UK General Medical Council Told Docs “Commit Fraud for MMR Vaccine Bonuses”

The UK’s General Medical Council issued formal written advice to UK medical doctors to commit fraud on the UK’s National Health Service for personal financial gain: “Target Payments for Preventive Health Measures” which asked and answered the question “Can GPs remove some children from their lists, temporarily, for the purpose of calculating the MMR target payment?” [full quotes below].

If UK doctors met target levels for vaccinations they qualified for bonus payments.  One way of claiming was to make a false return.  The GMC’s advice was for doctors to file false returns of the numbers of patients who had received the MMR vaccine.  Doctors were advised to take unvaccinated child patients off the patient list temporarily to claim the bonuses but also to ensure the parent agreed, [thereby implicating parents in the fraud].

The GMC is the UK statutory body established to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine by medical doctors.  Dishonesty, financial impropriety and fraud fall within its purview [in more ways than one it would seem].

This is the same organisation which recently found Professors Walker-Smith, Simon Murch and Dr Andrew Wakefield guilty of numerous charges filed by Sunday Times’ journalist Brian Deer.  No parent complained and the doctors enjoy wide support amongst parents of many autistic children they did their best to help.  Other doctors who have refused to toe the UK’s Department of Health line on medical practice have found themselves facing or threatened with proceedings by the GMC including amongst many others these four cases: UK’s GMC, Dr Jayne Donegan’s Story, Vaccines & MMR – – Dr Sarah Myhill – – Dr Peter Mansfield – –  Dr. Barry Durrant-Peatfield.

So if it concerns getting MMR vaccine uptake up to help the drug industry, fraud is fine.  But make sure you implicate the parents and what better way to do that than to pressure them into agreeing their children become temporary patients possibly for emergency treatment only or else be dumped from the patient roster completely. But if you raise valid concerns about the safety of vaccinations watch out.

What should the GMC have said?  The GMC should have given a clear lead to doctors and should have said [but did not] that temporary removals of child patients from a GP’s roster is never an option because it is neither ethical nor honest  and that such bonus payments created a conflict of interest between the doctor’s financial gain and the welfare of the child patient.

The GMC is independent (allegedly) of the NHS and of Government but in practice is run and controlled by the UK medical heirarchy and paid for by the medical profession.  Where the GMC finds that a doctor is not fit to practise, it has legal power to erase that doctor’s name from the medical register, to suspend the doctor from the register or to place conditions on the doctor’s practice. These restrictions apply to practice in any sector of employment in any part of the UK.

The GMC has a great notoriety in the UK with frequent calls for it to be abolished, suggested legislative threats: “Minister to look again at NHS bill’s threat to GMC” British Medical Journal: 1999 February 20; 318(7182): 482 and has attracted critical analysis of its decisions including in peer reviewed journal papers:

The Intimidation of British Pediatricians” Carole Jenny Pediatrics, Apr 2007; 119: 797 – 799.

“United Kingdom General Medical Council Fails Child Protection” Catherine Williams Pediatrics, Apr 2007; 119: 800 – 802;

“Meadow, Southall, and the General Medical Council of the United Kingdom” David L. Chadwick, Henry F. Krous, and Desmond K. Runyan Pediatrics, Jun 2006; 117: 2247 – 2251;

It is a criminal offence in England to aid abet, counsel or procure the commission of a criminal offence – such as obtaining pecuniary advantage by deception.

The GMC Formal Advice to Doctors to Commit Fraud

The GMC posed the question “Can GPs remove some children from their lists, temporarily, for the purpose of calculating the MMR target payment?” in an article entitled “Target Payments for Preventive Health Measures” first published in GMC News in June 2003.

And the GMC’s answer was effectively “it’s OK provided you have patient consent“.  It seems it also happens to be OK if it helps to increase the MMR uptake figures.  The advice was not offered for other vaccinations.

The GMC also failed to make mention of the financial and moral impropriety of doing so in their answer to the question they themselves posed:-

This must not be done without the parents’ agreement. Parents must be given a full explanation of what was proposed and why, their child’s rights as an NHS patient, and the implications for their child’s future care. Doctors working within the NHS must treat all patients entitled to NHS services on an equal footing. So temporarily removing a child from a GPs list must not adversely affect their care, for example in accessing secondary care and out-of-hours services, or in providing relevant information to ensure continuity of care and allow effective working with other agencies. Doctors must act honestly in their financial dealings. So GPs must ensure that any arrangement to remove a child from their list and re-register them for ‘immediately necessary treatment’, or on some other basis, would be in line with their contractual obligations to the NHS.“

So provided the doctor does what the GMC advises and ensures “that any arrangement … would be in line with their contractual obligations to the NHS” it is fine as “Doctors must act honestly in their financial dealings“.

All this is of course barking mad.

The GMC also advised that if the evidence is available this is not contrary to GMC guidance on good medical practice:-

“Are temporary removals from a GPs list acceptable to the GMC? In the absence of evidence that ‘temporary removals’ satisfy the concerns outlined at Q5, we cannot give any reassurance that such arrangements would be seen as consistent with our guidance on good practice.“

The conflict with the GMC’s other advice is clear.  The GMC advised UK doctors “must not ask for or accept any inducement, gift or hospitality which may affect or be seen to affect the way you prescribe for, treat or refer patients.“: Conflicts of interest – guidance for doctors

But it seems the GMC do not mind when it comes to MMR, even where the inducement is so strong it encourages fraud on the NHS.  But then, the GMC did not seem to mind about that either.

Ironically  “GMC Today” newsletter carried a story titled “Is the NHS immune to fraud?” [Oct 2005] about reducing and reporting fraud in the National Health Service, stating:-

Most people who work in and use the NHS are honest, but there is a minority that tries to defraud it of its valuable resources. By working to reduce fraud and corruption to an absolute minimum and hold it there permanently, the NHS CFSMS can release these resources for better patient care. In the largest organisation in Europe, even a small proportion of fraudulent staff and patients has a huge impact. Fraud is committed by a range of NHS professionals, who might claim for work not undertaken, alter prescriptions, create ghost patients or make fraudulent claims for out of hours visits, advice not given or treatment not provided. In some areas, claims by NHS professionals fell by between 43% and 54% after processes were fraud-proofed.

It is now accepted that even the NHS is not immune to fraud.

The GMC has an agreement on cooperating and coordinating with the NHS Counter Fraud service.  The story gave a number to call the confidential NHS Fraud and Corruption Reporting Line and an email address too.  It reports:-

“If you have a concern about a fraud taking place within the NHS, please call the confidential NHS Fraud and Corruption Reporting Line on 0800 028 40 60. All calls will be dealt with by trained staff and professionally investigated. Lines are open Monday to Friday 8 am–6 pm. You can also email us at nhsfraud@cfsms.nhs.uk at any time.” Memorandum of Understanding between the General Medical Council (GMC) and the National Health Service Counter Fraud Service (NHS CFS)

We had not got the heart to tell ’em.  Would you?

When Was This?

When this news was published by The OneClickGroup in October 2007 the GMC’s response was to claim the advice was withdrawn in 2006.  But the fact the advice was published at all is damning.  Not only that, the advice continued to be published on the GMC website as late as 7th October 2007 with no indication to doctors it had been withdrawn.

After The OneClickGroup’s exposée the GMC removed the page containing the advice from its website and republished the advice but with a banner across it claiming “Withdrawn November 2006”: Target Payments for Preventive Health Measures.

Additionally, the advice was published for over 4 years from June 2003 until October 2007 [just about the time the GMC was ready to attack Wakefield, Walker-Smith and Murch].

Who Ran The GMC Then?

The President when the advice was first published until 2009 was Sir Graeme Catto – also incumbent when the GMC started the proceedings against Walker-Smith, Murch and Wakefield.

So it just goes to show, you cannot trust anyone in “authority” these days.

Anyone wanting to make a complaint to the GMC?  Here is where you do it:-

Making a complaint

But don’t hold your breath waiting.

Sir Graeme’s email address and contact details at The University of Aberdeen are found here:-

http://vcs.abdn.ac.uk/medicine_therapeutics/staff/SirGraemeCatto.shtml

[But probably not for much longer!]