On Wednesday 06 Oct 2004 22:14, Mary Hawking wrote:
> Could you let the list know their response?

The fabled envelope with "General Medical Council" written in large 
friendly letters in the top left hand corner has arrived. And this is 
what it contained:

==========
18th October 2004

Dear Dr Leuty

Thank you for your letter of 6 October 2004 to the President.

The allegations against Dr Bee included that he certified the cause of 
death in the relevant case as hypoxic cerebral degeneration and that 
death was due to natural causes. In doing so it was alleged that Dr Bee 
failed to take notice of or make enquiries into forms and medical notes 
which stated that the patient had suffered from asthma and had been 
administered morphine, that he failed to discuss the case with her 
treating physicians, and that his certification of the death as being 
from natural causes was not properly based on the post mortem findings. 
Dr Bee admitted all these allegations which were therefore found 
proved.

The purpose of our fitness to pratise procedures is not to punish. Our 
statutory responsibility under the Medical Act is to protect patients 
and to act in the public interest which includes upholding the 
reputation of the profession. The Master of the Rolls commented in an 
appeal judgement in 2001 that “The reputation of the profession is more 
important than the fortunes of any individual member. Membership of a 
profession brings many benefits, but that is part of the price.”

By his own admission, Dr Bee carried out a post mortem in which he 
failed to take adequate steps to establish the cause of death. This is 
potentially a serious omission since it means there was no useful 
purpose to carrying out the post mortem, and the opportunity to learn 
more about the circumstances leading to the death was lost. When looked 
at in this context, it might be argued that the finding that these 
omissions did not amount to serious professional misconduct was 
surprising.

It is now for the Commission for Healthcare Regulatory Excellence to 
decide whether to appeal to the High Court against the PCC's decision. 
Dr Bee was represented at the PCC by a legal team instructed by his 
medical defence society, and that team will be able to continue to 
represent his interest should an appeal be lodged.

I hope this helps to explain the background to our press release.

Yours sincerely,

Peter Swain, Head of Conduct Case Presentation, Fitness to Practise 
Directorate
==========

Plenty to chew on there. I am thinking of replying, though probably by 
email to avoid any more GMC envelopes than are strictly necessary. I 
would welcome your comments before I do so.

A number of points occur to me.

I am relieved that are acting to deter rather than to punish.

I am less impressed by the appeal judgement that "the reputation of the 
profession is more important than the fortunes of any individual 
member". A lawyer might well believe that to be so. I would not want to 
belong to a profession which mistreated a small number of its members 
for the good of the majority. (Was this the same judgement which dealt 
with the single incident of misconduct in an unblemished long career?) 
If the GMC were to apply such a harshly cynical attitude then the 
kinder members of our profession might find their position untenable.

His paragraph on "no useful purpose to carrying out the post mortem" 
seems biased with hindsight. We now know the cause of death, but prior 
to the post mortem we did not. Dr Bee's examination undoubtedly 
excluded many possible causes of death, but unfortunately failed to 
detect Death by Killer GP which was not a well-known condition until 
recently. With hindsight all the clues were there, but we don't 
recognise what we don't know (which philosopher said that?).

He doesn't say whether the PCC considered this was a single incident in 
an unblemished career, and if so why his Directorate thought the Privy 
Council appeal judgement did not apply.

Finally, the only mention he makes of Dr Bee's welfare is that notes 
that Dr Bee has a legal team instructed by his defence society.

I suppose I didn't expect them to be soft and cuddly. Perhaps like 
Benjamin they are a little worried about their future?

-- 
Michael Leuty
Nottingham, UK