Bringing the Disciplinary to Account

DFNHS EC memberArun Baksi, on why he and his colleagues are proposing a new way of making NHS discipline for doctors fairer

The ‘disciplinary’ is something very few emerge from without lasting effects. You might argue that is a good thing: we are responsible for people’s lives and health when they are highly vulnerable, after all – should we not be answerable for our actions?  Should we not learn from mistakes?  Should not the very few who deliberately do wrong be disciplined?

Alas, that is far from the reality. The NHS disciplinary process is currently far more likely to be a long way from justice than it is a fair and open way to safeguard standards and lives. It is, we believe, quite simply unfit for purpose. Unfairness, bias, and discrimination are still highly prevalent in the disciplinary proceedings thatNHS doctors are subject to, despite repeated improvement measures, recommendations, and reports. The personal and monetary costs of these disciplinary measures are costly but the true costs unknown andunaudited, as are the actions of those in trust management who lead these processes.

Changes made to the investigation and disciplinary process of doctors have failed to prevent increasing instances of unfair, biased, and malicious proceedings. Unfair and malicious proceedings continue, and a culture of secrecy, bias, and retribution prevails. The wide ranging and often permanent impact on health, mental wellbeing, livelihood, and loss of expertise resulting from these procedures afforded to the individuals affected have been widely acknowledged. Currently there is absolutely no meaningful process in place to monitor and audit disciplinary proceedings and their outcomes. There is no record or audit of monetary costs. While doctors have been penalised when found to be guilty Trusts have rarely been subjected to any form ofscrutiny or disciplinary action when their actions may have been incorrect or misplaced. This issue requires further consideration.

It should go without saying that all disciplinary action should follow the principles of natural justice; those are Adequate notice, a fair hearing, and the absence of bias.’ Further, MHPS states that ‘A clear audit route must be established for initiating and tracking progress of the investigation, its costs and resulting action. Yet these principles of natural justice and the requirement for audit are not observed by many, perhaps most Trusts.

We propose the establishment of an Independent and elected Scrutiny Panel with statutory powers to oversee and regulate disciplinary action against doctors in each NHS trust. You can download our discussion document here. This would establish a perception of balance and fairness that is long overdue and would also allow for transparency and proper audit.

The first responsibility of every doctor is to do no harm. The overarching objective of the Independent Scrutiny Panel is to protect the public interest which includes ensuring that everyone involved in the trust act in and put the public interest first.

Please consider writing to your MP about this. You can download a template for this here.  You can find who your MP is, and which way they have voted in Parliament recently, at: https://www.theyworkforyou.com/mp/

Arun Baksi

baksi@baksi.co.uk

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