Bloodless Revolution 2017

“This type of action on a large scale is capable of moving mountains. First it creates the idea that the public is aware of the recipient and their position and action or lack of it Two it creates stress as they decide how to respond even if it is a fob off or silence. Three it educates because many of these people believe their own little world. Four PA’s and Secretaries also see it and may be more receptive than their boss - hence the truth spreads. All of this creates cracks which multiplied across many people breaks the rock.

Brian Gerrish

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DUTY OF CANDOUR




“Candour is the quality of being open and honest in dealings with other people. It embraces frankness, truthfulness, sincerity, directness, straightforwardness and the avoidance of deception and covert behaviour. Transparency is another word used to capture the values embodied in candidness/candour, meaning that nothing is hidden from view.”


So begins a 12-page document “Duty of Candour Handout” by the Dental Protection [1]. One would think it was describing Common Law! And of course, it is. A Duty of Candour is the natural stream flowing from the upholding of Common Law. If we are all equal under the Law, we are entitled to be treated by others as they would like to be treated by us.


Since November 2014 a statutory Duty of Candour has been introduced in England [2]. It is being recognised as a massive step forward (from the previous Memorandum of Understanding – no duty of candour!) but far from perfect. Bristol Royal Children’s Hospital, one latest scandal bears testimony to that.


The operation of Duty of Candour in Public Office is a random matter, and where it fails, varies in its lack of application. We may agree that not every nurse/ doctor/ surgeon/ police officer/ judge etc is guilty of the crimes/ deceit/ lies etc we are witnessing, but to our great shame there are numerous examples of the absence of a duty of candour in hospitals [3], police stations, prisons, court rooms, children’s homes, and every place acknowledged as a Public Office or Institution. Chief Executives of a Hospital who withhold vital evidence of a death or injury, the Coroner who deliberately selects witnesses to avoid exposure of a Hospital error, the Police who collude to cover a colleague or another official, and the medic who refuses to speak up against the wrongs of another medic, are sorry examples of a lack of Duty of Candour.


If the training of each individual in Public Office began with instruction in Duty of Candour (for few have heard of or considered its relevance in their relationship with those they serve) and were made aware of the dire consequences of unconformity with such a Duty, many terrible occurrences would be avoided. A vitally needed change of culture would emerge. With specific regard to the NHS, this has been the desire expressed by those MPs and Lords and Ladies of the House of Lords who took part in Debates in the two Houses [4].


Meanwhile, in the NHS, because of the established arrangement between doctors and the GMC, despite the new laudable publication “When things go wrong – The professional duty of candour”, the conversation held between the medic and the damaged patient is based on the superior attitude which the doctor takes [5]. The patient, he or she is trained to believe, is unable to understand the complexities of modern medicine; the patient does not possess the doctor’s standard of education in medical matters...


The doctor submits a report to the GMC which then engages with the medic – in secret! The Government has sanctioned a self-regulatory system for the Medical Profession, which makes them behave as being above the Law. Patients or families of patients affected by medical wrongs should demand in the spirit of openness and transparency, the Report which the doctor has sent to the GMC.


A fully operational statutory personal Duty of Candour within the Health Services in accordance with the new law would greatly reduce the medical condition known as iatrogenesis and the way the results of it are handled. “iatro”: physician or medical treatment + “genesis”: creation, origination, describes any injury or illness that occurs because of medical care; a disease or death caused by medical intervention [6]. Multi-millionaire artist Andy Warhol died of it at only 58!


A fully operational statutory personal Duty of Candour within all Public Officialdom would negate the attitudes of superiority supported by Darwinist and Orwellian principles, Freemasonry and Common Purpose, and return us to the purity and openness of Common Law – do no harm, cause no loss, commit no fraud..!



1. http://www.orthowise.com/assets/handout---duty-of-candour.pdf

2. http://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-20-duty-candour#guidance

3. Daily Mail’s MailOnline article by Jane Feinmann, 1st April 2014. Robbie Powell.

  • Bristol Royal Infirmary, baby heart surgery, 1984 – 1995
  • Liverpool Alder Hey babies’ organs harvesting, 1988 – 1995
  • Mid-Staffs Hospital, deaths due to poor care, 2005 – 2009

4. https://hansard.parliament.uk/Lords/2011-11-07/debates/1111075000471/HealthAndSocialCareBill#contribution-1111075000239

https://publications.parliament.uk/pa/cm201011/cmhansrd/cm101201/halltext/101201h0001.htm

5. http://www.gmc-uk.org/guidance/ethical_guidance/27233.asp

6. http://www.healingtherapies.info/Iatrogenesis.htm


Dear (Rt Hon / Mr etc) [Name] MP,


It is a matter of great concern to me that the current “Statutory Duty of Candour”, in place since November 2014, does not address the issue of personal responsibility when something goes wrong in the NHS. The individual who has caused harm or death to the one in his or her care should act under Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.


However, in practical terms, the medic considers him or herself to have medical knowledge beyond the comprehension of the patient or the patient’s representative. The medic submits a report to the GMC, detailing the problem and the GMC makes contact. The conversation is secret and the report is not shared with the patient or representative. This results in nothing! Because Governments have allowed the Medical Profession to operate a self-regulatory system it allows members to stick together so that nobody can, by law, question their conclusions or sanctions.


In the event that you might not be familiar with the term “Duty of Candour”, may I draw your attention to two Debates in Parliament, one in the House of Commons, the other in the House of Lords? The Commons airing of “no duty of candour” was an Adjournment Debate on 1st December, 2010 brought by Mr Robert Syms MP (Poole); the Lords debate was called “Amendment 20” brought by Baroness Masham of Ilton on 11th November 2011. Both may be located online through the Parliamentary websites.


Despite many impassioned stories of great distress from the constituents of the Members of Parliament and the experience and knowledge of the Lords and Ladies, all we have is a ragged safety-net whereby only the “Body” – in effect, the “Building” in which the error or harm occurred – need offer an apology. The individual is free to continue unabated, covered by the agreement as stated above.


The current situation makes the 2014 “Statutory Duty of Candour” a farce, and a cruel contradiction of the admirable Principles of Common Law of “Do No Harm”. Honesty and Transparency are the backbone of Candour, and I firmly believe that the establishment of such openness in the behaviour of every employee of every rank in Public Office would lead to better practice, higher standards and an increase in trust.


As my representative in Parliament, I request your gracious response to my call for further Parliament Debate and Decision to establish a Statutory Personal Duty of Candour which shall be binding upon all in Public Office from trainee stage to full professional status.


Until such a Duty of Candour with personal responsibility is in place, the culture of cover-up, deception and amendments of medical records such as we have seen in Mid-Staffs, Bristol Royal Infirmary, Liverpool Alder Hey and more recently, Bristol Royal Children’s Hospital (2015) will certainly continue.


Yours sincerely,


Name

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