The random thoughts of a sceptical activist

Chiro regulator admits systemic failures

I have never been 100%  sure of the exact numbers of complaints of mine the General Chiropractic Council had to deal with.

I certainly submitted a list of 524 names, but the number changed as the complaints were processed. Quite a few chiros were added to my initial list because they were at the same clinic as another I had complained about and some have been removed for various reasons. Then there were more than a few issues of chiros changing their names, moving clinics, moving abroad and other things that made it difficult to keep track, so I didn’t bother to keep my list absolutely up to date. There didn’t really seem any point in fretting over the minutiæ. After all, the GCC are a statutory regulator and they could be trusted to keep track because it was their statutory duty to deal with these things, couldn’t they?

But I do have an accurate list of all the Witness Statements I have submitted. I was required to produce a Witness Statement for each complaint for the Professional Conduct Committee (PCC), even though I was never called to give evidence in person — the cases were decided by the PCC ‘on paper’ as they say. As an aside, this is surprising because I was told there were more than a few chiros who wanted me in the witness box.

I produced these Statements using a mail merge as the only practical way of providing the three page statements for all of them, each with the correct details of the chiropractors concerned. The GCC, via their lawyer, provided me with lists of names in batches, which I copied into a spreadsheet. I mail-merged the Statements, signed them and sent them back. I therefore had an exact list of those for whom I had produced a Witness Statement.

Not adding up

However, I realised some time ago that the numbers just didn’t seem to match up — I hadn’t been asked for Witness Statements for all those I had complained about.

If it had been a dozen or so adrift, I wouldn’t have assumed that these had been removed somewhere along the way and I wouldn’t have queried it: I would have accepted that the GCC and their lawyers were keeping an accurate record of everything. They are a statutory regulator after all.

But I came to a figure of over one hundred fewer witness statements than I thought there should have been.

It could be that they were still processing these and that I’d be asked for the Witness Statements in due course, but I sent the last Witness Statements at the end of May last year. Time was dragging on.

Maybe a few had been lost on the way? Maybe they’ve been ‘mislaid’?

So, on 28 February, I asked the GCC:

 With regard to my complaints against chiropractors, I would be grateful if you could supply the following information:

1. The total number of chiropractors I complained about, the number added later and the number dropped before the complaints were passed to the Investigating Committee.

2. The number of chiropractors notified under §20.-(9)(a) of the Chiropractors Act 1994 or otherwise notified.

3. The total number of complaints referred to the Professional Conduct Committee.

4. The total number of Witness Statements received from me.

5. The total number of cases falling into each of the following categories as specified in §22. of the Act

(i) §22.-(2) Allegation not well founded

(ii) §22.-(4)(a) Admonishment

(iii) §22.-(4)(b) Conditions of practice order

(iv) §22.-(4)(c) Suspension order

(v) §22.-(4)(d) Removal

This would make any discrepancies glaringly obvious.

Despite chasing them on several occasions — the last time was in an email I sent last night, giving them a deadline of the end of business tomorrow to respond — I’ve not received an answer.

Then, today, the GCC issued a press statement:  General Chiropractic Council conducts internal review of its fitness to practise systems.

That (deliberately?) rather innocuous title belies deeply worrying admissions.

Over the last year, the GCC has been conducting a thorough internal review of its fitness to practise systems. As a direct consequence the GCC has:

  • taken steps to make the process far more cost effective
  • made major proposals to the Council for Healthcare Regulatory Excellence (CHRE) and the Department of Health for legal changes.

It’s always good to review what you’ve done; to learn for the past and to strive to use that to improve your processes.

However, they then admit this ‘review’ found some very serious issues:

…the GCC internal enquiry disclosed a substantial number of complaints and enquiries which had not been properly processed and are accordingly the subject of urgent action.

Although I’ve had no reply from the GCC yet, it looks to me as if this ‘substantial number of complaints’ are my ‘missing’ complaints.

They go onto say:

These, together with other systemic failures, have led the GCC to conclude that its internal office procedures require substantial improvement.

Was it just a series of clerical errors? Was it a cover up? How long have they known? Was it my email that prompted them to go away and count them or did they already know they were short?

But when did they realise the numbers didn’t add up? They said they had been conducting a ‘thorough review’ over the last year.

The draft minutes of their Council meeting on 26 January, published a few days ago with the open agenda for their meeting on 29 March, may shed some light on this:

So, even in January, the Council were being told the complaints were at an end.

Their closed agenda for the same meeting may give a little clue that they were then aware of problems:

So the question remains: did they uncover the failures by themselves or did my email, asking for the numbers, prompt them to start counting? Or did they realise they had been found out?

Watching the watchers

The Council for Healthcare Regulatory Excellence are the body charged with overseeing the GCC and other statutory health regulators:

We check how well the health professional regulators carry out their work

Every year we carry out a performance review of each regulator. We look at how the regulators carry out their functions against agreed standards. We highlight good practice and identify issues that might benefit from a co-ordinated approach.

What have they been doing while the GCC have been failing?

Well, other than making a few minor suggestions for improvement, giving the GCC a clean bill of health.

In their Audit of the General Chiropractic Council’s initial stages fitness to practise process, published only four months ago, they say:

We consider that the cases we reviewed demonstrate that the GCC has been thorough and proportionate in investigating complaints made about its registrants’ fitness to practise. We concluded that the Investigating Committee’s decisions were consistently detailed and well reasoned. We found evidence of excellent record keeping and regular communication with the parties, including sending informative and explanatory letters. This confirms the positive conclusions we reached in the last two years’ audits about the GCC’s handling of fitness to practise complaints.

How the CHRE, as the overseers of the GMC, the GDC and the other regulators, were not able to spot the systemic failures in one small regulator is anyone’s guess, but the whole system has been shown to be an utter shambles.

The question now is: how are they going to extricate themselves from this fiasco?

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