Discussion in 'Action Alerts and Advocacy' started by Supporters of Dr Myhill, Jan 6, 2011.
Great news! Hats off to Dr. Myhill and supporters! June
I've just read through the determination of the latest IOP, and while it's all good news that Dr Myhill can practice again, I wouldn't want people to get any false hope about the long-term implications of this decision for the ME/CFS patient. It's a Good News, Bad News situation...
Good News: Looks like the High Court hearing will go ahead, so the GMC won't be evading that.
Bad News: She has to take down loads of sections of her website, in their entirety.
Good News: Dr Myhill can practice again, with another set of restrictions.
Bad News: That's only another interim order, to be reviewed within 3 months
Good News: The GMC appear to be divided: legal counsel for the GMC maintained that the interim suspension was 'appropriate and proportionate' but the panel on this occasion clearly disagreed (and rightly so).
Bad News: The latest 'determination' doesn't back down on the concept that "there may be impairment of your fitness to practice and that such impairment may pose a real risk to patients and to the public interest" - it just adjusts the order to something far less draconian.
Good News: Dr Myhill can now resume giving help and support to ME/CFS patients as a GP.
Bad News: The order restricts prescription to the guidelines in the BNF and NICE guidelines, and medication detailed there can only be prescribed for the clinical conditions for which it's described by the BNF and NICE guidelines.
In particular, this means that Dr Myhill can't prescribe B12 or magnesium injections, and this clause about prescription looks like a complex and murky minefield to me.
One could sum it up by saying that Dr Myhill can carry on being a GP so long as she doesn't do any of the things that have had such a dramatic and positive impact on the lives of her ME/CFS patients.
It all looks to me like a bureaucratic consequence of a situation where all the treatments that actually work are either made illegal or aren't included in the BNF and NICE guidelines. One can easily understand why the situation causes such confusion - just another episode in our whole Kafkaesque situation - another Catch-22.
What's a doctor to do? In reality the situation is that you can carry on being a doctor, so long as you don't treat ME/CFS patients effectively. So if you're a doctor who happens to have good, practical, clinical understanding of ME/CFS, and want to help ME/CFS patients rather than feeling 'disgusted' by them, what are you to do? If you do what you know is effective, you risk being struck off for it. And up to a point...what's a bureaucrat to do? The rules and procedures, and the clinical guidelines, are garbage, but it's your job to uphold them. Do the right thing, and you risk losing your job. Dr Myhill could perhaps practice effectively as Sarah Myhill, as a nutritionist, or something similar, and we could all opt out of seeing "Doctors" in favour of people who can actually help us - but would that be better on balance? And where would we get our B12? It's a minefield...
Just before Christmas, I met up with an old work colleague who was actually the guy who told me about Dr Myhill and about the doctor nearby who practices in association with her (who I am not naming here to avoid dragging her into the witch-hunt as well, but east midlanders can PM me).
The conversation was most revealing...
This guy is a really nice bloke and we get on great but his politics is very different to my own. Like him, I was always very sceptical about seeing this doctor, and about handing over my money (as we all are of course, but are eventually forced into taking those sort of risks when we can't get any help elsewhere). Last time I spoke to him properly about it, and while he was self-injecting, he was always very down about the whole thing. He didn't think he could perceive any obvious benefit; he thought some of the advice was helpful, and there were some positive signs, but he wasn't convinced it was really working and he still felt nervous about the whole set-up, because of course it's 'outside the mainstream' and that's a tough place to find yourself, for anybody.
So anyway: up until I met him just before Christmas, I had no real idea what he thought about this case. I hadn't seen him for a year or so, and his was the only negative experience I'd heard of in relation to Dr Myhill's methods (the injections were quite painful and inconvenient for him, but he persevered). In my imagination, I was assuming that he wouldn't be a strong supporter, because it didn't seem to have worked out for him.
So I asked him in very neutral terms what he thought about Dr Myhill and the treatment now, in retrospect.
Like me, he agreed that there's no way to be sure exactly what had led to his dramatic improvement, but - also like me - with a bit more distance, looking back, he had to say that the year when things changed dramatically for him was the year when he was being treated by this doctor, and - also like me - his overall feeling was that it was most likely that those treatments were what had led to the long-term change in his condition. (Both of us have tried umpteen other types of treatment with no progress, over a decade or more).
Again to my surprise, he volunteered that the case against Dr Myhill was disgraceful (I forget the exact word he used, but I think either of us would agree with 'disgusting', 'travesty', 'appalling', 'outrageous'...whatever you like...)
I was just gobsmacked. This was the only real shred of doubt I had in my mind about Dr Myhill and her treatment protocol: that it didn't seem to have worked for this mate of mine. And yet here he was, talking of a dramatic long-term improvement that he now attributes to that year of treatment, to the extent that having been quite a bit sicker than me, for quite a bit longer, and having more in the way of formal "ME/CFS diagnosis" than I've had, he's now recovered even more than I have, even to the extent that he's now resuming some light exercise without major ill-effects!
And by the way, like me, and like nearly every credible recovery story I've heard, he also agrees that no, of course, there is never going to be a real 'cure', and the condition is still always there, along with the risk of relapse - but that with the right treatment, and the right understanding, and some hard work and some time, (and perhaps a bit of luck is required), it's still possible to get to a situation where you can lead something almost resembling a normal life.
Just amazing. I didn't think I could feel any more strongly about this issue than I already did, but hearing him describe his perspective, I'm even more amazed by the whole bizarre situation.
It really is like this: anybody who finds anything out about ME/CFS through research, anybody who effectively treats ME/CFS, anybody who does anything to try to help and support ME/CFS patients, seems to get singled out and attacked for it and driven out of the medical system. You can continue to be a medic - so long as you keep kicking this particular group of people in the teeth. It seems like the whole medical system is hell-bent on keeping us suppressed. It's not conscious, or personal, or deliberate, for the vast majority of medics, I'm sure - it's somehow systematic, ingrained, institutional.
But really, what on earth can explain this whole medical blind spot, I just don't know. I've heard that it's a long-established part of the history of medicine to treat anything it doesn't yet understand appallingly badly. Multiple sclerosis patients have only recently been promoted out of the 'punchbag' category - as soon as we came along to take their place, it seems - perhaps there always has to be a convenient scapegoat for some sadistic reason. But how it can still be the case, after all the lessons of history, that the world of medicine is still carrying on in the same way, in the 21st century, just boggles my mind.
Ah well...nothing to be done but to battle on...and celebrate our victories, however small they may be...
I recommend that you read this interview with Burt Berkson, Ph.D., M.D. I think he has some excellent insight into this issue you have raised.
Thanks ever so much for that link Rich; it does indeed illuminate the question that keeps boggling my mind.
I think a heck of a lot of people - maybe most people - now understand that big pharma has a powerful interest in not approving replacement, cheap, or natural therapies, so that anything they can't patent has more and more of a disadvantage as they get more and more powerful. A lot of people cobble that into a conspiracy theory, but those with more understanding realise that it doesn't really work that way; it's the structure of the system that does it, not a cabal of evil geniuses. I often put it this way, to people with business experience who will understand how institutional stupidity functions: if you are looking at a spreadsheet with a set of various options to be studied, the business cases will determine which ones get through, often without anybody's eyes even being on the details. The one that has no pay-off because IP can't be obtained has no chance: the costs are hundreds of millions, and the reward is zero. With the best will in the world, none of the people inolved can force something like that through - the directors could go to prison if they did stuff like that.
Are you familiar with the psychoanalysis of capitalist corporations as psychopaths? A company has legal status as "a person", but this "person" is legally bound to the principle of maximising profit for its shareholders - it's a "person" whose sole interest is in making as much money as possible, and that's enforced by the law. As such, as time goes on, it literally can't have any moral principles, it has no emotion or humanity even though it's legally a "person", it has to do what makes money, and anything good it does is achieved by the inefficiency of having to be run by humans, who do whatever they can to modify its behaviour, but technically whenever they do anything human or decent that doesn't maximise profit, the directors are breaking the law by letting them do it. So this person, if they were a human, motivated 100% by pure greed, would be labelled a psychopath. Ergo: all corporations are psychopathic, no matter how hard their founders try the whole "don't be evil" thing.
So anyway: that's the part that lots of people get, how the research gets skewed by the financial interests of Big Pharma, even though far too many make it a personal thing and not a systematic thing.
What I was struggling with, and your link has helped with, is to start to think about the instititional pressures and the systematic structures that play on MDs. There's some fantastic insight in that interview (along with some quite extraordinary but very believable claims to those who've had similar experiences). Sadly, the whole thing is so appalling - I mean, it really is such an unimaginably anti-human, evil situation - that we all just really struggle to accept it: it's too monstrous for our heads to hold it. There are some aspects of this that really make me despair sometimes, because I can't think of any argument that would ever have convinced me of some of the things I know now, if I hadn't experienced it directly myself. I see the looks of disbelief when I point out some of the realities, and frustrating as it is, I have to think: well fair enough, I would never have believed something so outrageous if I hadn't seen it myself, and I can see how it would rock somebody's entire world-view to take these truths on board: it's frightening stuff.
It's still really hard to fathom, even in the interview; hard to explain or excuse the behaviour of somebody who, presented with clear evidence of remarkable, totally credible, life-saving results, right in front of their eyes, still doesn't follow it up and has no interest whatsoever in it because it's not what it says in the book. I think I could spend a lifetime with such a person and never understand them. But I can at least understand that I know this is how most people are: they do their job, follow the rules, as they're trained to do, and they figure if they do that, nobody can fault them. And most people are ruled by the fear and insecurity of losing what they have, I guess, no matter how much they have.
So I can see a lot more of it now, I understand the process a lot better, though I guess I'll never really understand the whole thing.
I have a couple of examples from my own experience that absolutely confirm what this interview says about MDs. One is a doctor who I've seen several times, not through choice, but because of a hoop I have to jump through from time to time. Last time I saw him, I mentioned XMRV. He'd never heard of it. He interrupted to say something like "I only go with peer-reviewed research"...and I said it had been in Science, so peer-reviewed of course, and was very high quality, and he said he only read the BMJ, and when it was in the BMJ, he would go with it. I've known this guy for a number of years (and sadly, I can't get him for malpractice for the want of a photograph), and I know for sure that he is purely interested in going by the book (and he even failed to do that in my case so I guess that's hard enough for him!), in a nice easy comfortable setting, with no pressure and no risk. So I can recognise that part of it all, in him. I can also recognise in my current GP, who I like quite a lot, that here's a guy whose hands are tied: he would love to do more, but he just can't access the information, or do anything with it: the system doesn't give him the time or space he would need to do his own research, and as Dr Myhill and Dr Wakefield illustrate, the risks to him if he did go outside the box would be extreme.
I've been agonising for a while now about what I can post about the second example, and concluded I can't risk it right now, which kind of says it all! if I say the wrong thing now, I might never be able to get the information out without immense personal hardship ensuing, and maybe I can find a way to reveal it without taking that personal hit. And I'm not 100% convinced it's enough of a smoking gun to be worth it. So I guess I've just proved the whole thing to myself: if you're anywhere near the medical world, the rewards can be immense, but the risks involved with doing the right thing make it unbelievably hard to navigate the minefield, and everything screams at you to toe the line. Even with the best will in the world, you have to weigh up when is the best time to play your hand, and what good it would really do. Just as with MDs: go outside the rules just once, and you can end up out of the game entirely, and then, on balance, you can't help nearly as many people in the future, so have you really done the best thing you could do? It's really tough sometimes...
Final thing, right at the end of the interview, which was a fascinating exchange. The interviewer looks forward to the day when all these medicines are accepted and on the books and we can all reap the benefits. Berkson's philosophy is more subtle but very principled and I agree: the way forward, instead, is for patients to have free, open, transparent access to all the information, and crucially, the choice as to what path to follow. I agree entirely that's the better and fairer strategy, although I would add that what humanity needs more than anything is a widespread understanding of how our institutional structures oppress us all, and that it's not about the individuals, or the great hidden conspiracy, because the real conspiracy is embedded in those virtual structures that systematically produce the results we all decry, and we'll never get anywhere until we all understand that and get to work on dismantling, reformulating, and just plain turning away from those colossal mistakes.
Thanks again for a really great link Rich.
Hi Mark, as someone with some background in systems theories of business, I can say that your arguments are perfectly understandable to me. Bye, Alex
Hi Rich, that was a really great article. The tone of the article didn't change my opinion, I was already of that opinion (my CFS doctor was shut down in the 90s but was 60-90% successful, they didn't care). What this article did was clarify things and demonstrate the problem may be endemic to all medicine.
Simplifying the heck out of it, I would boil it down to a simple proposition: doctors are either bureaucrats or scientists, and very very few are scientists. Give me the scientists, every doc who ever helped my CFS was also a researcher.
Really nice summary Alex: I like it: bureacrats and scientists: the distinction between people who just want to do things by the book and people who want to solve big problems and improve the way things are done. In every walk of life, the number of people who actually stand out of line to challenge the way things are done, to their own cost, is very, very small - the vast majority just do as they're told and follow procedure - it's a much, much easier life! We shouldn't really be surprised that doctors are no different.
Hi, Mark, Alex and the group.
I think you guys have articulated the situation very well. The capitalist, market system has done a lot to motivate people and has brought progress in a lot of areas, but it does have downsides when it is applied to food supply and health care, because when profit is the parameter that is optimized, nutrition and health outcomes are often sacrificed.
Privately held companies are able to balance these goals in a better way, if their owners are enlightened. However, if their competitors are publicly held corporations, it can be difficult for them to compete, unless they can get their story out to the consumers so that the consumers decide that there is a greater goal that they are working toward, and they are willing to pay the additional cost to do that. Some examples that these things do happen are the organic foods movement, the "green" movement, and the "fair trade" movement. I think the key to encouraging this is to get the word out to individual citizens and potential consumers. In my opinion, the internet is a bright hope in this regard. So long as it remains free in terms of what people can post and to whom, it will be a vehicle for getting information to individual people that they will not get from other sources, such as the media, which are also operated with a profit motive. Those of us who participate in health groups have had the experience of hearing more sides to the story, and when we couple that with our own personal experiences, we get a certain amount of enlightenment about things that we otherwise would not have gotten. In the U.S. and the U.K. as well as quite a few other countries, there is still a democratic basis to the determination of public policy. If enough individual citizens become knowledgeable about an issue and are motivated, they can influence public policy and bring about change. It's true that money is a big factor in elections, because it buys media time and exposure, and thus, votes. But so long as the votes are counted fairly, it's ultimately votes that determine outcomes of elections. When the majority feels strongly enough about something, they can prevail against big money. What's necessary is to get true information out there, and then to motivate people. This of course is a challenging job, but there are signs that it does work in some cases. In today's paper, I see that the federal government in the U.S. is starting to take action to limit fluoride. This has been a long time in coming, but maybe the worm is turning on this issue. There has also been some movement on the mercury situation. Less than half the dentists in the U.S. now use it. Alternative health care use is growing in the U.S. A few years ago it was published that there are more visits to alternative practitioners than to M.D.s, and these are paid for out-of-pocket, not by insurance, so that shows how strong the motivation of the people is. Getting the word out is the first step in improving the situation, in my opinion, and the internet is a major asset in this regard. We see a lot in the news about how the internet might influence China to adopt more democratic policies, but it cuts both ways. Countries like the U.S. can become more "democratic" as well, if people get good information and become motivated. We don't have a centralized, communist government, but our government is dominated by moneyed interests, because money can produce votes, and votes determine policies. So I see some signs of hope for the future. It just doesn't happen as fast as any of us would like.
I generally agree with this. Where I disagree is that it is only an institutional problem, no cabal or conspiracy. I would agree that most people participating are probably not really aware of the bigger picture but I can tell you that there are people who know exactly what is going on and are using the conservatism of the medical industry to maximize profit and consolidate power as much as possible.
I was part of somewhat similar efforts in the chemical industry. The ultimate goal is to roll up power centrally (Washington) and then take control of the apparatus. Just take a look at financial services as a wonderful example. It's almost like it's written in the Constitution that a former Goldman Sachs CEO has to run the Treasury or other major government institution overseeing Wall Street.
George Stigler (Economist) was concerned with regulatory capture and it's clear this has occurred. Don't let big business fool you: They love regulation when they have control over it.
One can rationalize this as being big business, or try to marginalize it by calling it a "conspiracy theory".
BUt here is what I see:
1) A deliberate effort since at least the 1980's on the part of the CDC, and the MRC to avoid doing any biological causation research into autism or CFS/ME
2) A exhaustive effort to create bogus studies and treatments by the CDC and MRC to a psychological causation. (IT's all in your head.... need CBT, or GET)
3) A deliberate effort to ignore the concept that CFS/ME/autism have an infectious cause and may be spreading (totally ignoring blood for years, even after Defreidas suggested a virus many years ago, ignoring biological causation research)
4) Overwhelming Efforts to release 4 studies on one day that suggests contamination is an issue with WPI. However, the articles are impossible to understand(even by some virologists) and given futher analysis give absolutely NO proof that the WPI has had contaminated results.
5) efforts to punish, discredit, and avoid funding doctors who have tried to help or draw attention to alternative treatments
6) completely igonoring, and even removing products from the market that may prove to be beneficial to patients (codex)
7) Ignoring proper treatments and research into LYME disease
8) Biased and often "one sided" arguments through the news media to get people to buy in on the whole deliberate, and spectacularly executed game plan
It is what it is. I don't see it a a conspiracy at all.
The circumstantial evidence seems overwhelming it has been a deliberate and well executed plan, to do all the above.
wow, thanks for the link. I had some idea of this, but I didn't realize how completely uninterested universities are in hearing new ideas
that's great news! But after this whole witch hunt, will she be able to practice treating ME patients like before or will she be cornered to treat them according to NICE guidelines of CBT and GET? Is the fight for justice really over?
on profit, that's not, in general, an evil thing because if you don't have profit considerations, you have the following risks:
* lack of customer service (particularly when you're the gov't and people don't have other choices)
* lack of budgeting/wasting money (again, think of gov't)
* lack of quality (inferior product, again, think of certain parts of gov't)
* lack of attention to employees (hiring good ones, treating them well so they are happy and productive and want to stay with the company)
* lack of attention to the market (what do customers actually want and what can they afford-- think central planning)
* lack of attention to surroundings (this is where conscience comes in--buying chocolate from non-slave-produced sources, giving to charity, doing what's environmentally responsible)
Profit motivates a firm to do all those good things well in order to do well in business and stay in business. As Henry Ford said, "There is one rule for industrialists and that is: Make the best quality of goods possible at the lowest cost possible, paying the highest wages possible."
Government, on the other hand, builds light rail projects where there isn't the population density required to support these projects financially, creating a perpetual tax drain. This is the sort of mistake that's made when there is no profit motive.
In health care, almost no one is making much profit. Not doctors, not hospitals, not health insurance companies--all these make below the median for business. The only ones making a significant profit that I'm aware of are pharmaceutical companies and power chair manufacturers (for some odd reason Medicare pays them an insanely high amount).
I agree that there are always some companies and banks who don't have consciences and aren't trying to do what's best (for the employees, the customers, and sometimes even for the business itself long-term), and that some corporations and banks in this category have undue influence on government.
from Mark's post on page three, it seems she cannot treat patients effectively (can't prescribe outside of NICE) and the fight for justice is not over
Congratulations to Dr Myhill for winning back some of her licence.
Also a big thanks for keeping us all updated and helping the campaign.
I am glad that the High Court hearing is going ahead so that she can be fully vindicated.
In due course, action should be taken against the GMC for the waste of time, money and the risks to patient safety caused by their disgraceful actions.
On behalf of Sarah, thank you all for your messages of support. These really do help. The High Court Hearing will have to be put back as the previous court documents were constructed on the basis of the erstwhile suspension which you know has now been lifted. We will keep you as up to date as we can about progress and possible dates.
Hi Mark, all,
I really appreciate you detailing your thoughts (frustrations!) here, it is always nice to know my fellow PWC's are an intelligent bunch.
I want to suggest something. Can we somehow form a debate on how best to make a change?
Lately I have tried to be as politically active as possible (writing letters, signing petitions etc), but it has occured to me that PWC's have been doing this for any, many years to no effect. So that begs the question: why isn't anything we're doing to try to raise awareness working?
I think we need to be more scientific about the approach we take - that is we need to think more about what is the best way to optimise the time and energy we each have? How do successful charities make a difference? How have other campaigners in similar areas (HIV, MS, the green movement etc.) become succesful? Do online petitions actually achieve anything? Are letters more likely to be read with interest if they are written in a particular tone? Should we encourage all charities to get together to discuss consistency in strategies? Is it better that I spend my energy writing posts on encouraging people to get involved politically rather than on the latest medical research?
I would like to make a suggestion: I think the best way to make a change is to get the media on our side, because I believe that once that is achieved there will be a snowball effect and other institutions will be forced to follow. And I think the best way to do this is to give journalists what they want. They probably get thousands of letters a year from people complaining about their illnesses. Why would journalists listen to CFS patients more than, say cancer patients? I think giving them what they want should involve talking engaging them more in the politics of the disease, rather than the science. We should be targetting political journalists more rather than the usual health journalists. And I think we should offer them a financial incentive in the form of a journalists' prize for CFS. A few thousand quid/dollars is relatively easy to raise. All we have to do is let them know that the more "political" in nature their article is, the more likely it is that we will vote for them. We should also let them know that since there are currently very few articles (or perhaps none at all) on the political aspects of CFS, that even if they write one, they are likely to win the prize...which young journalist could resist the temptation of receiving a nice bit of cash for exposing the corruption?
Lately I think we need to get programmatic about our campaign - it needs to be efficient, targetted and dare I say it even "dirty". History tells me nothing's going to change unless we do.
I have received this from the GMC regarding costs incurred so far on the Myhill case.
After a previous FOIA request, which did not disclose internal costs, I complained to the Charities Commission and also to the GMC auditors on the basis that the GMC was not keeping proper accounting records as required by law.
Subsequent to this, I received written assurances from the GMC that they would keep such records in the future. This reply implies that they do not do so.
I shall be complaining again about this.
Subject: FOI request - \ - F10/3438/JM
Date: Wed, 19 Jan 2011 11:38:29 +0000
Our reference: F10/3438/JM
I refer to your letter to the GMC dated 5 December 2010, in which you requested the internal and external costs incurred by the GMC as a result of the complaint against Dr Myhill (case reference C1-314994282)
I apologise for the delay in providing you with a response.
For the purposes of your request we have amalgamated the recorded costs we hold in relation to the cases which resulted in the IOP hearings of Dr Myhill on 29 April 2010, 7 October 2010 and 14 October 2010.
Our internal legal team have spent approximately 98 hours dealing with the two cases which resulted in the IOP hearings referenced above and other correspondence relating to Dr Myhill. This includes time spent in preparation for the High Court hearing.
The external costs we have incurred in relation to the three IOP hearings and the adjourned High Court hearing are approximately 26,273 (including VAT). This figure includes panellist’s fees, expert reports, transcriptions, staff and running costs on the days of the IOP hearings.
We are unable to provide the cost of work at our investigation stage as we do not record this on a case-by-case basis.
I hope the above information is useful to you.
If you have any concerns regarding the processing of your request please contact Julian Graves, Information Access Manager, at the address at the bottom of this email, or email email@example.com
Information Access Officer
0161 923 6324
General Medical Council
3 Hardman Street
I have sent this letter to my MP.
If you wish to send similar letters to your MP please do, but please don't just copy and paste all of it - see last paragraph!!
Thanks for your continued support.
Rt Hon John Bercow,
House of Commons,
CONCERNS ABOUT THE SREEENING OF COMPLAINTS AT THE GENERAL MEDICAL COUNCIL
I am writing to you because of concerns I have regarding the above.
As you may recall I have been assisting Dr Sarah Myhill in her defence against the GMC with respect to certain complaints made by doctors and other individuals.
At a recent Interim Orders Panel, the GMC lodged a complaint against Dr Myhill concerning her acting as a midwife, a medical practice which they considered put Dr Myhill outwith her permitted, and at that time, restricted medical licence.
The complaint was made anonymously but included a weblink which was as follows:
You will notice that I am quoted near the bottom of this page and if you care to click on the link to Rosemary and her babies, you will see that in fact Dr Myhill delivered some rather fine piglets! I think I am right in saying that the GMC’s regulatory powers do not extend to the safe delivery of porcine offspring but I await to be corrected.
My concern is that the GMC did not follow its own procedures for checking that complaints are at least worthy of commencing an investigation. The following wording is taken from
‘’At an early stage we will decide whether there are issues which we need to investigate further, and if so, what form the investigation should take.’’
It is fairly self evident, I would contend, that not one single officer at the GMC clicked on the mentioned weblink and saw the fetching piglets in all their glory. This is a very serious issue because if the GMC can accept complaints such as these then what other spurious complaints are being accepted prima facie by their officers?
I can, of course, if you wish, provide documentary evidence of the GMC’s actions in this respect.
I would be most grateful if you could contact the GMC and ask for their opinions on this sorry tale.
I have copied this letter to Niall Dickson, Chief Executive of the GMC in the interests of openness.
On a different note, I have not forgotten your very kind offer of tea at Speaker’s House and I will contact your office in due course to arrange this for myself and my father, Peter. The defence of the Youth Centre and Day Care Centre services are going well.
Cc Niall Dickson,
General Medical Council
350 Euston Road,
London NW1 3JN.
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