Stop NHS funds being spent to destroy doctor's careers
Stop NHS funds being spent to destroy doctor's careers
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Latest: July 23, 2022
Stop misuse of NHS funds!
GP practices across the country are experiencing significant strain with declining GP numbers, rising demand and struggles to recruit and retain staff. The overall number of GPs has seen little growth since 2015 and there has been a safety warning from the doctors’ union, the British Medical Association (“BMA”) in January 2022 as GP numbers continue to decline. Yet Health Education England (“HEE”), a publicly funded body tasked with delivering training to those who wish to provide NHS Services in England, has spent hundreds of thousands of pounds of public money trying to oust a highly qualified disabled doctor with excellent credentials and patient feedback, from General Practice.
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I am a doctor who qualified in India and was diagnosed with Neurodiversity (Dyslexia and dyspraxia) as an adult. This should not have been a barrier to me successfully working as a GP. I am highly qualified and I have four postgraduate qualifications to my name. Following my medical degree, I worked as a trainee surgeon and obtained Membership of the Royal College of Surgeons (“MRCS”). I have a Diploma in Head Neck Surgery (DoHNS) and as a doctor who is passionate about teaching and training, I also completed a Diploma in Clinical Education. I'm also highly experienced with close to two decades working in the NHS.
In 2013, in order to achieve better work-life balance and spend more time with my toddler son, I changed specialty to General Practice.
After satisfactory completion of the first two years of GP training, I was diagnosed with Neurodiversity (Dyslexia, Dyspraxia and Dyscalculia) for the first time after a formal assessment. My Occupational Health doctors recommended straightforward adjustments and auxiliary aids such as medical dictation software, slightly longer consultation times, paper-based examinations and dyslexia awareness training for my colleagues. However, this advice was consistently ignored by HEE.
When I raised concerns about lack of support, the then GP Dean, who was not medically qualified, led a relentless campaign against me. My difficulties were attributed to my being an International Medical Graduate (IMG). It is a well known fact that inherent bias against IMGs leads to differential treatment and discrimination. In fact, a recently published report by BMA states that almost a third of doctors from ethnic minority backgrounds have left or are considering leaving the NHS due to experience of racism in the last two years (BMA- Delivering Racial Equality in Medicine). Given that almost 42% of the current UK medical workforce is from minority ethnic backgrounds, this can have potentially catastrophic consequences for patient care. In my case this bias and stereotyping persisted even after a long unblemished career in the NHS.
I was persistently criticised for taking longer consultation times even though there is clear guidance around dyslexic doctors requiring extra time for electronic recording and using computerised systems. I tried my best but when you are dyslexic, writing up consultations within tight timeframes without dictation software is a difficult task.
While working in GP practices, I received some exceptional patient feedback which was ignored by the HEE team, such as:
‘I have only known Dr Priyank Vashishtha since he was the only GP available for an emergency appointment, but I have specifically asked for him since. He has been an absolute pleasure to see and I trust him completely as my General practitioner. He has an excellent patient manner and makes me feel completely at ease….’
‘…..The key thing I wanted to share is feedback to you about the experience I had with Dr Priyank Vashishtha. Exceptional is the one word to summarise it! His breath (sic) of knowledge was fantastic but his clear differentiation above other doctors was his consultative friendly manner. He spoke with such clarity and took the time to ask my opinion and reconfirmed at the end of the consultation if he had meet my needs. He exceeded them!....’
‘..I have seen Dr Vashishtha over the past couple of months for a number of consultations and I have been very impressed with his empathetic nature.’
‘…Your ‘bedside manner’ plus patience you show is first class and 5 to 10 minutes was never an issue!...’
‘Dr Vashishtha is professional, responsive and knowledgeable. As a patient I felt he interacted positively, and above all he listened to my issues before jumping to any conclusions.’
‘…I have worked with a number of GPs myself in and around the NHS and I find it rare to come across such a passionate GP..’
While I passed the practical/ clinical skills assessment (“CSA”) of the Royal College of General Practitioners (“RCGP”), because of difficulty with computer-based assessments, I struggled with the written examination called Applied Knowledge Test (“AKT”) in the absence of adjustments as the format of this was particularly difficult for those with neurodiversity. The RCGP informed me that they would have provided me adjustments to mitigate the effect of my neurodiversity, had HEE provided them at the workplace.
In October 2018, with no adjustments or auxiliary aids in place, my performance was assessed as unsatisfactory by HEE and I was released from my GP position. I appealed this decision and was certain I would succeed at the appeal. The Postgraduate medical training guide recommends that appeals should take place without unreasonable delay and the appeal panel should be individuals not involved in the original decision. Which is why the events that followed were not just grossly unfair but incredible. Ten days before my appeal hearing, I was informed by HEE that it was being postponed due to failure to find an RCGP representative for the panel. It was rescheduled by HEE again a few times and to my great shock, in September 2020, the Postgraduate Dean emailed me to say that my right to appeal had been removed. I immediately raised a grievance against his unilateral and shocking decision. I had assumed it would be sent to a neutral third party to review but to my amazement, the same PG Dean wrote back to me stating: “I have considered the points you have raised in your letter. I am satisfied that my decisions are appropriate and that they stand”. He had dealt with my appeal by upholding his own decision!
The Buckinghamshire GP practice that I had been working in terminated my placement stating that my needs were too great even though none of the recommended adjustments had been implemented.
For perspective, the cost of simple adjustments and assistive technology to support me at work and enable me to carry out my day-to-day duties as a GP would have been in the region of £5000 and part of this would have been funded by the Government. Instead, HEE have chosen to squander hundreds of thousands of pounds of public money in trying to support a wrong decision that robbed a disabled doctor of his career as a GP.
Why this is important
Dyslexia is not uncommon and affects up to 15% of the population. In its simplest form, it affects skills involved in reading, spelling and writing of words. This means that people with Dyslexia learn and train differently, but they do have several unique strengths- higher creativity, reasoning and problem solving. Also, Dyslexia occurs across a full spectrum of intellectual abilities and does not affect an individual’s IQ. The General Medical Council acknowledges the contribution that disabled doctors like me, can make to patients’ lives and states “A diverse population is better served by a diverse workforce that has had similar experiences and understands their needs.”
Despite undiagnosed disability until late in life, I have always been a high achiever, have several qualifications in medicine, an unblemished career and have always had positive feedback from my patients. My dyslexia assessment confirmed that I had developed coping mechanisms which had helped me succeed in medicine. All I needed was a little extra understanding and help from my HEE trainers and GP practices where I had been placed.
Dyslexic individuals often have talents and attributes that make them outstanding doctors- visual-spatial awareness, problem solving and communication skills, empathy and connection, to name a few. Indeed, Medicine has numerous dyslexic doctors who were/are at the top of their profession:
- Harvey Cushing (1869-1939): ‘Father of modern Neurosurgery.’
- Prof Terence Ryan (West 2004; dermatologist from the University of Oxford): “….leader and innovator because he could recognize disease patterns that his medical colleagues could not easily see”
- Professor Beryl Benacerraf (Radiologist at Harvard Medical School): “Because of dyslexia, my brain works differently, and I can see these patterns. I do have a gift that other people don’t have, and I will always stay ahead of the crowd and see more in an image than other people.” (http://dyslexia.yale.edu/).
When I brought proceedings against HEE and one of the GP practices for disability discrimination, they instructed two large law firms with a senior barrister as well as a QC against me.
The reason cited by HEE for ending my GP training was inability to pass the RCGP’s AKT exam within prescribed time even though I still had one attempt remaining at the time. Moreover, there is precedence of other candidates having obtained additional exam attempts by RCGP. Not only this, in response to my Subject Access request (“SAR”) RCGP replied to say that they would have granted an additional attempt had I been in training, and this is also confirmed by RCGP’s internal communications obtained in response to an SAR.
So HEE’s position is in direct conflict with the RCGP’s position. HEE have tried to shift blame to the RCGP and repeatedly stated that the decision to oust me was out of their hands but I have clear evidence that RCGP would have supported me, had I been allowed to continue my training position by HEE.
Every licensed doctor who practises medicine in the UK goes through a robust process of revalidation every five years to assess fitness to practice. In 2018, I was revalidated by the GMC following HEE's recommendation. However, after I raised proceedings against them in 2019, HEE's lawyers raised in the tribunal that I was not safe to practice even though I have never had any patient complaints against me and no patient safety concerns have ever been raised against me in the GMC. Three of the UK’s leading Dyslexia experts and the British Dyslexia Association have provided advice and guidance and written to HEE at different times in my support.
During my hearings HEE lawyers have employed a campaign of “dirty tricks” often taking advantage of my disability. Documents are often sent at the last minute giving me little time to absorb. HEE also refused to accept expert reports clearly stating that I was disabled at a preliminary hearing, causing me to incur thousands of pounds in legal costs to argue the contrary, only to concede my disability at the last minute. On another occasion, they reneged on an earlier concession of part of my disability, and refused to acknowledge this, despite written proof of concession being provided by my representative.
This is outright unethical but typical of the practice by HEE’s firm of solicitors who have fleeced thousands of pounds of taxpayers’ money to defend a claim rather than admit that their client got it wrong.
My case and why I am crowdfunding
I am unable to fight HEEs large team of lawyers, senior barrister as well as a QC, on my own. The hard-won careers of doctors are being jeopardised by HEE, a publicly funded body that was set up to do the very opposite. At each of my hearings, I have been pitted against two top barristers including a QC, with two separate legal firms and their army of supporting lawyers. Hundreds of thousands of pounds of public money have been spent in trying to crush a disabled doctor and silence him. It comes as no surprise that these are the same lawyers who have been involved in arguing the nation’s doctors out of whistle blowing protection (https://www.crowdjustice.com/case/dont-let-them-get-away-with-sp/).
With an incidence of up to 15%, it’s highly probable that there will be Neurodiversity within any workplace. It can be a significant asset to an organisation, bringing a different dimension to problem-solving or creativity in how an organisation operates and delivers its’ services. The NHS should be on the forefront of supporting its’ dyslexic workforce and upholding the principles of Justice, Equity, Diversity and Inclusion. Instead, NHS funds and the taxpayer’s money is being spent in lining the pockets of parasitic legal firms that have not shied away from using unethical practices to run down a litigant in person with a known disability.
Despite the immense struggles I have faced in my career because of unmitigated Dyslexia until late in life, I have always been a very positive person and I have always managed to succeed through hard work and resilience.
I know I am not the only one who has suffered in this way. The GMC’s website has several anonymised stories about other disabled doctors. Some are shockingly similar to mine, one writes - “There is very little support for doctors who are neuro-divergent…As a GP trainee, during placement at a GP practice the staff were not particularly supportive when I tried to seek reasonable adjustments for my disability, I was made to feel inadequate and stupid which resulted in a deterioration of my mental health....”
By winning this case, I want to ensure that no other dyslexic person is treated in this appalling manner again and the commitment to equality that the NHS makes, is afforded also to its own workforce.
I want to change the culture that supports public money being squandered on “fat cat” lawyers to cover up mistakes within NHS - both towards patients and its own doctors.
I also want to prove that people with Dyslexia can achieve anything if supported in the right way.
Many thanks for your time!
Dr Priyank Vashishtha
July 23, 2022
Stop misuse of NHS funds!
Dr Priyank Vashishtha
July 22, 2022
We hit initial target ahead of time!!
A big thank you to everyone who donated to help me reach my initial target ahead of time: I have been in touch with senior counsel who come with extensive experience of healthcare related cases and thanks to you I can double up in my fight. I anticipate my case will be groundbreaking and will help further the cause of disability rights not just for doctors with dyslexia but for people from all walks of life. I am moving to my stretch target and I am appealing to all of you to help me raise funds to run the second phase of my campaign.
Let's do this together! Thank you.
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