The new international word of the year for 2016 is ‘post-truth’. The term refers to the practice of appealing to emotion and personal beliefs rather than objective and verifiable truth when attempting to influence public opinion. Apparently, the usage of the term increased by over 2000% in 2016 although most of us will recognize the practice is hard-wired into human nature. Certainly, the notion of counselling patients based on ‘the evidence’ is not guaranteed to succeed when seeking consent to perform certain procedures or instituting specific lines of treatment. But now we have a term for this reality.
One of the most distressing but extremely welcome items of news that was reported this week is the overturning of the conviction of Mr David Sellu. He was convicted of manslaughter by gross negligence at the Old Baily in November 2013 and given a prison term of two and a half years. Whilst the details are scanty in the mainstream press a picture is emerging from the social networking platform of a good man, a conscientious surgeon, a popular teacher who was found guilty based on misrepresentation, distortion of facts and some highly unethical practices of both police and Crown Prosecution but also of professional colleagues. There are doctors who engage in malicious and false allegations and there are others who know the truth but remain silent for fear of repercussions. As Einstein said, “The world is a dangerous place to live; not because of the people who are evil, but because of the people who don't do anything about it.”
I am transcribing some of the comments from the alternative media but keeping them anonymous:
“There was suppression of evidence by the police and cps in this case. Evidence that would have clearly vindicated him and proved the hospital was responsible. There was a group letter by all the anaesthetists at the hospital that supported him. His colleagues did support him, though many did what they had to do to survive and sold out.
“The details if you speak to anyone involved are scary and go much deeper than just management at the Clem (Clementine Churchill Hospital) This was child abuse ring level of corruption going on here transcending the medical profession and leading right through the police, cps and judicial system and of course the good old bastion of fairness, the GMC.”
“Never worked for him but know many who did and by all accounts he was one of the good guys. Probably explains why he was thrown under the bus!”
Another hearsay comment:
“I worked with someone who had been one of his trainees. They told me he had been an excellent surgeon and teacher, the head of his department and very clinically sound, in fact he was known for being able to diagnose subtle things through clinical examination alone. They also told me that they felt that his conviction was disgraceful and that he was being scapegoated.”
Hearsay. A report of someone else’s words that is not usually allowed as evidence in a court of law!
But who do you believe these days? The Right Honourable Jeremy Hunt, Secretary of State for Health caused no end of trouble by claiming that he would improve patient safety by imposing a new contract which essentially meant it would be cheaper to employ more doctors at the weekends. There was a completely fictional ‘weekend effect’ where more patients were supposed to die if admitted at weekends. The solution? Spread the existing doctors over seven days and keep this cost neutral by removing pay incentives when working antisocial hours. The absurdity of this was so apparent to the junior doctors involved that they went on strike. Unfortunately, they were betrayed by their union, the British Medical Association, sold down the river by the Chief Medical Officer, Sir Bruce Keogh (who had played a very significant role in the fundamentally false accounts of the ‘weekend effect’) and as for the GMC? They can only hold their heads in shame at being party to bullying and threatening behaviour with suggestions that striking doctors may face disciplinary action for prejudicing patient safety.
The irony of this hypocrisy was not lost on those who are immune to the ‘post-truth’ propaganda of contemporary (medical) politics. In the GMC’s very own guide to appropriate professional behaviour it is incumbent on all registered medical practitioners to take prompt action if they think that patient safety is or maybe seriously compromised. The imposition of the new contract was not going to enhance patient safety but presents a very serious risk that the already stretched weekday services would be liable to fail if staff were rescheduled to work at weekends. It was so fundamentally stupid and in the absence of any rational or responsible behaviour by senior figures in both the government and the health service it was left to a group of junior doctors to crowd fund a legal challenge to the right of Jeremy Hunt to impose such a contract. In an astounding move of Machiavellian chicanery literally hours before the case came to court Jeremy Hunt declared that he had never implied that he was going to impose the new contract, just recommend that it should be imposed. For those of you are old enough to remember one Victor Meldrew, he would have spoken for all junior doctors when faced with such bare faced dishonesty by a government minister (https://youtu.be/mLNrLI3OBwg).
But it gets worse. As mentioned above, all registered medical practitioners have an obligatory, professional duty to report concerns where patient safety may be compromised. But if they do, and they happen to be a junior doctor, they can be sacked. There is no protection for junior doctors who raise such concerns within their current or proposed new contracts. The BMA, Department of Health and various bodies responsible for training and staffing with in the National Health Service are in a state of denial about this anomalous situation. So it is left to one brave soul, Dr Chris Day, with the financial support of thousands of junior doctors and the legal opinion of the UK’s most senior employment lawyer to challenge the lack of whistleblowing protection for the 54,000 plus junior doctors in the UK. His is not a ‘post-truth’ reality, this is an objective and verifiable reality and you can read more about it on Dr Day’s website (https://www.crowdjustice.org/case/junior-doctors-round-2/)
I have not forgotten about Hong Kong, but like Victor Meldrew when commenting on the ‘post-truth’ reality of medical politics in the UK there is only one response: “I just cannot believe it!”
Postscript: Just heard that Chris Day’s appeal has been scheduled for one year hence. This is an issue related to patient safety and involves every single person in the United Kingdom. No-one is immune from accidents, injury or illness. If and when something happens we want to be able to count on the best possible treatment and that is not going to happen if unsafe practices are allowed to flourish and the morality of the medical workforce in the NHS is continually eroded. Will update as news comes in.