System failures and learning from the case of Dr Manjula Arora: 21st century regulation needs to be compassionate, caring and supportive
The recent judgement and suspension of Dr Manjula Arora has caused huge apprehension within the medical community and raised debate about whether the fitness to practise process is fit for purpose. This editorial focuses on the need for 21st century regulation to be proportionate, fair, supportive and compassionate.
Stephanie E Singh2
Author details can be found at the end of this article Correspondence to: Iqbal Singh; firstname.lastname@example.org ntroduction Dr Manjula Arora was working as a sessional independent contractor GP at Mastercall Healthcare, a company that provides a range of services to patients registered with GP practices. In 2019, Mastercall was in a contractual association with the North West Ambulance Service, providing a service that involved North West Ambulance Service paramedics referring patients awaiting ambulances to Mastercall clinicians. Mastercall reported Dr Arora to the General Medical Council for having asked for the Mastercall North West Ambulance Service clinical assessment service to be switched off because of the high volume of calls and for saying to the IT department that she had been promised a laptop.
The General Medical Council screeners and case managers referred the case to the Medical Practitioners Tribunal Service and it was heard in May 2022. The tribunal determined that there was no case to answer in relation to the allegation that Dr Arora had asked for the service to be switched off. However, on the second charge there was a lengthy hearing centring on whether Dr Arora had been dishonest in saying that she had been promised a laptop whereas the medical director of Mastercall had said that he had informed Dr Arora that he had noted her interest in receiving a laptop to work from. The tribunal’s findings and determination decided that this action could be perceived as dishonest and suspended Dr Arora for 1 month (Medical Practitioners Tribunal Service, 2022). Dr Arora has since appealed and will be supported by the British Medical Association and many professional organisations.
This case has left the medical profession in a state of amazement, apprehension and sadness at the total lack of compassion shown by the General Medical Council’s Queen’s Council (QC) and the General Medical Council itself. Doctors have found it difficult to comprehend how, in a system with huge failings, an issue around a request for a laptop, which should surely have been handled locally, ended up progressing to a Medical Practitioners Tribunal Service decision to suspend a doctor for 1 month (Nagpaul, 2022). The conduct of the General Medical Council legal team and the QC raises serious questions about a culture that needs to ensure that doctors are treated with the same respect and dignity as they offer to their patients and needs to apply learning from the gross negligence manslaughter, mental health and wellbeing, Fair to Refer and other reviews (General Medical Council, 2019a, b).
How to cite this article: Singh I, Ahmed R, Stewart P, Singh SE. System failures and learning from the case of Dr Manjula Arora: 21st century regulation needs to be compassionate, caring and supportive. Br J Hosp Med. 2022. https://doi.org/10.12968/ hmed.2022.0288
Compassion The fundamental principles of compassion, dignity and respect are the bedrock on which the health and social care system in the 21st century should be built. This is important not only for patients but for the thousands of staff it employs. Compassionate practices and leadership help to forge positive relationships built on trust and mutual respect. This allows a culture where staff feel empowered to raise any concerns that they may have and moves away from a culture of blame.
Compassion must be delivered throughout the management and leadership structures of the NHS. This should be reflected in all workforce practices, processes, policies and disciplinary procedures. Regulation in the 21st century needs compassion embedded in all of its structures.
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British Journal of Hospital Medicine | July–August 2022 | https://doi.org/10.12968/hmed.2022.0288