Cancel culture is, according to Wikipedia, a modern form of ostracism in which someone is thrust out of social or professional circles – whether it be online, on social media, or in person. Those who are subject to this ostracism are said to have been “cancelled”. As a construct, it has proved to be controversial, possibly reflecting the multi-dimensional nature of it. I understand cancel culture rather simplistically, like ‘blocking’ somebody on Twitter. That block does not stop that individual from ever learning about your input in future, but blocking is a symbol that a line has been drawn indefinitely.
I’ve often commented on the social death I experienced when I was removed from the GMC medical register. It was in my case considerably worse than that. My case clearly had a health component to it in 2006, and, when I was erased, I lost my professional and personal identity. I have never married or had a partner since. I became physically disabled having contracted acute meningitis due to heavy drinking. I have found it difficult to want a regular salaried job, let alone be deemed fit enough to have one.
This brings me onto my wider concerns about patient safety. In my case, there is a strong case to remove me from the medical register due to my severe alcohol dependence syndrome. I couldn’t last a minute without having a drink, and my life focused around drink. But on the other hand, I have now not had a drink for 15 consecutive years, and I have definitely contributed to medical research and education (examples), and indeed blogposts for the British Geriatric Society (examples).
There are elements to this which merit attention, I feel. Every cultural stigma is encouraged for doctors who have been erased from the register, often due to conduct arising from poor health. This otherness is compounded with ‘rules’ such as having to identify yourself clearly as a doctor on an observership, during ‘erasure’ period, even if you never go anywhere near a patient physically. The word ‘erasure’ is obviously designed to maximise impact of otherness. But the causes of ‘erasure’ are not simple. It is now conceded that a series of medical errors can culminate due to features of a system out of control, and that making somebody the fall guy is not actually tackling the issue at hand. The General Medical Council, whatever it is precisely, has already made it clear that some misjudgments were made in their handling of the BawaGarba case, and overall many of us would like to ‘learn not blame’. It is for example ‘work in progress’ whether the General Medical Council could or should overrule decisions made by its independent tribunal (tweet).
Furthermore, the statutory duty (or one of them) of the General Medical Council is to promote patient safety under historic legislation. Although I sympathise with the argument that the General Medical Council is ‘not an employment agency’, look at me. I became disabled suddenly, after I was erased, so therefore I am actually entitled to reasonable adjustments for a phased return on coming back to employment. There should be some rehabilitation for doctors after a long period away, not least because all the guidelines changed, so did the IT systems. It is therefore no surprise that despite being fully registered with a license to practise I have never been successfully returned to training. The loss of income and opportunities are colossal, especially when you consider that I am genuinely enthusiastic about medical education and research.
This is simply weird, when we are being told in perpetua that there is a recruitment crisis in the NHS. The coronavirus pandemic will possibly exacerbate this. And part of the reason doctors in the workforce may have poor well being is that the workforce is under-doctored and over-stretched. It makes sense to have more doctors. There are thousands of doctors not in training who easily could be – and I think that this is simply unforgivable.
But this is just one half of an extremely problematic narrative. It is already conceded that Black, Asian and Minority Ethnic (BAME) doctors, overseas graduates, older male doctors and some non-specialist doctors are more likely than their counterparts to be referred to the GMC by employers or healthcare providers. And likewise, it is reported that Black nurses and midwives as well as those of Unknown ethnicity are disproportionately represented in the population of referrals to the NMC. The definition by Sir William Macpherson of ‘institutional racism’ continues to be important, if somewhat controversial. For many, institutional racism itself exists, and scrutiny is needed why or if the NHS has not got a problem with it. Whilst the use of the term ‘lived experience’ might be controversial, to deny the existence of racism is potentially problematic, even if an expression of free speech.
In the absence of clear processes for rehabilitation of ‘offensive’ doctors, I think there is an element of ‘cancel culture’ to all this. I don’t want to go down an essential rabbit hole of whether the NHS and connected bodies are institutionally racist. The irony is that there is statutory protection for the rehabilitation of even hardened criminal offenders. Doctors deemed to be offensive by some of their peers are not afforded the same protection. Whatever the reason, this should be a cause for concern, I feel.
Dr Shibley Rahman blog 
Very well articulated article
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