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About the Author
Foreword
“How much responsibility are you willing to take before it’s given to you” - Seth Godin
Acknowledgements
•The Almighty God, the author of knowledge and wisdom •My mother (Princess Margaret), a Registered General Nurse, for her love and immense contribution towards my education. I also thank my brothers: Irikefe, Enakeme, and Steve •Donovan Grant, Danielle Cohen, Huda Smart, Francis and Yvonne Amos, Sylvia Eugene, Alisa Anderson, Barbara Bennett, Carol Powell, Lianna Barrow, Steve Stuart, Boma Benjamin-Stowe, Bassey Ajayi, Filden and Nnaana Adjei, Chansa Makungu, James Hearn, David Johnson, Adata Belonwu, Cathy O’Neill, Khalida Ahmed, Dr Petula Nurse, Dr Iain D. Nicholl, Dele and Funmi Osinowo, Wole Ososami, Rachel Clarke, Peter Efeteyan, David and Sheila Crabb, Ezekiel Ighomuaye, Austin Etabunor, Godfrey Unueroh, Kingsley Unueroh, Ojevwe Ighomuaye, Damian and Sandra Luke, Dr Jan Martin, Mrs Sara Smith, and Jonar Nader •Other kind-hearted people who helped me directly or indirectly
Introduction
Section 1: A Glimpse into the Issues
1.1 Professional Opportunism
“If the maintenance of standards becomes the exclusive province of [the managers and supervisors], then it is fallible to misguided loyalties, denial and avoidance.”
1.2 How Pathetic
“It is clearly in the interest of the general public that they should be able to have confidence in the coronial system and this confidence has been undermined by your failures in these cases. Having considered everything before it the panel has determined that your fitness to practise … is impaired by reason of misconduct and deficient professional performance in the case of Mr Tomlinson.”
1.3 Naughty Scientist
1.4 ‘Standard’ Reasons Why Healthcare Professionals Waive Their Right to Attend a Professional Discipline Hearing •Child-care commitments •Relocation to ‘America’ •Travel plans •Severe debilitating pain in both legs – but able to walk to the GP Surgery for a medical certificate! •Feeling Intimidated •Lack of self-confidence •Lack of confidence in the regulatory process – as they feel their fate is already decided •Perception of the regulatory process as ‘too stressful’ •Lack of basic knowledge about the regulator - how the profession ‘works’ •Resigned acceptance
“Parties can waive their right to a public hearing, but otherwise hearings as required by Article 6(1) subject to the identifiable limitations should be held in public.”
1.5 More ‘No, thank you.’
“I do not intend to appear at the hearing.”
a.did not complete all the required sections of the patient assessment forms or provide sufficient detail therein; b.did not provide adequate clinical reasoning to support your diagnoses; c.did not adequately document the treatment you gave; d.did not adequately document the treatment goals; e.did not adequately document the advice given to patients who were to undertake exercises or ice treatment at home; f.did not write discharge letters to GPs;
1.6 MMR Vaccine Debacle
“Measles, mumps and rubella vaccines have all been shown to be safe and UK families are fortunate to have free access to these which is not true for many parts of the world. The false suggestion of a link between autism and the MMR vaccine has done untold damage to the UK vaccination programme.” The Department of Health said: “The safety of MMR has been endorsed through numerous studies in many countries. Thankfully more parents are having their children vaccinated with MMR and they see it as being as safe as other childhood vaccines.” 1.7 Wakefield's Comeback
Section 2: Reflection on Professional Practice
2.1 The Reflective Process
2.2 Demonstrating Good Practice “Having a mistake pointed out is part of the process of doing science. While you would never want to discover that you made a mistake, what's ultimately important is to do good research, and sometimes that requires you to make a correction. We've tried to be completely transparent about the mistake that we made and correcting it as quickly and clearly as possible.” - Amelia Karraker, speaking about her retracted article titled “In Sickness and in Health? Physical Illness as a Risk Factor for Marital Dissolution in Later Life”
2.3 Blame Culture “I reflect on incidents and, instead of blaming myself for short-comings in our service, I search for solutions to problems.” - Postgraduate Nurse Liz Charalambous “In most work environments, staff members are afraid to speak up. So, it is likely that they will: suffer in silence; work to rule; lose enthusiasm; feel let down; and eventually leave. Meanwhile the power-hungry manipulators move up and infest the organisation.” - Jonar Nader
•Who committed the error and why? •Has it happened before? •What harm or potential harm caused? •Chances of such error happening again •Corrective/Preventive action (if any need to be taken)
“Doctors, lawyers and teachers need to be more moral so that they are seen to serve the common good. Trust between professionals and the public has been eroded because they are now regarded as ‘self-serving’ and ‘uncaring’.”
Section 3: Joining the Debate
3.1 Re: Public Consultation by the Health and Care Professions Council
3.2 Professional Registration: What's the Point?
“The mediocre manager says to the ‘incompetent staff’: We’ll have weekly meetings where I will pretend to be interested in your workflow while the truth is I’ll actually be smarting about the fact that it will take another six of these blessed meetings and a further three months before I can get rid of you without you suing the business.”
3.3 Malicious Reporting by Managers?
“If your manager gives you the freedom to make mistakes and does not hold your prior misdemeanours against you, consider yourself fortunate. All too often in this selfish world, people delight in pinning evidence on others. It is common to find people who delight in others’ weaknesses. They reveal the fact that they know more about you than they should, and then they suppress their knowledge, so long as you show them that you are grateful. If ever you waiver from the path that suits them, they will threaten to divulge your ‘secrets’ to others.”
3.4 Equal Comparison: The Key to Fairness
“Employers [should] provide equal access to Continuous Professional Development, regardless of individual working patterns, to ensure that equality policies are implemented.”
“Many forms of discriminatory treatment arise out of or are linked to infringements of other human rights, while infringement of other rights such as freedom of expression or the right to a fair trial also often have a discriminatory component. This means that any comprehensive attempt to address issues of discrimination and inequality must also engage with the other human rights issues that play a role in creating the injustices in question, while attempts to promote respect for human rights in general must take account of equality and non-discrimination concerns.”
3.5 Tackling Discrimination
3.6 Equality, Diversity and Inclusiveness
3.7 Constraints on Duty of Care “There's still this real culture against whistleblowing...if you were to report somebody, no one on your station would ever talk to you ever again, you would have to move and live somewhere else... you know, if he's a good bloke, how could you say something against him even if he is a terrible practitioner?” - A paramedic classroom educator
“If a midwife is looking after a woman and every time they go to report a problem or issue they are met with undermining behaviour, they are going to stop asking for help. There is a breakdown in communication.” 3.8 The Curse of Whistleblowing
“A vast amount of public money has been wasted on my persecution by the trust that ran and now runs the hospital. The trust did everything to prolong my suspension and prevent a settlement and when they couldn’t get rid of me by any other means they sacked me in my absence when I was ill. Patients have been betrayed. Even today, there has still been no investigation into the deaths that I witnessed.”
“Despite having one of the strongest whistleblowing cases in the country, where I have won interim relief hearing, whistleblowing has destroyed my career, pension, health and now my possible loss of home. Despite this, there is still no help...after 30 years of flawless service to the NHS. I have been unable to find work. One job offer was withdrawn when they discovered I was a whistle-blower.”
“Blacklisting of NHS staff is not uncommon. Surgeon Edwin Jesudason faced similar situation of being blacklisted. Such a highly skilled man of integrity has been victimised by the NHS as a result of whistleblowing, which he did in order to protect his patients. Losing Edwin from the NHS is a great loss to patients. Another case is that of whistle-blower Kate Clarke, who exposed agency nurses dozing whilst being paid at £648 for their shift. Kate now cleans tables at a fast food restaurant unable to find work at NHS.”
“The message must go out today that we are calling time on bullying, intimidation and victimisation, which has no place in our NHS.”
3.9 The Irony of Cultural Differences
3.10 ‘Good’ or ‘Bad’? “People generally see what they look for, and hear what they listen for.” – Harper Lee
3.11 Interim Orders
3.12 Legal Conundrum for Registrants
3.13 Inquisitorial or Adversarial?
“The watchdog [GMC] is traumatising doctors and may be undermining the safety of patients through its adversarial approach to doctors with health problems.”
“Fitness-to-Practise hearings are largely a Kangaroo court. Each individual panel can make its own findings, its own decisions and its own punishment for [professionals]”
One may also ask: Who monitors and assures the work of the HCPC especially as far as it relates to decisions deemed as unfair or unduly severe by registrants?
3.14 Potential Damage to Reputation
‘I am now very concerned about my professional reputation, which has clearly been damaged, and can be restored only if the truth is revealed or indeed if somebody talks straight.’
“It may be a hardship upon individuals that statements of a defamatory nature could be made concerning them, but the interests of the individual is subordinated by the law to a higher interest, viz; that of public justice, to the administration of which it is necessary that witnesses should be free to give their evidence without fear of consequences.”
Section 4: Which Way Forward?
4.1 Destigmatisation of Errors
“Although organisations need to make mistakes in order to improve, they go to great lengths to avoid anything resembling an error. That’s because most companies are designed for optimum performance rather than learning, and mistakes are seen as defects that need to be minimised.”
4.2 Honest Evaluation
“If people are good only because they fear punishment, and hope for reward, then we are a sorry lot indeed.” 4.3 ‘Regulation 20: Duty of Candour’
Conclusion
References and Further Reading
Correspondence
Edwin Goodwin studied Applied Biomedical Science (2005-2008) at the University of Wolverhampton (UK), graduating with a 2.1 Honours degree. He also holds a Postgraduate Certificate in Biomedical Science (PGCert) which was awarded to him in 2010 by the same university.
Shortly after his undergraduate studies, he joined the National Health Service (NHS) in England as a qualified biomedical scientist (2009-2012). He had previously been a coterminous student/trainee biomedical scientist at Sandwell and West Birmingham Hospitals NHS Trust where he successfully completed his IBMS Registration Training Portfolio for the Certificate of Competence (July 2008). In December 2008, he became a registrant of the Health and Care Professions Council (HCPC).
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In the Pharmacy profession in Great Britain, there seems to be a long-drawn-out battle between the representatives of the profession and the law-makers on the need to decriminalise dispensing errors. The fact that a dispensing error could give you a criminal record invariably means that there is an under-reporting of errors. Consequently, the profession is robbed of lessons that could be learnt from many people’s mistakes. Consider this statement by author Bob Gass: “The only mistake – is not to risk making a mistake.”
This essay is however not about pharmacy and pharmacists but about all healthcare professionals. It is a thoroughly researched thesis that contains not a mere rhetorical discussion, but a dynamic, head-on confrontation with the issues.
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