All around the world teachers and doctors attract enormous respect from the general public, who understand that these are not just difficult jobs to do well, but they remain extremely valuable occupations to any community.
Most people would be astonished to learn that, despite the fact that these prestigious professions attract the best and brightest, they are regulated by others who may not have the same competence as the experts they supervise.
Wherever you live in the world, the quality of your doctor and teacher may be increasingly challenged by their regulator.
The UK BBC News Website of 24th March led with the headline: ‘Teachers and head teachers call for Ofsted to be replaced’ and reported: ‘Teachers and head teachers handed a petition to the government on Thursday, calling for Ofsted to be replaced. The petition was started before head teacher Ruth Perry took her own life while waiting for an Ofsted report.’ That petition has been signed by 52,000 people.
The UK headline in The Guardian Newspaper screamed, ‘Pressure mounts on Ofsted amid outcry after death of headteacher’ with the sub-headline below reading: ‘Ruth Perry’s death a ‘direct result of pressure’ from a report by England’s education watchdog, says family’.
The British newspaper reports that pressure is mounting on Ofsted after the death of the Berkshire headteacher Ruth Perry, whose family has called for an urgent review of the school’s watchdog, describing its inspection regime as “punitive” and “fatally flawed”.
Perry’s sister declared to the newspaper that her family was in no doubt she had taken her own life in January as a “direct result” of the pressure put on her by the process and outcome of the Ofsted inspection, which downgraded her school from outstanding to inadequate.
UK doctors may be surprised by the parallels with their own government-appointed regulator, the General Medical Council (GMC), which appears to behave in a remarkably similar manner to Ofsted; an obsession with paperwork rather than the essence of health care, with strikingly similar results in terms of the stressful impact.
In the UK, thousands of the best doctors and teachers are leaving, often citing the stress of regulation, meaning these overly officious officials are imperiling the basic survival of both professions.
But these regulators aren’t just butchering the professions, they are killing professionals too.
Under the headline, ‘Coroner to ask GMC to check vulnerability of doctors it investigates’ the British Medical Journal reported: ‘A coroner is to write to the UK General Medical Council asking it to reform its procedures after a consultant anesthetist killed himself within hours of receiving an email telling him he was being investigated’.
The article by Clare Dyer, published on 02 March 2020, explains that ‘Sridharan Suresh, 50, a consultant at North Tees and Hartlepool NHS Foundation Trust, drowned himself in the River Tees on 2 May 2018. That day he had received an emailed letter from the GMC telling him that his NHS and private employers would all be notified of allegations he had inappropriately touched a teenage girl and would soon be called before an interim orders tribunal.
In April 2018 Suresh gave midazolam to a 15-year-old girl to sedate her for a dental procedure. Among the occasional side effects of midazolam are confusion, hallucinations, and unusual thoughts or behavior. The girl accused him of touching her sexually and made a report to Cleveland Police. There was no witness to the incident, which Suresh strongly denied, and the description she gave of the alleged perpetrator was strikingly different from Suresh’s appearance’.
Raj Chaudhary, Medicolegal Representative for the Doctors and Dentists Protection Union, wrote in rapid response in the British Medical Journal, responding to the original Clare Dyer article:
‘I was at the Coroner’s Inquest. With regards to the GMC, the evidence before the inquest was that the GMC wrote to Dr. Suresh to seek his work details and indicated that it would write to the organizations he worked for. The information it had about him and that it was likely to disseminate was an email from the police containing an allegation of serious sexual misconduct. It appears that there was little or no substance to the allegation, and the GMC itself had made no inquiry to establish its substance, but the threat to this doctor’s reputation from the GMC’s intention to disseminate this information was very obvious.
What troubles me is that the GMC has known of the impact its letter had on this doctor, yet, 22 months after his death, its response appears to have been limited to highlighting how polite the tone of its letter was. There seems to have been no effort to make changes to its procedures or learn any lesson. The GMC’s Fitness to Practise processes clearly have the potential to cause injury, perhaps in more ways than what happened in this case, but the GMC’s inflexible approach and apparent resistance to learning even following this loss of life are troubling’.
That suicide was back in 2018, and the Coroner’s inquest was in 2020, yet in 2022 there was another tragic headline in the British Medical Journal: ‘Psychiatrist died by suicide four days after learning of GMC investigation’.
The article by Clare Dyer, published on 27 September 2022, went on to explain: ‘A psychiatrist has died by suicide after he was notified that the General Medical Council was investigating him over a complaint against him.
Michael McPhillips, who had a private practice in west London, feared a public hearing, the inquest into his death was told. He left six suicide notes for family and friends, in one of which he wrote, “Dead people can’t be put on trial so the obvious solution is for me not to be alive”.
West London assistant coroner Anton van Dellen recorded a conclusion of suicide, adding, “I have no hesitation in concluding that the information in the content of the communication from the GMC did contribute to Dr. McPhillips’s state of mind and therefore contributed to his death.”
There seems to be a striking contrast between the multiple cases of suicide linked to the regulator of doctors, (the Clare Dyer British Medical Journal article of March 2020 explains that: ‘It emerged in 2013 that nearly 100 doctors had killed themselves in the previous decade while involved in GMC investigations.’), yet the suicide of this one headmistress, appears to have attracted much more media attention, compared with the suicides of several doctors, suffering from what appears to be a remarkably correspondingly dysfunctional regulator.
The inspection report at Perry’s school found it to be good in every category, apart from leadership and management, where it was judged to be inadequate, but this low score dragged the overall judgment down to the lowest category.
Why are the suicides of doctors in the face of an aggressive regulator ignored by the mainstream media, while the case of Ruth Perry continues to dominate headlines?
The Daily Telegraph of 24th March has reported that the Labour opposition has proposed scrapping Ofsted grades and replacing them with a school report card showing what schools do well and what they need to do to improve. Might not a similar system work much better for doctors than the current punitive regime of the GMC? Why did it take just one death of a Headteacher to produce proposals at the highest level, for revision of the teachers’ regulator, but several deaths of doctors, facing similar predicaments, has evoked relative indifference from parliamentarians, the public, and the press?
Some cynics have commented that the media storm is in fact because this Headteacher was running a school in a very middle-class area, and the parents became mobilized out of concern, in reality, for the education of their children. A negative Ofsted report leads to a school’s ‘death spiral’; it’s impossible to recruit good teachers to a ‘failing’ school, or attract pupils, while ambitious parents pull their kids, and send them elsewhere.
By the horrendous process of what happens after such a grading (which Ofsted has continued to refuse to acknowledge, just like the GMC), a negative school inspection report creates an abyss, crawling out of which becomes impossible.
Hence possibly the suicide of this Headteacher.
The odd thing is this Ofsted process does nothing to help pupils, just as the GMC striking many good doctors off does little for patients.
Because both regulators have lost sight of what a good teacher or doctor looks like, they proceed to ‘strike off’ professionals, to reassure the public they are doing their job. The reality, that they often strike the wrong professionals off, is of no consequence to these officials, who put their own institutional survival ahead of the professions they regulate.
But perhaps a key difference between UK doctors and teachers is the response from the teachers to Ofsted has been much more unified, while doctors appear fragmented in the face of a menacing GMC. This may assist journalists in covering the teachers’ stories more effectively. The Daily Telegraph on March 24th reported how headteachers across the country have begun to wear black armbands during inspections in protest.
The Guardian Newspaper reported that: ‘Teachers and parents took part in a protest outside another Berkshire school that was expecting Ofsted inspectors on Tuesday morning, despite pleas from teaching unions to pause inspections amid the growing outcry.’
Yet both UK doctors and teachers were together on strike in the same week, separately mounting large-scale signals of professional solidarity against the Government over pay.
However, both professions have failed to draw the most obvious lesson from the parallels between the two British Government appointed regulators – which is that politicians are out to hobble the professions of teaching and medicine because cutbacks in education and the health service mean basic standards are under threat.
Only the professions can effectively protest what is happening; parents pay attention to teachers and patients listen to doctors (sometimes).
In the face of this threat (doctors and teachers are more popular with the public and have more credibility than politicians), the Government seeks to beat both professions into submission so they become obedient employees of the state and not independent, autonomous, and therefore challenging professions.
Regulation, with its focus on tick box paperwork exercise, becomes a pernicious instrument by which the Government shapes the nature of what a profession becomes.
Medicine and teaching are evolving into obsessions over getting the paperwork right, rather than caring and educating.
According to The Guardian Newspaper, a petition calling for an inquiry into the Ofsted inspection has gathered more than 100,000 signatures.
There is a petition on the Houses of Parliament Website seeking to dismantle the similarly dysfunctional regulator of Doctors here.
Do doctors have something to learn from teachers?
Doctors, unlike teachers, pay an annual subscription charge to fund the GMC, so the regulator which seeks to destroy the vocation is being funded by those professionals. Yet physicians remain denied any say in the decisions the GMC takes, or who runs it.
So, Doctors are paying for the privilege of having their calling ruined by their regulator. Teachers might give doctors detention for sheer continued stupidity.
‘Destroy Ofsted’s power, says sister of the headteacher who took her own life’, was another recent headline in The Daily Telegraph, March 22nd.
Or, is the medical profession itself, in a sense, gradually committing suicide?
Raj is a psychiatrist and author of The Mental Vaccine for COVID-19.