There are some things one remembers even though they may never have happened.
In an earlier blog, we highlighted some of the barriers which stand in the way of justice for disabled former officers in receipt of an injury pension, and serving officers seeking to retire due to injury on duty or disabling ill health.
We commented on how individuals are effectively prevented from securing their pension rights.
The system seems loaded against them due to the scarcity of information, support and professional representation. IODPA reaches out to those who would otherwise not secure their pension rights and in so doing we learn about and witness first hand the deficiencies of some of the doctors who are asked to provide medical assessments on behalf of police pension authorities.
One aspect of these assessments which our members have highlighted is the matter of the reports which these ‘selected medical practitioners’ (SMPs) produce. All too often they seem to bear little resemblance to what was said and done during the assessment.
The upsetting experience of one of our members might illustrate what we mean.
An injury on duty pensioner was being assessed by a SMP for the purpose of determining whether there had been any alteration in his degree of disablement.
The SMP referred the pensioner to a consultant neuropsychiatrist, who saw him some little time later. The pensioner had his wife present throughout the assessment. He was asked some questions about alcohol consumption, and the pensioner stated that he, together with his wife, drank three bottles of wine a week.
When the consultant’s report was issued, the pensioner, and his wife, were shocked to see that the consultant had written that he drank three bottles of wine a day and believed he should be categorised as presenting with ‘Harmful use of Alcohol’. The consultant went on to comment that he should reduce his alcohol consumption and be prescribed thiamine – a drug given to alcoholics to help reduce vitamin deficiency.
It was bad enough that the consultant, who was not entitled to make any recommendations, or even comments on treatment, did just that, but worse was yet to come, for the error was not corrected.
When the pensioner pointed out the error to the consultant and asked for her report to be amended, the consultant refused to do so. Thus this error, which essentially labels a sober man an alcoholic, has remained on file.
The point of this illustration is that, if the assessment had been recorded, then the error would have been revealed in evidential form and would have been corrected, either by agreement, or by compulsion through legal proceedings.
You might think it only common sense that medical assessments and interviews held in connection with police pension rights should be routinely recorded. That the doctors concerned be supplied with proper recording equipment, which produced a simultaneous copy for the medic and for the individual.
However, that is not the case, and is likely to remain the situation. Not least because some SMPs have voiced opposition to any form of recording of their sessions. Some have gone so far as attempting to stop individuals from making their own recording of the assessment or interview. We will comment on that situation below.
In our earlier blog we produced figures on the number of appeals made to Police Medical Appeal Boards concerning pension matters. For an appeal to be arranged, a police pension authority must accept that there is reason to believe an error of fact or law was made – by a SMP or by a police pension authority.
We believe that the number of appeals heard cast only a glimmer of light into the darkest of corners. It is entirely probable there are many more errors which have not been revealed and have not been challenged.
Of course, it is not only SMPs and consultants who can have faulty recollection. A study [1] revealed that patients only retain between 40% and 80% of what their doctor has told them during a consultation. It is not hard to understand that former officers with mental injury, placed under the huge stress of a medical examination and interview, the results of which will determine the amount of their pension, might find it even harder to recollect much of what went on.
It is partly for that reason IODPA recommends members always have someone with them during any process concerning their pensions.
We are aware of instances though, where certain SMPs have objected to anyone other than the individual being privy to what is said and done. Happily, the General Medical Council (GMC) has advised that doctors should not raise any objections to a friend being present.
Looking at the wider picture, it would be better all round if there were fewer appeals. There would be less stress and financial uncertainty for the individuals and less cost for forces. To achieve a reduction in appeals, however, there would need to be a decrease in errors, and we think that is unlikely to come to pass, given the fact that, by all the accounts we receive, SMPs and police pension authorities are, shall we say, rather prone to committing errors.
Errors should be corrected without the need for appeal to a PMAB. The Police (Injury Benefit) Regulation 2006 make that very clear, for regulation 32, parts (2) and (3) makes provision for SMP’s to be asked to reconsider any decision.
A reconsideration is an opportunity for the SMP to be made aware of any errors of fact or law, and to correct them. But, before an individual can bring such matters to the attention of a police pension authority and request a reconsideration the errors need to be identified.
IODPA therefore advocates that anyone who attends a medical interview or examination by a SMP, or any other doctor to whom they have been referred to by a SMP, should not only insist they are accompanied throughout by a friend, but should also make a recording of the entire event, and should do so openly.
We advise that the doctor be told the session is being recorded.
If any doctor objects, then the objection should be acknowledged and the doctor told they have no legal power to prevent the recording.
Doctors should have no cause to object, for a recording is as much a protection for them as is it is to the individual.
Recording is lawful because you are only processing your own personal information and are therefore exempt from data protection principles.
The recording remains the property of the individual, who may well find it could be admitted as evidence should they decide to appeal any decision made by the SMP, or if matters go to an industrial tribunal or judicial review. The GMC will also likely accept the recording as evidence in any complaint proceedings against a doctor.
A little bird has told us that a certain SMP thinks that they have the authority to ban individuals from making recordings of medical interviews and examinations.
That SMP is wrong.
Expert police pension solicitor Mark Lake advises on the argument that a recording, covert or otherwise, may not be admissible in legal proceedings:
I do not think such an argument can possibly succeed for 2 reasons. First, the SMP is acting as a public law decision maker in this interview and not as a treating doctor.
Second, any confidentiality in the consultation belongs to the patient and not the doctor.
Although a SMP may be considered to act in a quasi-judicial way, that is solely because any decisions made are binding unless appealed. By decisions we mean only those a SMP is tasked to make under the Regulations. A SMP is not a judge and does not have the powers of a court.
Essentially a medical interview or examination for pension purposes under the Regulations is just that – a doctor’s consultation with a person who they must respect as having the status of patient. The doctor must abide by the ethics of their profession and also with the law, with particular regard to the Access to Medical Reports Act 1988 and the General Data Protection Regulations.
Is the view of IODPA on the recording of these sessions a lone one? It seems not, for we can turn to the combined wisdom of the General Medical Council and to the Medical Defence Union, the Medical Protection Society and the Medical and Dental Defence Union of Scotland for their opinions.
All of these organisations recommend that doctors raise no objections to a patient recoding any interaction with them.
The GMC has confirmed there exists a doctor/patient relationship when a doctor is conducting a medical examination or interview for an employer or pension scheme manager. SMPs are obliged to follow GMC guidelines and advice, as failure to do so opens the door to civil claims and to complaints to the GMC.
In its guidance on good medical practice, the GMC states:
You must give patients the information they want or need to know in a way they can understand. You should make sure that arrangements are made, wherever possible, to meet patients’ language and communication needs.
Clearly, this is an endorsement of patients making recordings, which allow them to obtain the information they need in a form which enables considered analysis of the information.
The Medical Defence Union offered its opinion in its publication ‘Good Practice’ [2] The article says:
By recording a consultation to listen to again later, patients are less likely to miss something important.
And;
It would be a mistake to think they are trying to catch you out or that a complaint or claim will inevitably follow. If you are concerned that the patient’s actions are a sign they do not trust you, you may want to discuss this with them at a later date, but recording a consultation is not itself sufficient reason to end your professional relationship with them.
The Medical Protection Society gave its opinion in its publication ‘Practice Matters’ [3] The article says:
A recording would potentially provide even more detail to support the doctor’s professional position. There should be no reason therefore why you should have anything to fear from such a recording.
And;
A patient does not require your permission to record a consultation. The content of the recording is
confidential to the patient, not the doctor so the patient can do what they wish with it. This could include disclosing it to third parties, or even posting the recording on the internet.
In a press release dated 2nd July 2015 [4], the Medical and Dental Defence Union of Scotland stated:
In an ideal world, patients would not feel the need to covertly record a consultation and would be open about it, says Dr Peddie, however, doctors should not necessarily feel threatened when they become aware of a recording. Indeed, a recording may be helpful in avoiding misunderstandings.
So there we have it. Recording of medical interviews and examinations for any purpose concerning pensions or ill health retirement is lawful, and is encouraged by doctor’s professional organisations.
SMPs should take careful note of this and accept that an accurate record is essential to ensure errors of law or fact can be revealed and dealt with without the need to take matters to a PMAB.
As for PMABs, then IODPA urges the Home Office to make provision for official recording of everything said and done during an appeal hearing and to advise PMABs not to obstruct appellants or their legal representatives who wish to make recordings.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC539473/ – Journal of the Royal Society of Medicine, 2003
[2] https://www.themdu.com/guidance-and-advice/journals/good-practice-june-2014/patients-recording-consultations – Good Practice June 2014
[3] https://www.medicalprotection.org/docs/default-source/pdfs/uk-practice-matters/practice-matters-oct-2014.pdf – Practice Matters, Volume 2, Issue 3, page 6, 2014
[4] https://www.mddus.com/about-us/media-centre/2015/july/doctors-should-not-fear-covert-recording –
I Totally agree that all interviews should be recorded. SMP’s cannot be trusted to tell the truth, so I believe it is a brilliant safeguard to have in place for both parties. I would always take a friend or Fed Rep/ NARPO rep with me as their knowledge is vital.
The required equipment could be paid for by the SMP parent company who charge £750 a shot to do examinations/interviews. (Heck of an hourly rate!!)
Don’t be bullied by these “People” and insist on your terms, after all it is all about you, not them.
I prey for the day they slip up whilst being recorded and get struck off. The GMC rules apply to them so if they don’t adhere to them – complain to the GMC and lets get them struck off. (Just my opinion) 😀
How I wish I had the facility to record my review with a SMP in 2001. Having already been through a successful Home Office appeal process in 1998, I was called to the Police HQ Occupational Health Unit on 5th December 2001. The SMP completed a particular reporting document during the course of the review and wrote: “He SHOULD be left on his current injury award” (Band 2). I signed and dated that document expecting to receive formal notification some time later. That notification did arrive but I had been reduced to Band 1 with no explanation why. I appealed that decision and asked the Force Solicitor for a copy of my file. He refused (even though probably in breach of Data Protection legislation). Only a matter of days before my appeal hearing the Police Federation official, who had been guiding me through the process, was provided with a copy of the relevant SMP document signed by me on 5.12.2001. I was appalled to see the SMP had attempted to obliterate the word “SHOULD” and replace it with the term “MAY HAVE TO”. The use of a recording device would have prevented such an obviously dishonest act by the SMP. Could the SMP have been coerced into making the alteration? Only the SMP knows but he was replaced soon afterwards. Doctors, you have nothing to fear from former officers in receipt of IOD awards. Whilst employed as serving officers we were expected to maintain the highest degrees of integrity and honesty. We expect nothing less from yourselves and your Police paymasters.
It seems the majority of these so called SMPs are only too willing to indulge their employers i.e. the Chief Constables and write dishonest reports on injured on duty pensioners. It is, of course, driven by the pernicious idea of saving money by reducing pensions while the SMPs line their pockets!
The system is corrupt and has been for years. Only recently with backing from IODPA and knowledgeable solicitors the tide seems to be turning.
Recording the medical assessment is a brilliant way to make these so called Doctors act in a way their oath determines!
I believe all medical assessments should be videoed. I bet the diminishing number of SMPs will almost disappear!
It’s common sense to record such an interview, I for one have got a dreadful memory so it would assist me greatly…..The only reason an objection would be made, in my opinion is because the interviewer knows they are being deceitful…..recorded fact can not lie, a paper written at or after interview can be manufactured to suit…
It’s unbelievable that CC are allowing these falsehoods and illegal practices to continue….as a constable ,had we behaved in this manner we would have been sacked …it seems to be one set of rules for us and no rules for them
Thank god for IODPA, their work and knowledge is invaluable
I look forward to the day when every decision made by certain SMPs will be placed under scrutiny.
Regulation 32 would be the simplest vehicle to provide justice to all those who have had their injury pensions unlawfully reduced, or denied. So too with those who have been denied ill health pensions.
Regulation 32 should be applied by a specially appointed doctor who has never been exposed to the biased ‘training’ delivered via the College of Policing, or the out of date and unreliable guidance produced by the Home Office. Due regard would then be given to the expert medical opinions provided by each individual’s own GP or specialists.
Some forces have taken the administration of the injury pension scheme down a very dark route. Instead of selecting ‘a duly qualified medical practitioner’ to make the medical decisions the Regulations require, they have instead settled on plumping for one or other of the medics who do nothing other than make a living out of SMP work.
How can a medical appraisal system be fair when the scheme manager – the police pension authority – is none other than a Chief Constable who may well allow concerns over pressures on their budget to create a breeding ground for maladministration? How can such a system be fair when the SMPs are hired and paid by commercial companies, who in turn are contracted and paid for by the police pension authority? It is a recipe for creating unspoken expectations of money-saving results.
No corrupt system can continue unchecked in a democracy. All who have been guilty of maladministration will suffer a fall. There will be decent moral voices raised, and raised so loud that they will shatter the rotten structures to pieces.
IODPA has gone from strength to strength since my first meeting at a pub in deepest Somerset. We have grown stronger as we armed ourselves with knowledge and power, we have done things correctly with the ‘softly- softly catchy monkey’ approach, not the wam bam thankyou mam method that some wished to use.
To the bent SMP’s, HR’s, Occupational health types and senior Police officers I say this “You had better get ready, we are coming after you one by one” your dishonesty and downright lies will be laid bare for all to see.
I still find it disgusting and hard to take in that the so called powers that be continue to act so aggressively. They are quite happy to allow this and many other things to carry on without any support or advice to Iods unless challenged. Even then they seem to continue with arrogance on this path that is potentially so life changing for so many, all in the name of saving money. There are still so many Iod’s from all forces across the Country who are oblivious to this current situation, the sad thing is that like us all they gave 100% and did not ask to be an Iod officer, this came about doing a career they loved giving unselfishly to others. Sorry to witter on but without help and support these ex officers with be ridden over ‘rough shod’ and other than word of mouth among certain groups will remain as individuals and be picked off by there respective forces one by one. The advice above is excellent along with several other bloggs written and I only hope that this and other advice travels far and wide for all to benefit from. Good luck to everyone going through this process
Its been so revealing to see and hear how many of these dishonest SMPS have been terrified of having firstly having anyone else apart from the officer present in their examinations and then the possibility that these could be covertly recorded.
We have all known the reasons for their fear, they haven’t wanted any living witness or data storage device to evidence their true dishonesty and the shocking lies that they tell in order to victimise disabled and vulnerable officers directly on the instructions of the Forces who instruct them in order to save these Forces money.
For those crooked Doctors, OH lackeys and vile senior Police officers who have overseen this reign of terror against disabled and vulnerable human beings, you have no idea at just how hard and determined we are to pursue you all to the ends of the earth to publicly expose your evil, you know exactly who you are and very soon so too will the public.
With regard to your blog and subsequent comments, it continues to perplex me that some ‘doctors ’continue to inflict their paternalistic ‘expert’ opinions and worse still ‘prescribe pharmaceuticals ‘ to individuals when it is quite clear that their interpretation of medical reviews / interviews is flawed by English language barriers, and misguided yet their ‘expertise’ is condoned. Medication is not the only avenue to therapy and help, though the majority of these ‘experts’ can’t see beyond a BNF because they are not of sufficient intellect or emotional intelligence.
Patient safety is a huge concern in the UK, yet these questionable individuals with the title ‘doctor’ are allowed to practice both in the NHS and even worse… make huge individual financial gain, sponsored by the HOME OFFICE in working for questionable quasi – organisations in an effort to conform to ‘saving money’ for the so called ‘establishment’.
What an absolute disgrace to the great ‘British’ medical profession when such individuals are given a licence to practice in such a way and make money out of their efforts’ If they were in a drug cartel they would be arrested………or maybe not as the police are too busy shafting their own officers to bother their arse with criminals!!!!!
I have learned from experience that it is far better to record any ‘review’ interview, and to have a witness present, to ensure that all points covered during that interview are recorded, and included in the SMP’s report, than to wish later that a recording had been made.
It has become common knowledge these days that not all SMP’s are as honest as they (legally or morally) should be. There is much evidential medical information given to them, verbally and within reports that is totally ignored, or ‘altered’, to suit a resulting lowering of the IOD pension.
The fact that any SMP would object to a recording of a review interview should raise a few more eyebrows!
Thank you once again for a very informative and enlightening article. The truth will win.
Excellent informative and useful piece of information. Crisp and clear for all involved in ‘The Process’. Thank you IODPA and Mark Lake, I for one will be keeping a copy for reference…. just in case.
It is common sense to record any review as it will protect both parties with factual recollection of the review. Some reviews have lasted hours and in the case how could Ann IOD or SMP be expected to remember what was said? I would suggest that anyone who is against recording reviews my have something to hide, or maybe they have already decide the outcome and would rather not have anything recorded to challenge their decision.
Why is it that Chief Officers of police, who are still Constables under the law and sworn to uphold it, allow knowingly such practices to occur?
They are (or were), expected not to allow politics, or for that matter anything else, to get in the way of ensuring the public they serve are protected from crime & injustice.
Years ago, that used to be the position taken, with the office or higher rank held being seen as a just reward. However, it now seems that in these times, Chief Officers are now political animals, never satisfied with just being a Chief & always looking to climb ever higher up the political pole.
There’s mothing wrong with ambition, I hear you say and that’s true. However, if it comes with an intention to protect future careers, by allowing injustice to occur, especially when that is happening to former colleagues, they were honour bound to support & care for, then that is when they have now overstepped the line.
If Chief Officers believe in a fair trial for a criminal, then they should be insisting that at the very least, the same applies to former colleagues, now unable to serve due to the injuries they received whilst on duty.
It would be very easy to arrange, as is required in criminal cases, for a Police Chief to ensure that the former colleague is in possession of the full facts, that they are ‘defended’ legally, (if needed). That all interviews are recorded and that full disclosure is made to the ‘defence’. Natural justice in action.
Sadly, that is often not the case, as the ‘political’ police chief knows he/she will not be popular with the politician’s, who don’t like to see fair play, as that costs money!
Luckily, in defence of these types of Chief Officer, we have IODPA carrying out the role of a white knight, advocating the true position & supporting former police officers where needed.
It’s a shame that they have to do this, as the only beneficiaries are the legal profession. The money wasted on PMAB appeals etc, could be better spent on protecting the public, if only the politician’s & their puppet Chief Officers, would only listen.
Another excellent and invaluable piece of information. IOD’s are beginning to feel more empowered and informed as they endure these dreadful tactics being employed by their former employees. Thank you IODPA.
Another excellent blog by IODPA. The information being researched and circulated on behalf of those who are being subjected to these reviews is absolutely priceless. Every piece written contains valuable and vital information that aids and assists IOD’s.
The recording of these encounters is essential and as I have recently learned read the SMP and PMAB words when they quote from original medical reports they do not always faithfully transcribe the original contemporaneous text nor check it and suddenly the SMP and PMAB’s words mutate the originals meaning to something else, Chinese whispers come to mind.