Month: September 2016

Case law simplified

Case law simplified

The study of law is like eating an elephant. The best way to do it is one bite at a time.
–  anon

We’ve all heard the phrase “information overload.”.   Trying to categorise the case law concerning Injury Awards is a mammoth sized example.

How can you tell whether the large mammal of a court transcript is the one in the room that you need, uselessly white or of the delirium-induced hallucinated pink variety?

What do you do when there are too many elephants on your plate and it’s becoming overwhelming? Packing all elephant related analogies into the trunk (for now, at least), we’ve made the first known attempt to group related injury award High court decisions together.

WiseMapping is a free online mind mapping program that anyone can use for
brainstorming ideas. We’ve used it to try and map together all the decisions so you can focus on the ones that matter.
*Edit. You might see a broken link below as the wisemapping security certificate may be invalid on some browsers. As we get this fixed pleae view the PDF version at the bottom of this page

Use the cross-hair to move the map.  Click the attachment ‘paper clip’.  And then click in the thumbnail box to open the court transcript in another window.

wisemap

We’ve put the map on the caselaw RSS feed for your convenience.

If you’ve noticed a relationship that we’ve missed, please leave a comment below.
case-law

 

Battle of the ALAMA

Battle of the ALAMA

“I am at liberty to vote as my conscience and judgement dictates to be right, without the yoke of any party on me… Look at my arms, you will find no party hand-cuff on them. ”
David Crockett

In 1835, Mexican President Antonio Lopez de Santa Anna (1794-1876) threw out the nation’s constitution and made himself dictator.  Many Americans in Texas, as well as Tejanos (Mexicans in Texas), hated this blow to their liberty and the growing tensions between Mexico and Texas erupted into violence when Mexican soldiers attempted to disarm the people of Gonzales, igniting the Texan war for independence. Like other states discontented with the central Mexican authorities, the Texas department of the Mexican state of Coahuila y Tejas rebelled in late 1835 and declared itself independent on 2 March 1836.

The Battle of the Alamo (February 23 – March 6, 1836) was a pivotal event in the Texas Revolution. Mexican troops under President General Santa Anna attacked the Alamo Mission near modern-day San Antonio, Texas, United States, killing all of the Texian defenders, one of whom was the famous Davy Crockett.

In an ironic twist of events, Santa Anna had fought for Mexico’s independence from Spain, only to decide to crush the independence desired by the people of Texas.

The Texas revolution finally ended at the battle of San Jacinto on April 21, 1836. It had been an uprising in defence of liberty.

Santa Anna shared a characteristic common to many other dictators. He was as contemptuous of the views, and rights, of the people of Mexico as he was towards the Texians. In 1824 Santa Anna gave his opinion as, ‘A hundred years to come my people will not be fit for liberty. They do not know what it is, unenlightened as they are, and under the influence of a Catholic clergy, a despotism is the proper government for them, but there is no reason why it should not be a wise and virtuous one.

In 2016, a senior representative of an organisation named the ALAMA, which boasts a membership of just 300 occupational health doctors, seems to have experienced a fit of pique. He lobbied the GMC in an attempt to get it to change its rules so as to exclude a certain class of people from the principles of confidentiality and respect for patients’ privacy that all doctors are expected to understand and follow. That class of people was disabled former police officers.

The ALAMA representative wished to prevent them from exercising their right to see a copy of any report written by a SMP before it is sent in to the commissioning authority. He wished to see disabled former police officers also lose their right to withdraw their permission for any such report to be sent in should they find fault with it. (See the guidance on line at http://www.gmc-uk.org/guidance/ethical_guidance/confidentiality_contents.asp)

The lobbyist was Dr Bulpitt, who is Force Medical Advisor for Avon and Somerset Constabulary. He is is the official police representative of ALAMA –  the Association of Local Authority Medical Advisors. He is no Santa Anna, but from him there emanates more than a whiff of the characteristics which distinguish dictators. His approach to the GMC demonstrates that he is contemptuous of the considered democratic view of the eminent GMC, which sets the standards which the more than 281,000 doctors registered with the GMC are required to follow. We are also suspicious that his lobbying was a personal campaign, and does not truly reflect the views of the members of ALAMA.

In ALAMA’s name, Dr Bulpitt has discarded the self evident truth that the GMC guidance follows legislation and complies with legislation. He fails to see that when the law isn’t applied to some, it doesn’t apply to any.

But is it the position of ALAMA, or the views of one man?  We can’t tell if it is the organisation as a whole which is intent on destroying the rights of disabled former police officers, or whether Bulpitt’s lobbying is an example of an individual unilaterally abusing his position within ALAMA to perform some sort of ‘Game of Thrones’ politics of power play.  

Dr David Bulpitt’s position and influence within this small organisation does not just have local consequences within Avon and Somerset. ALAMA represents many of the doctors who work as SMPs across the country. Should Dr Bulpitt’s views sway the GMC to amend its guidance, then that will affect every injury award review and injury award application nationwide.

Unlike Davy Crockett, who solely relied on his conscience and judgement, this particular doctor has the yoke of best practice defined by a regulatory body to adhere to –  best practice that he wants to have the ability to choose when to park aside and who and when to exempt, to suit his own agenda.

ALAMA was founded after a conference on inhalation hazards in Firemen held in Edinburgh in March 1979. In April 1980 a follow-up meeting for local authority doctors in Manchester saw the start of an ALAMA steering committee.

The declared aims of the Association were to hold an annual meeting, to develop some kind of link with the Society of Occupational Medicine, the Faculty of Occupational Medicine and the British Medical Association.

Plainly, its founding aims were not to lobby the GMC to discriminate against certain cohort of people! So, what is the exact lobbying we are talking about?

The GMC are currently reviewing their 2009 Confidentiality guidance – making sure it is “relevant to doctors’ needs and to be compatible with the law throughout the UK.”  The public consultation on the revised draft of the guidance on confidentiality closed on the 19 February 2016.

In January 2016, almost three months after he had professed to the Home Office that he had already contacted the GMC, Dr Bulpitt used ALAMA headed notepaper to belatedly write to that organisation.

bulpitt-gmc-disclosure-28012016
(select and use arrows bottom left to navigate pages)

Within his letter he compared the right of certain specified members of the public – who happen to be people retired from the police service – to withdraw consent for medical reports (under the Access to Medical Reports Act) to being synonymous to condoning a repeat of the 2014 Glasgow bus catastrophe that killed six and injured fifteen others.

Just like the Tejanos in 1835, we are understandably appalled at the attack upon our liberty. Such purging of protection under the law for chosen targets leads inevitably to greater and greater abuses and more and more destruction of rights. This process was aptly chronicled by  Martin Niemöller … to misquote this pastor, “First they came … for the people with disabilities. And I did not speak out because I did not have a disability”.

Dr Bulpitt sets his scene by first constructing a diversionary straw-man argument. Ignoring the contentious and unlawful mass review programs instigated by a minority of police pension authorities to reduce their ‘financial exposure’ to the cost of police injury on duty pensions, the doctor starts with smoke and mirrors by saying the OHP (occupational health practitioner, in other words the SMP) is only concerned with the fitness to work, in an attempt to sway the GMC Assistant Director for Standards & Ethics away from his true agenda.

Why let the truth get in the way of a good yarn? That his lobbying has no basis in fitness to work, dealing as it does with the destruction of the rights of people pensioned off from the police service, doesn’t cause Dr Bulpitt to see the irrelevance in his narrative.

Clinical Information obtained and recorded by OHPs, especially during a one off assessment, is exclusively for the purpose of advising employee and employer on fitness for work.  Therefore the consent to request this information is made in that context. Clinical  information is not obtained to provide clinical care and therefore the basis of the consent to  request it is quite different from Drs who provide clinical care.

According to the Introductory Memorandum to The Police (Injury Benefit) Regulations 2006  the Police injury awards do not depend on membership of the Police Pension Scheme, but are in effect compensation for work-related injuries (the degree of disablement in relation to capacity to earn).

Continuing to omit things which irritatingly do not tally with his story, Dr Bulpitt fails to say that a great many SMP’s have in fact become of late a pale shadow of the independent and impartial decision-makers which they are required to be in law.  He leaves out the inconvenient fact that he regularly demands clinical information including full medical records since birth; expunges from his lobbying of the GMC the information that the occupational health unit almost always did provide clinical care to the injured police officer whilst injured and still in service.

Apparently, in Dr Bulpitt’s version of the parliamentary process, it is only civil servants in the Home Office that ‘sets down’ legislation, conveniently forgetting the role of the Houses of Commons and Lords.

The Police Pension Scheme serves as a particular example of where clarity is urgently needed as to whether additional consent is necessary once an individual has requested their employer to enter them into the process for health assessment, and consideration for payment related to ill health. At present GMC guidance appears to sit uncomfortably with the Regulations for the Police Pension Scheme which are set down in Legislation via the Home Office.

Rather peculiarly, the official ALAMA representative’s letter goes from faux concern for Council employed drivers; Police Officers using Firearms; Teachers with responsibility for children, on directly to his real bugbear – the Police Pension Scheme.

Could it be that mention of other local authority aspects were just a diversionary tactic?  Is his real true agenda purely to convince the director of ethics that there is an imagined disconnect between GMC guidance and the Police Injury Benefit Regulations?

At present GMC guidance appears to sit uncomfortably with the  Regulations for the Police Pension Scheme which are set down in Legislation via the Home  Office.

IODPA would like to see evidence of where this proclaimed inconsistency lies. We believe there is no evidence. Dr Bulpitt chooses not to explain himself, and presents as fact something which is wide open to critical challenge. We believe that the current GMC guidance is based on a careful and rational analysis of the Regulations and of relevant court cases which have addressed the issues of confidentiality and consent in respect of reports commissioned by employers and pension scheme managers.

We have witnessed too many instances of reports written by SMPs which contained factual inaccuracies, incorrect application of the Regulations, and which exceeded the limitations of the brief of the SMP to see very readily why Dr Bulpitt wants these reports to be winged direct to the commissioning authority without scrutiny.

He fears that injury on duty pensioners have finally become aware that their rights under the law, and under GMC’s guidance, have consistently and widely been denied. He fears that a high percentage of reports will be subjected to withdrawal of consent and will not land on the desks of HR managers. His ambition to manipulate the Regulations so as to effect reductions of pension payments would be thwarted.

His letter to the GMC exposes very clearly that this doctor has only the wishes of his paymasters in mind, and cares nothing about the health and well being of disabled former police officers, nor cares anything for their right to continue to receive the level of pension their injuries deserve.

Current GMC guidance requires that the patient is offered a copy of the OHP’s report about  them before it is sent. Many Drs consider that the guidance leaves ambiguous whether the  patient is then able to withdraw consent at that point and thus prevent release of the report  to whoever commissioned it.

We would like to request that the GMC consider an additional section in future guidance
advising Drs and patients specifically for situations where health assessments are requested  by third parties from specialist OHPs and which particularly recognises the impartial role of  OHPs making clinical assessments generally and especially in
The context of Health and Safety Legislation.
• When instructed in accordance with the terms of insurance typically in a Pension
Scheme
• When instructed under Regulations set down under legislation e.g. by Home Office

In their reply the GMC calmly proclaims that Dr Bulpitt’s grotequese bus tragedy analogy is already covered by the guidance and the exception Dr Bulpitt demands is given short-shrift.

Our understanding is that patients are entitled to withdraw consent for a  report to be disclosed to a third party unless there is legal requirement to disclose the information, or disclosure can  be justified in the public interest (for example, because failure to disclose the information could leave others at a  risk of death or serious harm).

So what can the ALAMA learn about the Alamo?

After he defeated the rebels at the Battle of the Alamo, President General Santa Anna unwisely divided his forces, allowing Sam Houston to surprise him at the Battle of San Jacinto.  Santa Anna was captured and forced to negotiate with the Mexican government for recognition of Texas’ independence and sign papers saying he recognised the Republic of Texas. He returned to Mexico in disgrace and retired to his hacienda. The people of Texas fought on for freedom and, eventually, on December 29, 1845, Congress admitted Texas to the U.S. as a constituent state of the Union.

Perhaps members of ALAMA will think it wise to consider how this particular representative is behaving and see fit to distance themselves from his lobbying techniques. The majority of conscientious and hard-working occupational clinicians do not deserve to have their ethics sullied by the machinations of one doctor.

One of Crockett’s sayings, which were published in almanacs between 1835 and 1856, was: ‘Always be sure you are right, then go ahead’

Every time we observe the lengths some twisted minds go to subvert the rights of others, IODPA is reinforced that we are right to keep going ahead.

Survey Results – R.E.S.P.E.C.T.—why some doctors are not getting any

Survey Results – R.E.S.P.E.C.T.—why some doctors are not getting any

“R-E-S-P-E-C-T!!! Find out what it means to me”― Aretha Franklin

Our straw poll would never receive awards for being scientifically robust, but it provides an overview to the opinion of serving and retired officers towards those doctors (aka force medical advisors) employed by police forces – and that overview certainly seems to be at odds to how doctors are viewed by the public at large.

Generally in the United Kingdom, which has been hit by an unprecedented number of medical scandals and transgressions in recent years, doctors still top the polls as the most trustworthy and hardworking of all professionals.   An Ipsos MORI recent polling found that doctors were the most trusted profession, with 90 per cent of respondents trusting them to tell the truth. In contrast, just 16 per cent of respondents trusted politicians and 22 per cent trusted journalists to do likewise.

Our survey (for all it’s faults) had representation from all forces except Lincolnshire (perhaps there is Democratic People’s Republic of Lincolnshire that clamps down on Internet access and purposefully prevents its citizens from communicating with the outside world – or more likely maybe there isn’t an issue with ill-health retirements in this force, so there is no incentive for those to look at related social media).

Only 8% of respondents trust their force medical officer.

Do you trust your force medical adviser?

 

COUNT PERCENT
No 277 66%
Don’t know him/her 107 26%
Yes 34 8%

Strip out the ‘don’t knows’ and you can see the stark realism that 89% do not trust their force doctor.

rplot-yesno-survey

And what forces have least trust in the force doctor and mostly make up the blue “no’s”?rplot-no-surveyAnd those with the most trust in the force doctor?  Due to the low numbers we can show all 34 votes and the vote’s corresponding force individually.

rplot-yes-survey

What this all suggests is that police officers at their most vulnerable have no faith in some of these occupational health doctors.

Those clinicians tasked with duties such as promoting healthcare policies and initiatives and advice on medical, health and welfare matters, are neglecting their core duty – to care for people.

There is no sane reason why force medical officers should not have the same high satisfaction rates as their peers in other specialities.  However, it seems some have misplaced loyalties to the pleasing of the employer and not the patient or  to the furthering of medical excellence.

When they are needed most they are causing deep pain and prolonged suffering . With notable exceptions, some are no longer regarded as the paternalistic figures they once were, but rather as a technical bureaucrat or a gatekeeper with an over-riding deigned reluctance – who begrudges having to deal with those police officers the Job has injured, discarded, disabled and defeated.

do-you-trust-your-force-medica-survey-results-_-polldaddy

PMQs. Parliament Recognises the purpose of Injury Awards

PMQs.  Parliament Recognises the purpose of Injury Awards

Let us hope that the recently injured police constable, stabbed in the back several times while attempting to arrest a rape suspect, not only recovers quickly without any long-term physical or psychological after-affects but will not have the misfortune to come across the self-styled Medical Retirement Officer (MRO) of Merseyside Police.

This MRO, a retired Chief Inspector named Peter Owens, has often stabbed medically retired officers in the back by unlawfully reducing or removing their injury awards.

Parliament has long understood the reason why injury awards exist the way they do.  Back in 1978 another injured officer from Liverpool was discussed in the House of Commons.

HoC debate 15 December 1978

Mr. Anthony Steen (Liverpool, Wavertree):My principal task this afternoon is to consider the plight of one young policeman, which illustrates the problem well. It concerns ex-police constable Turner, who lives in Liverpool and who was living in my constituency.

In 1974, at the age of 25, after six years in the force, he was on duty in Liverpool, standing on the pavement, when he saw a stolen car being driven towards him, pursued by a police vehicle with a blue flashing light. He was about to throw his truncheon through the windscreen of the car when it swerved and drove right at him, mowing him down.

ask the Minister to see established the principle that those who protect the public should not be penalised if injured in the course of duty when such duty involves danger to their own life

 

The Under-Secretary of State for the Home Department (Dr. Shirley Summer-skill): A police pension is not reduced on account of any pay received from civilian employment. The combination of Mr. Turner’s salary in his new civilian post and the pension received from the police service meant that Mr. Turner suffered no loss of salary because of his changed circumstances.

And in the present day …

PMQs – 14th September 2016

 If only those who administer injury awards had the same goodwill towards those injured on duty than the above Members of Parliament.

Henderson’s Precedent

Henderson’s Precedent

Don’t use the conduct of a fool as a precedent
The Talmud.

Sometimes you read a decision handed down by an authority and are so appalled by the maladministration which is revealed by the light of justice in action that you miss the obvious.

The 2011 Pension Ombudsman’s decision in Mr Henderson’s complaint is one such example. North Yorkshire Police Authority (NYPA) had foisted upon this poor medically retired police officer a level of injustice concerning his pension such that anyone with a grain of common sense would have recognised as the actions of fools.

(Note that, in another example of foolishness, when the old Police Authorities were scrapped, the Government decided that each Chief Constable should be the police pension authority. In other words, they now not only are the injury pension scheme managers, but are also supposed to be their own oversight agency. Given that many of them have not a clue about the Regulations, and nor do their so-called professional HR people, it is no wonder that NYPA could make such an almighty cock-up – and then not even have the good grace to put things right without the need for the directions of the Pensions Ombudsman.)

Download: Mr M Henderson V North Yorkshire Police Authority (NYP)
View:
(if it fails to open in google docs, try again.  It will work eventually!
Mr M Henderson V North Yorkshire Police Authority (NYP)

Mr Henderson was retired in 1991, following an assessment by a Dr Givans of permanent disability caused by,

‘. . . problems [that] consist of pain and stiffness in the left knee and right hip with associated weakness of the legs’.

He was awarded an injury pension on band four – the highest level, which is described in the Regulations as, ‘very severe disablement.’

Mr Henderson’s degree of disablement was reviewed in 1993, when it was decided there was no change to his circumstances.  Some fourteen years passed, during which time Mr Henderson struggled on with no ability to work and earn, then, in 2007 he was reviewed for a second time. NYPA performed a complete reversal from the 1993 review and this time, for reasons unknown, thought he could be a personal security co-ordinator, a scrutiny officer or a rent recovery officer.  This is someone who had been a band four for 16 years.

His injury pension was reduced by NYPA from a band four to a band two. We can only imagine the huge shock and upset this must have caused the poor man, who had never been fit to work since leaving the police.

He appealed, but, amazingly, the PMAB magnified his torture by reducing him further from a band two to a 0% band one.  The (cough) ‘wisdom’ of the PMAB was they thought Mr Henderson’s right hip problem was not related to the injury on duty.

So far, so bad.

Mr Henderson turned to the Pensions Ombudsman for some sane insight into the situation.

Fortunately, (and inevitably) the PO upheld Mr Henderson’s complaint and found against both the PMAB and NYPA. The PO directed that North Yorkshire Police Authority had to refer Mr Henderson’s case back to the PMAB for review and to make it clear to the PMAB what it was to consider.

The PO concluded that:

‘[NYPA had unlawfully] invited the PMAB to reconsider the original decision and expressed its concerns about Dr Givans’ decision’

As readers of our pages will know, it is, and always has been, unlawful to revisit any final decision on the cause of disablement when conducting a review of degree of disablement. NYPA and the PMAB were apparently blithely unaware of this. So much for professionalism. Or is it that neither actually cared a damn, and just did what they wanted to do, regardless of the law?

Before we jump ahead and talk about an important implication of the PO’s decision, we need to have a crash course about some legalese.  Hold on though as the punchline will be worth it.

The legal doctrine of precedent has a Latin term: stare decisis – ‘standing of previous decisions’ as the legal principle of determining points in litigation according to precedent.  It means that Judges must follow past decisions to ensure certainty.

William Blackstone (English jurist, judge and Tory politician of the eighteenth century) opined that judges do not create or change laws. The law has always been that way and the Judge’s role is to discover and declare the true meaning.  Since it is discovered by the Judge that the law has always existed in the way he or she rules then this means that case law operates retrospectively.

There is a hierarchy of precedent that starts from the Supreme Court, goes down through the Court of Appeal, High Court, Crown Court, County Court all the way to Magistrates and tribunals.

Obiter dictum translates to “said in passing” and this exists in the doctrine of precedent covering decisions by legal authority lower in the hierarchy than the Courts themselves.

In legal-speak the Pension Ombudsman is a ‘persuasive authority’.  In plain language this means that, although a PO decision is final and binding on both parties (and an appeal of a determination of the Pensions Ombudsman can only be lodged at the High Court on points of law or questions of fact), the decision does not set a definitive precedent onto judgements made by a higher court.

But, as a persuasive authority, any given PO decision is one which any higher the court can, and will, consider and may be persuaded by it.

It is also a decision which any police pension authority, and any PMAB ought to take due notice of, as to act contrary to it is sure to attract challenge and appeal.

Now we have talked about the persuasive precedent of the PO, let us return to the decision made in Mr Henderson’s case.

In the conclusion of the decision the Ombudsman stated this:

NYPA shall refer Mr Henderson’s case back to the PMAB for review and make it clear to the PMAB what it is to consider. NYPA shall restore Mr Henderson’s injury benefit to its previous rate until such time as a final decision is reached.

The PO decided the decision of the PMAB would be quashed.  It must be readdressed – this time correctly – and no reduction to rate of injury benefit shall occur until it is all over.

In other words, until there is finality – until all appeal avenues have been exhausted – the injury award of Mr Henderson must not be altered.

Persuasive precedent.

Bully boy tactics by civilian so-called medical retirement officers, director of resources or other such non-medical technocrats should please take very careful note of the PO’s conclusions in the Henderson case.

Such people have been known, with intent fuelled by self-interest, to casually make unlawful threats to disabled former officers of suspension of their injury award or punitive reduction to a band one.

These threats are made just because there is no capitulation to their wrongful orders for disclosure of medical records since birth or non-completion of an odious and irrelevant questionnaire asking for sensitive personal information which no PPA has a right to demand.

They need to be reminded that not only does Regulation 33 not apply in such circumstances (decision upon the available evidence if there is a failure to attend a medical examination), but the PO has made it very clear that any reduction in pension payment, whether made lawfully or not,  has to be suspended until all avenues of appeal are exhausted.

It rather takes the wind out the sails of their threat doesn’t it?

PPAs and their HR managers – and compliant (‘Show me the money’) SMPs should take note that if the sanction of reduction of pension has been performed without any medical evidence an appeal is clearly inevitable.

Taking the precedent to it’s logical conclusion, any punitive unlawful threat to ‘do this, or else!’ is meaningless.  All that is being achieved is to take the decision out of the hands of the police pension authority and into the remit of an appeal.  The reduction can not be enforced until the appeal process has finalised.

It seems to us in IODPA that the system is well and truly broken. Chief Constables and their staff lack the necessary expertise to understand the Regulations. In some areas, they see injury pensions as a drain on resources, so throw their PPA hat into the bin and clap on their ‘I’m concerned about the budget’ hat and set about scheming how they can manipulate the review process so as to reduce injury pensions.

PMABs, if anything, are worse. They are a panel of medical professionals whose knowledge of the Regulations is based on out of date Home Office guidance, which has no legal authority and which has been roundly discredited by the Courts. They struggle with the niceties of legal protocol. To them the rules of precedent are a dark pool into which they prefer not to venture.

So, PPAs, PMABs, HR types, SMPs and all the other acronymic twerps who are currently the bane of the lives of disabled former police officers continue to act according to their own vacuous precedents, rather than to legal precedent. They keep on repeating, and elaborating on, their own woeful mistakes.

They are truly fools, one and all.

 

 

 

 

Access to Medical Reports Act

Access to Medical Reports Act

“If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment.”Marcus Aurelius, Meditations

Here is an unsettling fact. It seems that most police force are aware of the Access To Medical Reports Act, but some chose not to comply with it.

The Access to Medical Reports Act 1988 (AMR Act) provides the right for people who have been medically assessed for insurance or employment purposes to withhold their consent for access to medical records, and also to see any report produced by the commissioned doctor before it is sent to the person or organisation who commissioned it.

This Act applies directly to the process of review of police injury pensions, as an injury award is a form of compensation (i.e. insurance) for injury on duty.

Here are extracts from two recently used consent forms, issued to IOD pensioners by two different forces, demanding agreement that the medical authority’s report shall go direct (or after a benevolent pause of three days!) to the Human Resource department:

From Avon and Somerset Constabulary:

consent
Avon & Som consent form

And from Northumbria Police:

np consent
Northumbria consent form

The forces who put out these manipulative psuedo-requests for consent will know all too well that there is legislation concerning the ‘provision of reports’. Why otherwise would they ask for ‘consent’ to release?  That said, everything is wrong about the demands asked of the signatory.  Both of these consent forms have but two options, each option which, with brazen shamelessness, breaches the Access to Medical Reports Act.

It is in fact illegal to release the report simultaneously to both the recipient and the third party, in this case the police pension authority.  It is also unlawful to demand a three ‘working day’ window to inspect the report.

Where a person is induced to enter into giving consent entirely or partly by a false assertion, such as not being truthful with the rights gifted to them by legislation and failing to provide understanding in broad terms the nature and purpose of the disclosure and the rights they have, then any misrepresentation of these elements will invalidate consent.

The insistence that the report cannot be changed is also contrary to the Access to Medical Reports Act.  Nowhere is the signatory explained their full rights.  The reason for this is clear – it is a plain attempt to blitzkrieg disabled former officers to ensure they yield to the will of the pension scheme manager; to force compliance with a bullying, superior force.

The AMR Act makes it crystal clear that consent to any report being released can be withdrawn without retribution.  If an individual being assessed is unhappy with any element of the report, and says so, then it is illegal for the doctor to release it to any third party, including the police pension authority.  In real-terms this means the review is over… stalemate.

Forces know this. We can only conclude that is why there is no mention of the Act in the consent form and that is why your rights are not explained.  Why give you an informed consent form when they can con you into forced acquiescence by saying you have 72 hours and the clock starts … now!

The basic points of the AMR Act can be summarised thus:

  • Section 3 of the Access to Medical Reports Act states that the person has to give his or her consent for their employer to be given access to their medical records.
  • Section 4 of the Act the doctor or medical practitioner must wait 21 days before sending the report to the employer.
  • An employer must obtain the person’s written consent which must then be provided to the doctor in order to be provided with access to the requisite report.
  • Under Section 5 of the Act a person can request the doctor to amend the report if they feel that it is incorrect or misleading.
  • An employee is entitled to withhold their consent for a report to be provided to an employer having been provided access to it under Section 4 of the Act.
  • Section 6 of the Act states that doctors will retain all reports requested by employers for six months

At this point we have to mention that the Police (Injury Benefit) Regulations 2006 require a police pension authority ‘refer for decision to a duly qualified medical practitioner selected by them . . . ‘ the relevant questions. At review, the relevant question is degree of disablement. Specifically whether there has been any alteration in degree of disablement. The Regulations also require,

30-(6) The decision of the selected medical practitioner on the question or questions referred to him under this regulation shall be expressed in the form of a report and shall, subject to regulations 31 and 32, be final.

30-(7) A copy of any such report shall be supplied to the person who is the subject of that report.

We can see, therefore, that the decision of the SMP must be in the form of a report. The SMP can not inform the police pension authority of his decision in any other way. So, no sneaky way round the Regulations or the AMR Act.

What happens if the doctor decides to release the report anyway?  Firstly they breach the Access to Medical Reports Act and a court order can be easily obtained to enforce the Act.  In effect this will nullify the report and any decision based upon it.  Secondly, the GMC will almost certainly punish the doctor for committing gross misconduct.  In all likelihood the doctor will be struck off.

Further, there will also have been a concurrent breach of the Data Protection Act.

As things stand in the strange alternative legal world view of Avon and Somerset and Northumbria, pensioners are being instructed to sign the consent form without seeing the report – in this case before they have even allowed access to their medical records. This is in no way seeking ‘informed’ consent. It is patently ridiculous to expect anyone to sign consent for the SMP to send in a report that has not yet been written, and has not been yet seen by the individual concerned.

The concept of consent arises from the ethical principle of patient autonomy and basic human rights.  You can not consent to release of a report that, at that time, is yet to come into being.

Informed consent must be preceded by disclosure of sufficient information – in relation to a medical report, the report has to be visible for consent to be formed. Consent can be challenged on the ground that adequate information has not been revealed to enable the patient to take a proper and knowledgeable decision.

Tellingly, in the police consent form, there is no mention at all of any of the rights provided under the Access to Medical Reports Act 1988 – there is no mention in the consent form of the Act itself.

The General Medical Council (GMC), the British Medical Association (BMA), and the Faculty of Occupational Medicine (FOM) have issued guidance on the law governing commissioned reports. They recognise there are protocols enshrined in law, and the guidance is a consequence of that law.

The Faculty of Occupational Medicine makes it clear in this document titled General medical council guidance on confidentiality (2009) and Occupational Physicians that it’s members have to comply with the guidance and ethics laid down by the GMC.

As quoted from this report, the GMC guidance –that confidentiality is a fundamental duty for all doctors and must not be breached without the consent of the individual concerned – strengthens the notion of “no surprises”:

… in the relationship between doctors and patients and because of cases reported to them where the content of a medical report deviated significantly from the patient’s understanding of what it would say.

In 2008 the FOM set their greatest minds to the task of examining whether Occupational Health doctors have to comply with the AMR Act.

An expert group was formed by FOM and this panel was chaired by Professor K Holland Elliott FFOM CMIOSH Barrister (non-practising).  The result was a published report titled “Guidance for Occupational Physicians on compliance with the  Access to Medical Reports Act” .

The main reason objective of the expert group was to  to “explain the legal basis of our practice and how this differs from mainstream medicine in relation to this Act”.

The default recommendation of the expert panel was that if the occupational health clinician is “responsible for the clinical care” of the patient then the Act applies at all times.

An important conclusion of the report was that if the occupational health clinician bases a report from medical notes obtained from a GP, hospital or consultant then the Act applies.

In paragraph 62, the group come across the Rubicon that is the question of consent – the barrier which no SMP or HR Department may cross without falling foul of the law: “The Act sets no limit on the time the individual may take to consent to the release of the report and so it may potentially be delayed indefinitely“.

The specific wording of that Act that they are referring to is this:

Where an individual has been given access to a report under section 4 above the report shall not be supplied in response to the application in question unless the individual has notified the medical practitioner that he consents to its being so supplied.

Pay close to attention to the highlighted text.  Consent can only be given once the individual has been given access to the report.

They concluded that they strongly agreed that, “An individual has a right of access to the medical report produced by the occupational health practitioner”.  

Also they strongly agreed with the statement that, “When an occupational health physician writes a report based upon medical records supplied by the GP or hospital, the occupational health physician needs consent to send the report”.

Dr Bulpitt of Avon & Somerset clearly understands the implications.  He said himself that if consent to disclose the report is withdrawn then,“we are in danger of the whole thing grinding to a halt”.

Remember that this isn’t the consent to obtain medical records in the first instance.  As we’ve mentioned, the consent concerning disclosure cannot cover the consent to release a report that is yet to exist.

Are you an employee of a police ‘inhuman remains’ (HR) department that still thinks that the Access To Medical Reports Act 1988 doesn’t apply to police injury awards?

Let us put your doubts to bed once and for all.  The British Medical Association (BMA) has a document titled “The Occupational Physician“.  It was authored by the BMA occupational medicine committee.

Chapter 11 Access to Medical Reports Act 1988
How the Act affects occupational physicians
Although the Act, for most practical purposes, applies to reports provided by an individual’s GP or hospital doctor, it also affects occupational physicians in the following circumstances:

  1. where an occupational physician provides clinical care to the employee (care is defined in the Act as including examination, investigation or diagnosis for the purposes of, or in connection with, any form of medical treatment)
  2. where an occupational physician has previously provided medical treatment or advice to an employee (in the context of a doctor/patient relationship) and therefore holds confidential information which could influence the subsequent report
  3. where an occupational physician acts as an employer’s agent, seeking clinical information from an individual’s GP or consultant. In this case the occupational physician, acting for the employer, should seek the employee’s consent to request a report and explain his/ her rights under the Act.

Often the occupational health record of a former police officer contains confidential information where the force medical officer has provided treatment or advice in attempt to get that person back to work – so this is (b) and is covered by the AMR Act.  Advice and/or treatment to get someone operational again should be the raison d’être of a police occupational health unit.

A report produced by an organisation’s own occupational health practitioner (or delegated agent) is covered by the AMR Act when the practitioner or predecessor has been involved in the employee’s treatment, even past treatment unrelated to the employee’s current medical condition.  How many serving, but injured, police officers prior to retirement were sent for MRI scans? Counselling? Private operations to speed recovery?  Referrals to rehabilitation centres?  This all amounts to clinical care.

The guidance from the GMC, BMA and FOM all coalesces into the single agreement that if a report is based from clinical information gained from the individual’s GP then this is (c), above, and is covered by the AMR Act.

Diana Kloss QC of St John’s Buildings Barristers’ Chambers published an article in the Occupational Medicine Journal (September 1st 2016) that covers this exact subject.  She touches upon the frustration felt by force medical officers such as Dr Bulpitt when she writes:

human resources and occupational health (OH) professionals are unhappy with the current guidance (under review) from the General Medical Council (GMC) that an OH report to management should be shown to the patient before it is sent and that they should be permitted at that stage to withdraw consent

She concludes that:

only when the employee is told what is in the OH report can he give valid consent to its disclosure to his employer…
Therefore, just as an employee can withdraw consent to disclosure of a GP report when he sees it (under the AMRA), so he can refuse to permit an [Occupational Physician] to send a report to management when he knows what it contains.

Somewhat playing to the intended audience of the journal, the QC mentions circumstances concerning the application of an ill health retirement in her article and makes a point that it is:

it is arguable that an [Occupational Physician] appointed to advise on an ill-health retirement pension may be considered to be in a position analogous to that of an expert witness especially when pension procedure is laid down in statutory regulations

But that argument has no relation to any medical report written from clinical information from an individual’s GP or consultant.  In any case, Diane Kloss herself makes it clear that even an expert witness can have consent to their report withdrawn. In Kapadia v London Borough Of Lambeth [1999] Dr Grime, a Registrar in the Department of Occupational Health and Safety at King’s College, refused to hand over his report on Mr Kapadia – that he undertook on the instructions of Lambeth – to the Borough’s counsel on the first morning of the hearing as no consent to do so was provided by Mr Kapadia.

In relation to police injury awards, such a medical report required by the Regulations is not written by an ‘expert witness‘, they are written by a suitably qualified medical practitioner – under the full jurisdiction of the GMC, FOM, BMA and AMR Act.  The applicant for an ill-heath retirement that withdraws disclosure just will be unable to prove to the police pension authority their entitlement to an injury award.  The ability to exercise consent can not be denied.

A review under Regulation 37 is also commenced with a demand for full access to all medical records held by the GP practice.  Notwithstanding the lack of any legal authority within the Regulations for asking for such information, any attempt to write a medical report on somebody without giving that person their statutory rights is scandalous.

And, if you’re wondering, why the distinction under the AMR Act between an occupational health doctor, not being a doctor responsible for the clinical care of the IOD pensioner, who writes a report from occupational notes, contrasted with the same doctor writing a report from medical information gleamed direct from GP and/or hospital notes?  The former is not compelled to comply with the AMR Act whereas the latter is under the remit of the AMR Act.

The answer shows the foresight of the legislators that penned the AMR Act.

No one in the UK is registered with a GP – they are registered with a GP practice.  There might a favourite GP there who you would prefer to see, or that nice doctor you saw since childhood may have recently retired.  You may have moved home recently and changed GP practices.  The GP practice may have amalgamated with a bigger, slicker more modern outfit.

The point is that a report written by a GP you have never met, from your comprehensive medical notes, who works at a GP practice which is responsible for your clinical care is no different from an occupational health clinician, who you don’t know, writing a similar report from the same medical files.

Neither ‘know you’, neither ‘have treated you’.  But the locum doctor working at an understaffed GP practice (a locum is a doctor who stands in temporarily for another doctor) that is tasked with the request from an insurer or employer to provide a medical report is put in exactly the same position as the selected medical practitioner:  a position whereby they must comply with the AMR Act.

This is why all reports based from medical records have to comply with the AMR Act.  And this is why you aren’t told of your rights.  People like Dr Bulpitt would prefer you not to know this.

Failure to properly advise IOD pensioners about the application of the AMR Act is a further deliberate misuse of the authority of a policing body.  The insidious and creeping behaviour of some public officials employed by the police undermining the rights of disabled former officer is stark.  The maladministration of injury awards is epidemic.

Until police bodies are held to account for deliberately attacking or neglecting legislation that have been set up to help protect our rights, the abuse will continue.

IODPA will always work to put an end to it.  If you have been to see a SMP and are not happy with the report (or felt the SMP performed a blatant and partisan interrogation), why not remove consent for that report to be released.   Be clear that the doctor’s licence to practice is at stake if he or she fails to comply.

Do not be browbeaten into compliance by threats of the legal services department that you have not complied.  Regulation 33 of the Police Injury Benefits Regulations only compels a medical examination and/or interview if the police pension authority has considered whether substantial change in degree of disablement exists and has decided there is enough evidence of that being the case to pass the same question, for decision, to the medical authority (negligent or wilful failure to attend said examination only permits a decision being made on the available evidence, attending satisfies this condition – subsequently withdrawing consent is a statutory right and is something else entirely).

You have control over who sees the report.  It is in your power to decide that no-one should see it.

Until you see a consent form such as this fully AMR Act compliant suggested example that we have created and the full AMR Act statutory framework explained separately,  explain to your force very clearly that you will not tolerate your rights being trampled upon:

This is a guide to your principal rights under the Access to Medical Reports Act, which is concerned with certain reports provided for employment or insurance purposes.  Your full statutory rights shall be provided in a separate document.  Potentially the occupational selected medical practitioner may have access to your patient record.  As a report, based upon medical records supplied by the GP or hospital, is being sought from the occupational selected medical practitioner and an evidence based judgement is asked for, then the Act applies even though the practitioner isn’t directly responsible for your clinical care.   This follows Faculty of Occupational Medicine  guidance. In line with GMC code of practice, you are a patient of the practitioner even though there is no traditional therapeutic relationship.
OPTION A

You wish to see the report before it is issued. The Selected Medical Practitioner will be informed and will not supply the report until you have seen and approved it. If the Medical Practitioner has not heard from you in 21 days, he will assume you approve and provide the report. When you see the report, if there is anything which you consider incorrect or misleading, you can request in writing that the Selected Medical Practitioner amends the report, but he may not agree to do so. In this situation you can:

  1. withdraw consent for the report to be issued
  2. ask the Medical Practitioner to attach to the report a statement from you giving your views.
  3. agree to the report being issued unchanged. The above will also apply if the Medical Practitioner declines to show you the report (or part of it) because he considers there are special circumstances which are described in the Act.
OPTION B

You can withhold your consent to a report being provided.

 

 

 

 

The Dr Bulpitt Files

The Dr Bulpitt Files

Please Home Office? Change the Law for us

2015-10-30

… its crazy us doctors have to treat them as patients

Read more

The Doctor who walks away with patient medical records

2015-08-03

Not only does he walk away with them, he names the patients the case files belong to and then Avon & Somerset police release the names…

Read more

I think we have overdone it

2014-10-31

An admission that the conveyor belt of reviews is starting to fray.

Read more

Dr Bulpitt realises only A&S, Merseyside and Notts are engaged in a mass review programs

2014-10-27

One of the ‘select’ few.  Dr Bulpitt fakes surprise, making reference to Cambridgeshire.  A force he was FMA during a particularly nasty bulk review program.

Read more

Ready to “invite” people in

2014-10-22

Everyone will be sent for interrogation…  Disabled former officers were told that they will only have to see a SMP only if their circumstances required…

Read more

Avon & Somerset HR admit to a difference between NAMF publications and what they tell pensioners

2014-10-15

An admission that they are using NAMF guidance, but they are not giving the same answers to FOI requests

Read more

Dr Bulpitt discusses entitlement to an injury award based on a fire service court decision

2014-09-30

But this is a mass review program isn’t it?  They are not allowed to revisit causation or entitlement!

Read more

Shall we tell NARPO?

2014-09-09

… oh, go on then.  Why is this a question? those affected should be told everything by default.

Read more

They know the score

2014-08-28

Doctors Johnson and Bulpitt discuss that being forceful and direct is the key as the disabled officers know the ‘score’.  These are vulnerable and disabled former…

Read more

Let’s give the PCC finance officer some medical case files

2014-08-28

…  but we might have put a label over the name.  The PCC finance officer has no right to have anything to do with medical files…

Read more

It’s all about the money and how much we can save

2014-08-27

A dcotor engaging with a finance officer.  Who’da thunk it!

Read more

Ducks are lining up!

2014-08-21

Disabled former police officers are painted as ‘targets’

Read more

Bulpitt says to the SMP “you’re the boss”. Both say don’t believe their GP. They will conceal.

2014-08-09

“We are one mind” they say.  General practitioners will conceal, so why not demand full notes from birth as there will be apportionment and causation there….

Read more

Dr Bulpitt discusses permanency with the SMP

2014-07-18

Again, there is a wilful failure to understand that revisiting permanency is unlawful

Read more

Not just a SMP, but “Our” SMP

2014-06-20

Strangely, Dr Johnson hadn’t actually start to work for Avon & Somerset yet (he started June 24th 2014 apparently)  …  And Dr Bulpitt even has…

Read more

“Who do I send to invoice to, Dr Bulpitt?”, Says Dr Johnson

2014-05-05

One question of many is why is the force medical officer talking about invoices and payment.  The friendship with the SMP is a cosy one.

Read more

Local Fed approval? You got it.

2014-03-28

Instead of stopping the train, the Fed welfare officer threw coals into the furnace to make it go faster.

Read more

We know what to do. There will be an awful lot of appeals

2014-03-26

Although a decade of unlawful guidance has been overturned and hundreds of lives ruined, Dr Bulpitt is still willing to put people through the trauma…

Read more

Let’s invent new Police Injury Benefit Regulations 2014

2014-03-21

There was no Regulations published in 2014.  In 2015, Regulations were published to bring in the new police pension scheme but there was no amendments to…

Read more

“Preposterous” Awards

“Preposterous” Awards

“Of all the preposterous assumptions of humanity over humanity, nothing exceeds most of the criticisms made on the habits of the poor by the well-housed, well- warmed, and well-fed.”― Herman Melville

Were Melville commenting today, he might well have had disabled former officers in mind as the ‘poor’ and the Force Medical Adviser of Avon and Somerset Constabulary as their well-warmed and well-fed critic.  In Moby Dick, Melville frequently uses biblical and mythological allusions.  Like the Biblical Ahab, in Melville’s Ahab (and our well-fed critic) there is a desire for something that he isn’t entitled to and that isn’t good for him to have, to try to get it by foul means, and then to get his comeuppance in the form of an ironic reversal of his own evil deed.

Although not all injured-on-duty pensioners are in the dire straits of penury, they are all poor in respect of the way their injury pensions are administered. The habit of the pensioners is to be in constant bemusement over how those who have a duty to administer injury pensions within the law so easily, and so enthusiastically seek to pervert the meaning and intentions of the Regulations.

As we have repeatedly said on these pages, IODPA is not against reviews of degree of disablement. Chief Constables have a wide discretion on whether or not to conduct a regulation 37 review of degree of disablement. They can consider the matter at such intervals as may be appropriate. However, it is not appropriate to initiate a review as a potential cost saving measure.

Reviews can not be used to undo the finality of the last final decision even if a certain force medical officer considers the award to be “preposterous” (see below). We can only wonder just how he managed to come to that opinion. On what evidence did he base his consideration?

No matter what a FMA might think about any individual’s injury pension payment he surely must be aware that only a substantial alteration to the degree of disablement can permit a revision of the level of pension paid. Is the verdict of “preposterous” informed by a generalised assumption of some deficiency in the process of granting an injury award? The FMA must know that the causation and the substance of the award always remains final and can not be revisited at review.

We are writing here about not just any old FMA, but one Dr David Bulpitt MRCGP FFOM, who is the Force Medical Adviser of Avon and Somerset Constabulary. It is a telling reflection of the rather nasty and lawfully inaccurate attitudes prevalent in some quarters, that Dr Bulpitt appears to have an inflated ego of such magnitude that he wants to rewrite history and convert the decisions of his predecessors, into becoming his decisions.

Dr Bulpitt is not shy about voicing his rather skewed opinions on injury awards.  He is not even a run-of-the-mill force medical adviser.  He has a national platform – as the police representative for the Association of Local Authority Medical Advisers (ALAMA).  Listed as a speaker in past ALAMA conferences for Occupational Health physicians who are “set on delivering the highest quality services and the best standards in patient care in the most effective manner”, you’d have thought his words would always exemplify the motto of ALAMA: “communication, education, consistency and quality of clinical practice of doctors providing Occupational Health Services” .  Unfortunately for Dr Bulpitt, his words may well come back to haunt him.

As Will Rogers put it, “After eating an entire bull, a mountain lion felt so good he started roaring. He kept it up until a hunter came along and shot him. The moral: When you’re full of bull, keep your mouth shut.”

In an intemperate email rant to the Police Workforce & Capability Unit at the Home Office, Dr Bulpitt displays his frustration and impuissance.

It seems he might well be vexed over his inheritance of the historical legacy of decisions that he thinks ‘he’ would not have made, conveniently ignoring that such attempts at historical revisionism is forbidden by the Regulations.  An interesting stance, given Dr Bulpitt is not privy to the Zeitgeist and full facts which swayed the decisions of his predecessors.

His ego asks for more.  The finality demanded by the Regulations is an affront to his wishful view of how things should be if he were in charge, and he can’t control his craving to fuel his desire to remove the injury awards of those retired from the force he represents, sacrificing his medical professionalism and independence in the process.

Frustrated by his impotence to alter history, he contacted the Home Office to tell them how hard-done-by he his.

 

[…] I suspect that you might be aware that we have a group of pensioners that are organising a campaign to resist having their pension reviewed.

So blinded by his own peculiar view of the Regulations, Dr Bulpitt actually thinks that a group of disabled former officers, who in their working lives were intent on seeing that the law was upheld, are now campaigning against reviews, per se.  Dr Bulpitt not only has hold of the wrong end of the stick, he has the wrong stick altogether. We guess he is referring to IODPA. In which case, how has he missed the plainly, and oft-repeated, statement of our mission, which is to challenge all aspects of unlawful reviews and maladministration?

IODPA has never sought to frustrate legitimate, lawful review process, but, in Avon and Somerset, and elsewhere, finding a legitimate review is about as difficult as finding an honest, decent and professionally competent FMA or SMP  (difficult but not impossible – they do exist but the good ones tend to avoid the debacles and imbroglios that always shadow bulk review programs).

Dr Bulpitt’s email continues in a manner that, perhaps unintentionally for him, actually answers his question of why pensioners do not want their injury award reviewed by Dr Bulpitt or anyone connected to Dr Bulpitt.

 

The issue is largely one of the Constabularies making in my view because they are on preposterous awards, frequently 100% and have hardly ever been reviewed if at all. One appears  to never had anything wrong with them and another had a certificate stating they did not have a permanent condition but got an injury award anyway.

Who are the ‘they’ that Dr Bulpitt refers to? The group ‘resisting having their pensions reviewed’ are all medically retired former police officers unfortunate enough to be retired from Avon & Somerset and other forces across the country where the review process is clearly being managed contrary to the Regulations.

Among everything else wrong in his email, Dr Bulpitt has the nerve to call the deliberate unlawful actioning of recommendatory Home Office guidance that reduction to 0% of the degree of disablement all former police officers once reaching sixty-five years of age as, ‘acting in good faith’.  

Oh!  That’s OK then – it’s fine to carry out a public duty unlawfully as long as it is done in good faith.  It’s perfectly fine to make an almighty cock-up, so long as it was done in good faith. It is acceptable to drive a coach and horses through the Regulations, bringing huge distress to disabled former officers and their families, so long as it is done in good faith.

This may be arguable in a pursuit of proving misfeasance in public office, an intentional tort rooted in bad faith, but the tone of Bulpitt’s email shows his intent is as far a polar opposite to a ‘good faith’ mistake as is possible.  Dr Bulpitt’s unsolicited use of the term ‘good faith’ clearly shows he has the spectre of misfeasance in his mind; just saying it is all in good faith doesn’t make it so.

As sure as eggs are eggs, Dr Bulpitt wants to globally revise the award downwards of all those retired by Avon & Somerset.  If this isn’t bad-faith then what is?

Do you think Dr Bulpitt paused for a minute and thought, as he typed his email, that it’s no wonder that people don’t want to be unlawfully reduced just because he, as the current force medical officer with only the scantiest knowledge of the circumstances, thinks there is nothing wrong with them and they shouldn’t have the award in the first place?

Or perhaps he feels he has sufficient knowledge. If so, he has been trawling through sensitive personal medical data which he has no right to access. The implication from his remarks amounts to a self-admission that Dr Bulpitt freely rummages around in the personal sensitive medical records of former police officers without consent. If that is the case, it is shocking to say the least.  How else can he justify his generalisation that those retired in the past, ‘have nothing wrong with them’?

The bunker mentality seeps through the words of Dr Bulpitt.

 

Apart from a coordinated campaign of FOI  requests, subject access requests and so on, they have been put in complaints to the GMC about  our SMP. Not too dissimilar from the picture in many forces that I have worked with but this one  is far more venomous and a lot of work has gone into worrying pensioners and frankly trying to smear the OH unit and the SMP by the Pipin group

Hold on there, Doctor. It sounds like you are saying that all complaints, all requests for information, and every attempt by injury on duty pensioners to shine some light into the murky recesses of the shambles that is the administration of their injury pensions, is done to annoy and smear? What utter hogwash! What a frankly outrageous attitude to display by someone who is supposedly trained and skilled in the art of diagnosis. What an example of bias overcoming logic.

Doc, your diagnosis is wrong. YOU, and the other people who have not got a clue about how to properly administer police injury pensions, are the disease. IODPA is the cure. We challenge because we have been attacked. We seek information because none is freely given out. We point out deficiencies because nobody has the wit or the will to remedy them unless backed into a corner.

 It is people such as Dr Bulpitt and Dr Johnson, the SMP used by A&S, who are smearing the Occupational health unit. They are dragging the unit into disrepute by abusing the Regulations.  Uncovering the truth of what is really going on cannot be twisted into smear campaign.  Smear tactics differ from normal discourse or debate in that they do not bear upon the issues or arguments in question.  On this website you will only find disclosure and arguments that always bear upon the focus of unlawful administration of injury awards.

The unguarded admission by Dr Bulpitt is another example in a long line of examples of how far some public officials will go in attempting  to undermine legislation.

Frustrated that Avon & Somerset legal services advise that it is unlawful to reduce an injury pension banding where an IOD pensioner disagrees with the SMP’s report and withdraws consent for it to be disclosed to the police pension authority, Dr Bulpitt states that he is at a ‘crunch point’.

Prevented by the GMC to force the release of a report that a SMP makes on an individual and unable to revise an award without it, his considered reaction is to ask the Home Office to change the law for him to provide immunity for SMPs from oversight by the GMC.

 

I know that others have written about this but surely it is crazy to have the GMC overseeing the work to the SMP and insisting that the pensioner is our patient and that we must put their  interests first?

Their insistence that we have to offer to share our report with the pensioner/applicant first is very difficult and potentially will prevent the review  of pensions if, as my legal department tells me, we cannot alter the pension without that report  and the pension authority cannot insist on it being released. They (the GMC) are adamant that  we must put the pensioner first and if that means not adjusting a pension to the correct level  then so be it.  My concern is also that this is getting so unpleasant for doctors we are getting very limited in our  selection of SMPs. FMAs are now very rarely employed and tend to turnover very quickly.

We cannot alter the pension without that report”.  Rather a conspicuously revealing and graphic sentence.  He uses the accusation of a conspiracy to save money in a dismissive throwaway comment concerning a pensioner who was unlawfully reduced in – cough! – ‘good faith’ three years ago.

 

[redacted] is being investigated over a decision [redacted] took 3 years ago when [redacted] had been instructed to review a pensioner who had reached the age of 65 and drop their award (we now know that is incorrect of course but [redacted] acted in good faith at the time). [redacted] contacted the GMC but has been frustrated by the apparent lack of any understanding of the role. The pensioner had his pension restored at appeal but has now gone on a crusade, accusing [redacted ] of “colluding with the pension authority to save money”.

But “we” (not the independent and supposedly impartial SMP) want to alter the “preposterous” award, he says!

You can make your own mind-up whether Dr Bulpitt is seemingly in cahoots with others.  The use of “we” in the above context goes nowhere in quashing any suspicion that the SMP is not totally his own man and the goal is to alter the pension in all circumstances.  You don’t need to be a clairvoyant to predict the direction of the desired alteration.

The Faculty of Occupation Medicine, of which Dr Bulpitt holds the FFOM post-nominal, has a ‘Competency 4‘ that governs the relationship between the occupational health doctor and the patient.

The absence of the usual therapeutic relationship between patient and doctor does not exempt the doctor from his/her professional duties imposed on all members of the profession..

Dr Bulpitt appears adamant that this should not apply to some members of the public and it seems he thinks that the required doctor-patient relationship is absurd.

 

surely it is crazy to have the GMC overseeing the work to the SMP and insisting that the pensioner is our patient and that we must put their interests first

The role is described as quasi-judicial but I see  little that is “quasi” about it. Surely it is not a doctor-patient relationship as we would understand

They (the GMC) are adamant that we must put the pensioner first and if that means not adjusting a pension to the correct level then so be it.

But it is not just the demands of the GMC, is it?  To be a FMA or a SMP the National Attendance Management Forum demands a prerequisite of membership of the Faculty of Occupational Medicine.  It is Dr Bulpitt’s own specialty designated body that demands the same compliance.

Given the Regulations are paramount and the Home Office refuses to release any central guidance in relation to injury awards, Dr Bulpitt continues forlornly, with a sigh of desperation and acknowledgement that some forces refuse to review contrary to the Regulations.

 

Can anything be done about this because we are in danger of the whole thing grinding to a halt?
So far as I know the Met are still not carrying out any reviews and have stated publicly that they  will not be doing so.

The Home Office sensibly skirts over the rant and calmly explains to Dr Bulpitt that the Regulations require a medical authority and the GMC therefore have primacy over the behaviour of any medical professional.

 

Hi David,
Thank you for your email. Whilst I understand your concerns and appreciate your comments it remains that as SMPs do fall within the remit of the GMC. You said that the GMC have been contacted to explain this issue but that the GMC do not seem to be understanding the role. Have any further attempts been made with the GMC to explain the role in further detail?
The Regulations state that the SMPs are being asked for a medical opinion and the fact that they sit under the remit of the GMC is something that cannot just be overridden through amendments to our legislation. It would be interesting to know more about the discussions which have been had with the GMC regarding this issue.
Kind Regards

Dr Bulpitt, and others with similar mindset, appear to have a clear appreciation or understanding of the laws that regulate their conduct in this area, but still they do their utmost to get around them.  When challenged, as we have so often witnessed in instances of other outrageous maladministration by public officials, they consistently fail to acknowledge that they have done anything wrong.

 

We are lucky here because our GMC liaison officer is very understanding and I took the  precaution of warning him that he would start seeing complaints. Thus far the GMC has not felt  any of the complaints against our SMP warranted investigation.  This has not necessarily been the case elsewhere

It is worrisome that Dr Bulpitt has apparently arranged an ‘understanding’ with the local GMC liaison officer.  Does this mean any complaint of wrongdoing is dismissed by the GMC responsible officer, regardless of the strengths and merits of the complaint?

Dr David Bulpitt’s position as Force Medical Officer has, we believe, become untenable with these shockingly offensive comments. He has demonised the entire population of disabled former officers who have injury awards, and his comments show extremely poor judgment and a surprising lack of sensitivity.

It is important that a doctor in a position of trust who is dealing with injured police officers and medically retired former officers enjoys public confidence and this is at risk with his continuing in the important role of Force Medical Officer.

We are so appalled at this insight into the recesses of the mind of Dr Bulpitt, and are so concerned about the bias and discriminatory attitudes which are revealed that we call for Dr Bulpitt to either resign quietly, or if he will not, for him to be dismissed.

If Avon and Somerset wishes to see a return to normalcy in its relationship with injury on duty pensioners and the emergence of good governance of police injury pensions, then this stumbling block named Bulpitt must go.

This is the full email chain.  Keep in mind if this is what Bulpitt sees as a measured email to the Home Office, what is he saying and doing in the privacy of his own office?

http://iodpa.org/wp-content/uploads/2016/08/38800-Annex.pdf

38800 Annex
[hover the cursor over the page to read all 4 pages or to download pdf]