article? If so please email me & I’ll reply.
Best wishes
Stephen
The arrogance and complete superiority this is why patients continue to be harmed because they are less than doctors and have no right to complain _How dare they complain they should be grateful..even if their care is negligent ,harms and damages them the marvellous medics are doing their best you know don’t be so horrible everyone
So what are we supposed to do when their best is not good enough and actually does us harm . ??
‘Do nothing immediately’ can be okay depending on context, but here is written with lack of care, sadly from an ex-chair ??
Replies from Warren and Azmina show compassion and respect.
I’ve had very good care from over 90% of GPs for my son, whereas one refused to examine as she was ignorant of his condition.
GPs die and patients die – fact. It isn’t a competition, but about doing the job well.
I’ve GPs in my family and have no bias.
The editor should have questioned the article.
Can this woman be for real?? Poor old doctors, so sensitive that they’re topping themselves just because someone said they did something wrong at work? Seriously?
What a shame this doesn’t make the oh-so-fragile doctors hesitate to launch vicious personal attacks on others, such as campaigners like Sara.
Funny, they don’t seem to lie awake at night worrying she might do herself in over they awful things they’ve said about her…
Anne – Yes, “this woman” (apparently now ‘Professor’ Gerada) is for real: we are challenging her. We have received an email from Dr Chaand Nagpaul CBE, Chair of the British Medical Association dissociating the BMA from her views.
“Thank you for your letter dated 6 September raising concerns about comments made by Dr Claire Gerada…. I am truly very sorry that these comments were made. Dr Gerada authored the article and posted the tweets in a personal capacity and the comments do not reflect the views of the BMA.”
“I have raised these concerns with Dr Gerada and she has informed me that she has contacted you directly to apologise personally for distress and offence caused. I appreciate you writing to me and making me aware of this matter.”
I have also received a letter from the Professor herself but I am reflecting on certain aspects of her reply before responding and publishing it. Her apologies should be as public as her original comments. Will keep everyone posted.
Thanks for that. It’s a least a bit reassuring! Good luck with your struggle.
CRASH. Thanks for your efforts on behalf of us all. It is about time somebody took these arrogant and self opinionated people to task. Much appreciated !
“No risk to complainant” – clearly knows nothing about mental health care where people who complain are diagnosed with a personality disorder then discharged.
Crash . The problem with apologies, as per that given by Dr. Gerarda, is that they cost nothing. She took the trouble to put her offensive thoughts and opinions on paper and then thinks an apology is enough. A person with such a long and distinguished career behind her, one would have thought she had learned some compassion for her patients . It seems that is not the case.
John – agreed. I have yet to challenge her reply.
Crash. Thanks your latest. I am currently compiling evidence against my former GP to report to B.M.A. ,He las also he has referred my complaint to the Medical Defence Union. NO fear of him feeling guilty for negligence or misconduct Arrogance seems to be a basic requirement in middle aged G.P.s these days.. Claim to know all and in fact know B – – – – r All.
John, sorry for the delay on this – there must have been a problem with Word Press’s alert system. I received 7/8 alerts at the same time yesterday some going back to 2017. Yours was the latest!!
I am giving yours priority because you need to know that the BMA is (effectively) the doctors’ Trade Union: they don’t hear complaints about their own members. The General Medical Council is the relevant Regulator, to whom complaints should be addressed. Their process is daunting too but I believe that recently they introduced regional representatives, who can meet complainants to discuss their concerns.
If so, you should take advantage of this. You still need to prepare a written complaint and a full bundle of evidence but it is always preferable to have a face-to-face discussions to emphasise your main points. There is other advice I can give you after Tuesday – I am currently dealing with a major new scandal at Sloven – see https://999crash.wordpress.com/2018/11/17/car-crash/ – on the ‘contacts’ page you will also find my direct contact details. I wonder if we should continue our ‘discussion’ directly or by comments on my blog, rather than take up more space on Sara’s?
Many thanks your comments. Very much appreciated I meant to say GMC rather than BMA.. Still gathering evidence using GDPR
Will contact you direct on your line.
Regards
John P.O’Brien