June 22nd, 2015

Regulator gives irresponsible doctors green light to say false and harmful things to the public

trust-me-im-a-doctor

But who holds you to account for what you say?

What stops a doctor going on to the radio, appearing as a trusted voice of the medical profession and representative of the BMA, but making false and misleading statements about an important public health issue? What if the factual errors and misleading advice cause people to smoke who would otherwise have quit? We know that in Britain doctors are held to account by the General Medical Council and sometimes the courts for professional negligence in their surgeries and hospitals, but who holds them to account for negligent statements to the public?

No-one it seems.  In Britain, the following case shows that doctors can say just about anything, no matter how wrong, irresponsible and harmful, and escape any professional accountability. The GMC simply washes its hands and lets them off.

(Note: just looking for the complaint? It’s here)

  1. Background: doctor makes false statements about e-cigarette on the radio
  2. Complaint to GMC: false, misleading and harmful claims refuted
  3. First response from GMC: he was only expressing an opinion
  4. First reaction from complainant: he was making false factual claims
  5. Second response from GMC: not serious enough and out of scope
  6. Second reaction from complainants: the reasoning is completely inadequate
  7. Final response from GMC: we rarely take action on statements by doctors
  8. Final reaction: doctors are unaccountable for their public statements

1. Background: doctor makes false statements about e-cigarettes on the radio

On 31 March 2015, Dr George Rae a high profile general practitioner from Whitley Bay appeared on BBC Radio Newcastle in his capacity as Chair of the British Medical Association in the North East.  In the course of a short interview, Dr Rae made a number of irresponsibly false claims about the comparative health risks of e-cigarettes and cigarette smoking.  These included, but were not limited to, the following three statements:

1. Rae: But you’ve got to realise that there are chemicals within e-cigarettes, particularly a group of chemicals called nitrosamines, and nitrosamines actually can cause cancer. They can be even more cancer forming than what you’re getting within cigarettes themselves.

2. Presenter: We often hear of tar, you know, in the adverts of years ago really, it’s all about the tar causing the problems, but with the e-cigarettes if there’s different types of chemicals, by the sounds of it they can cause the same types of problems.

Rae: Absolutely, there’s absolutely no doubt about that at all, and that is the whole point.

3. Rae: But no [e-cigarette use is] not better, because what I’m actually trying to get across, and I’ll say it again, there are potentially more cancer forming chemicals within e-cigarettes than you’ve actually got in cigarettes per se themselves.

So there you have it – a prominent doctor claiming that e-cigarettes are as dangerous or more dangerous than smoking, speaking as representative of the BMA and to an audience of tens of thousands.  There is no question that this is completely wrong and highly misleading.   You can read the transcript or listen to an audio recording – there is no dispute he said these things.

2. Complaint to GMC: false, misleading and harmful claims refuted

So working with David Dorn, a prominent vaper and commentator from the North East who had heard the broadcast live, we decided to formulate a complaint to the General Medical Council (GMC).  The GMC is in theory the body that regulates the professional conduct of doctors. Our view was, and remains, that professional standards apply to doctors even when they are outside the consulting room and that making recklessly false statements to the public is a form of professional misconduct, or ‘public health negligence’ as one expert described it privately.  We considered a complaint to this body was justified because of what GMC says about Duties of a doctor, which include:

  • Keep your professional knowledge and skills up to date
  • Never abuse your patients’ trust in you or the public’s trust in the profession

…and in Complaints and the role of the GMC, which states that the GMC can take action to stop or limit a doctor’s right to practise or to issue warnings:

  • We take action to prevent a doctor from putting the safety of patients, or the public’s confidence in doctors, at risk.
  • This might be for example because they … have not kept their medical knowledge and skills up to date and are not competent.

We believe these competence and confidence criteria unambiguously apply in this case, so we formulated a detailed complaint that examined Dr Rae’s claims in detail and provided referenced evidence showing his views to be false, and by a large margin.  In the covering letter to the GMC we say:

7th April 2015

Dr Rae asserted that e-cigarette use was as dangerous as smoking or more so. This is incorrect by a large margin and potentially harmful if it influences smokers’ perceptions of risk. Beyond that, I will not repeat the complaint in this covering email but I would respectfully like to request that GMC reviews the detailed complaint.

The complaint concerns an important aspect of the role of GPs in public health: that being public statements made when speaking as doctors and medical authorities. Doctors command high levels of public trust and are often permitted to speak as unchallenged authorities (as in this case): real damage can be done by a doctor making misleading or false statements via the media.

The complaint addresses what I hope is an important issue for the GMC – the responsibility of doctors to be factually accurate and evidence-based in what they say to the public via the media, and their professional accountability if they make false or harmfully misleading statements.

See: Full text of complaint (PDF)

I won’t repeat the complaint here – please take a look at the details in the linked PDF – I hope you agree it was thoroughly and politely done.  Then return to the exchanges that followed.

3. First response from GMC: he was only expressing an opinion

This reply from GMC attempts to excuse Dr Rae by claiming that: (1) his statements are merely an expression of opinion (they are were factual assertions); (2) to state e-cigarettes are sometimes unregulated (incorrect and not the basis of the complaint anyway); (3) that e-cigarettes may not be as safe as first thought (nonsensical and not the basis of the complaint).

23 April 2015

Dear Mr Bates

Thank you for contacting us with your concerns about Dr Rae and his interview regarding his opinion on the use of e-cigarettes.

We have carefully considered your complaint but have decided not to take the matter any further. I am sorry if this is not the outcome you were hoping for.

The reasons for our decision

We understand that you are unhappy with comments made by the doctor during a radio interview about e-cigarettes and vaping. We note that you are concerned that some of the doctor’s comments and views appeared to be contrary to other published advice about e-cigarettes and their safety.

Having considered all of the information provided we feel that the doctor has expressed an opinion about e-cigarettes in this interview and highlighted that, as in some cases they may currently be unregulated, there may be instances where they may not be as safe to use as first thought.

While we note your concerns that these comments may be contrary to other information about vaping, there is no information to indicate that the these comments would suggest that the doctor’s fitness to practise is impaired or that the GMC needs to take action against the way he can work as a doctor.

We have no powers to regulate a doctor’s opinion in this way and we cannot compel Dr Rae to retract his opinions and statements in this matter. We will therefore be taking no further action against his at this time.

The matter will remain on the doctor’s record for future reference. You may wish to contact the programme makers to voice your concerns about their interview.

About our role

Our role is to ensure that doctors who are registered to practise medicine in the UK are safe to do so. We only take action where we believe we may need to restrict or remove a doctor’s registration to protect patients or the reputation of the medical profession.

Would you like to know more?

I understand that you may be disappointed by our decision not to undertake any further investigation. I enclose a factsheet that gives more information about the type of cases we do investigate that may help you understand why we have made this decision.

I appreciate that making a complaint can be difficult and we are grateful to you for bringing this matter to our attention. I hope this letter has been helpful to you in understanding the reasons for our decision.

I am sorry that the GMC is not able to help you at this time.

Yours sincerely,

[GMC staff]

Enc: ‘Your complaint and the GMC’ factsheet

4. First reaction from complainants: he was making false factual statements

The attached factsheet invites those who are unhappy with the GMC to discuss the case: If you are not happy with the way we have handled your complaint, please discuss the problem with the person who handled your complaint.

So we decided to discuss the case, responding as follows – pointing out that it was not a matter of opinion but several incorrect factually-based assertions; reminding GMC of the harmful consequences of smokers acting on Dr Rae’s advice; the precedent of allowing doctors to say anything to the public, however wrong or dangerous; the inappropriate attempt to shift responsibility to the broadcasters.

24th April 2015

From: Clive Bates

Dear [GMC staff]

Thank you for this response to this complaint. I am of course disappointed, but I am also very surprised and concerned that this decision suggests that doctors seem to be unaccountable for what they say to the public about health issues. In good faith I will follow the guidance in the leaflet you attached: “please discuss the problem with the person who handled your complaint.

I would be grateful for your reaction to the following points:

1. Dr Rae was not expressing opinions but making false assertions

Dr Rae made fact-based affirmative claims, he was not merely expressing opinions. An opinion is of the form: “I dislike the smell of e-cigarettes”, “I wouldn’t recommend them”, “I prefer people to quit completely”. Dr Rae made factual claims about the toxins in e-cigarette vapour and the risk of using these products compared to smoking. These claims are false, misleading and likely to cause harm.

The three affirmative claims that I highlighted were as follows (please refer to the original complaint):

Rae: But you’ve got to realise that there are chemicals within e-cigarettes, particularly a group of chemicals called nitrosamines, and nitrosamines actually can cause cancer. They can be even more cancer forming than what you’re getting within cigarettes themselves.

Presenter: We often hear of tar, you know, in the adverts of years ago really, it’s all about the tar causing the problems, but with the e-cigarettes if there’s different types of chemicals, by the sounds of it they can cause the same types of problems.

Rae: Absolutely, there’s absolutely no doubt about that at all, and that is the whole point.

Rae: But no [e-cigarette use is] not better, because what I’m actually trying to get across, and I’ll say it again, there are potentially more cancer forming chemicals within e-cigarettes than you’ve actually got in cigarettes per se themselves.

These are not opinions, they are factual claims that can be easily refuted with the most basic grasp of the evidence. The first is wrong by a factor of 1800 times. The second is incorrect: there is no similarity physically or chemically between e-cigarette vapour and the tar in cigarette smoke, and no equivalence in the health risk. The third asserts that e-cigarette use poses a higher cancer risk than smoking, and that is completely untrue – we can be certain of that because e-cigarette vapour contains far fewer carcinogens and at much lower concentrations.

Has the GMC asked Dr Rae to substantiate these specific claims? Has the GMC validated that these claims are correct and acceptable for a medical professional to make in public?

None of the rationalisations provided in your reply address these concerns. The statement in your email, “there may be instances where they may not be as safe to use as first thought” does not provide any basis for legitimising the statements made by Dr Rae. In fact most adults greatly overstate the risks, and e-cigarettes are much less dangerous than most people think.

2. This is a case of professional negligence with real harms involved

The heart of the public health concern in this case is that people who smoke or vape may act on the false assertions that Dr Rae was making on the radio. If they did respond rationally to the statements made by Dr Rae, then smokers would not try to switch to e-cigarette, e-cigarette users may consider relapsing to smoking and young people just beginning to smoke might be deterred from trying e-cigarettes instead. In each case those who respond rationally to Dr Rae’s false assertions of fact will suffer far greater toxic exposure and harm. These are real risks, not just a matter of debate or contending opinions. In making such statements, Dr Rae is in our view committing acts of public health negligence – and these are made more serious because his statements reached thousands of people simultaneously through a radio programme.

Does the GMC believe statements made by Dr Rae pose no risk to health or will not adversely affect smoking behaviour? If Dr Rae’s false and misleading claims do pose a risk to health, on what basis can his actions be considered acceptable rather than negligent practice for a doctor?

3. The classification of false statements as legitimate opinion sets an unacceptable precedent

It would be wise to consider the wider precedent established by the GMC’s decision in this case. If statements like this can be considered legitimate opinion, it implies that doctors have no accountability for anything they say to the public, however factually inaccurate and whatever the public health consequences. If a doctor asserted in the face of all evidence to the contrary that a particular diet could cure cancer, that vaccines were harmful to children, or that condoms were ineffective in protecting against HIV infection, would that be considered as just expressing an opinion and a matter of indifference for the GMC?

I would be grateful if you could explain or give an example of where a doctor’s statement about a public health issue would be considered a matter for the GMC.

4. Irresponsible statements made by doctors are not the responsibility of broadcasters

In suggesting that I “may wish to contact the programme makers to voice your concerns about their interview“, the GMC appears to be transferring responsibility from a negligent doctor to the broadcaster, and by inference to the broadcasters’ regulators, the BBC Trust and OFCOM. This is extremely concerning. Doctors have a high degree of trust in society and strong professional ethos. In this case the BBC assumed that a doctor accepting an invitation to speak about an important public health issue would give a reliable account of the state of knowledge about these issues.

I would be grateful if you could explain by what means doctors are held to account if they make false or misleading public statements which plausibly cause adverse health consequences.

We did take some care in making this complaint and provided an extensive reasoned and evidence based case demonstrating the Dr Rae had made false and misleading claims of fact. The response from the GMC and the reasoning provided is disappointing and wholly unconvincing. I hope you will respond by taking this complaint seriously and, in the spirit of the discussion suggested in your leaflet, that you will respond to the points and questions set out above.

I look forward to hearing from you.

Yours sincerely.

Clive Bates.

5. Second response from GMC: not serious enough and out of scope

To which the GMC replies changing its argument.  This time it claims that the issue is both too trivial for them to deal with or falls outside its remit.  None of this holds water: the complaint was made against a specific doctor for his public statements.

24 April 2015

Dear Mr Bates

Thank you for your recent correspondence. We are sorry that you are unhappy with our decision to close your complaint.

All complaints received are considered with the upmost seriousness, however not all complaints are matters that would require our action. In this case we do not feel that the concerns you have raised may require us to take action against the doctor’s registration at this time or fall within our remit for investigation.

At this point it may be helpful to reiterate that the GMC can only consider the fitness to practise of individual doctors. We are not a general complaints body and cannot provide answers to specific points such as those referenced in your email as it is not within our role to do so.

We appreciate that you strongly disagree with the comments made by the doctor but we do not consider there to be any suggestion that his fitness to practise medicine is impaired to warrant GMC action to restrict or remove his registration. As such does not fall within our remit to consider your complaint further at this time.

We are sorry that we are unable to assist you further.

Yours Sincerely

[GMC Staff]

6. Second reaction from complainants: the reasoning is is completely inadequate

We respond with exasperation and ask under what circumstances doctors can be held to account for what they say in public.

To: GMC Fitness to Practise

2nd May 2015

Dear [GMC staff]

I am surprised and somewhat exasperated by your reply. I was taking up the offer to discuss the case that was made in the leaflet enclosed by your colleague [GMC staff]. My purpose is to obtain an explanation of GMC’s reasoning in making its decision in this specific case. I am not making general enquiries.

The reasoning provided in [GMC staff] response bears little relationship to the substance of the complaint, so I think it is reasonable to ask some simple questions about how the decision was reached. Dr Rae was not ‘expressing opinions’ he was making affirmative statements of fact about toxic exposures and the comparative risk between smoking and e-cigarette use – these assertions were unambiguously wrong and potentially harmful. There is no evidence anywhere to support any of his statements, and I presented evidence to show that he was wrong by a very large margin. The issue is not a difference of opinion, any more than erroneous and potentially dangerous beliefs about medical treatment can be dismissed as matters of opinion.

The more general questions I asked were intended to help you explain the reasoning in this specific case. It is not unreasonable to ask in what circumstances a doctor’s public statements would be deemed a matter for intervention by the GMC. If the answer is ‘in no circumstances are the public statements of doctors a matter for the GMC’ then please just clarify that is the case – is that what you mean by ‘or fall within our remit for investigation’? Alternatively, please clarify where a doctor’s public statements are deemed a matter for the GMC. At present, I am left with the impression that doctors can make any public statement, no matter how incorrect, irresponsible or damaging, without any professional accountability.

As I was invited to, I am trying to discuss the case with the investigator. I would like to see some reasoning for the decision in this specific case that addresses the actual complaint made and to understand GMC’s decision-making in this case by reference to GMC’s general approach to factually incorrect public statements made by doctors. There is nothing that I have asked that falls outside the GMC’s charitable purposes.

I look forward to hearing from you.

Yours sincerely

Clive Bates

7. Final response from GMC: we rarely take action on statements by doctors

The final GMC response came in the form of a scanned letter. The key paragraphs are:

Public statements

Typically, a complaint about comments made by a doctor in public is less likely to lead to action being taken than a complaint about a clinical incident.  However, we look at each complaint we receive on its own merit and we do not prejudge them based on the nature of the complaint. If the doctor’s comments were particularly offensive or unprofessional, we may decide to look into them further.

Reason for closure

In this instance, we did not open an investigation into your concerns because we do not believe they are serious enough to suggest we may need to restrict or remove Dr Rae’s registration or ability to work. We do not believe that in making these comments Dr Rae has put current or future patient safety at significant risk.

So if a doctor’s comments are “particularly offensive or unprofessional” then GMC “may decide to look into them“.  We take this to mean that:

  • for comments that are just ordinarily offensive or unprofessional there is no accountability or means to complain about professional conduct
  • that even particularly offensive or unprofessional comments sometimes may not attract interest from the GMC
  • that being wrong by a factor of more than 1000 times and saying things that are clearly false, misleading and harmful to the public does not qualify as particularly unprofessional commentary.

8. Final reaction from complainants: doctors are unaccountable for their public statements

We declined to pursue this further on the basis that it is a waste of time and that GMC is primarily concerned with protecting the GP rather than upholding professional standards or holding him to account. However, so that others can judge whether this was unprofessional conduct, we decided to make this record public.  We draw the following conclusions:

  1. The main concern emerging from the responses from the GMC is that doctors appear to have no professional accountability for what they say publicly, however false or damaging, even though they have to abide by professional standards throughout all other aspects of their work.
  2. The concept of ‘public health negligence’ is not taken seriously, yet making misleading statements about smoking to thousands of people via broadcast media has the potential to harm many people by adversely modifying their smoking-related behaviour.
  3. The GMC did not attempt to justify Dr Rae’s statements, did not seek a justification from Dr Rae and did not investigate the issue.  However, Dr Rae’s statements unambiguously breach GMC guidance on what is expected of doctors (professional competence, knowledge and skills) and gives cause for the public to distrust the medical profession more generally – itself a basis for action by the GMC.
  4. The GMC argued that the case was insufficiently serious to warrant an investigation – but only after  incorrectly claiming his views were a matter of opinion and offering other inadequate reasons.   We are concerned that the case was closed with a cursory dismissal. Subsequent correspondence simply served to shore up that decision without any rigorous argument. The GMC refused to be drawn on the principles it applies to assessing false or misleading public statements by doctors.
  5. One argument was that the concerns were too trivial to warrant further investigation.  Many doctors would recognise smoking as the single most important source of preventable disease, and GPs are collectively paid over £80 million through their contracts to reduce smoking around £10,000 for the average sized practice  It seems to us to be the height of irresponsibility to give the public demonstrably false information and so exaggerate the risks of alternatives to smoking.
  6. We have no wish to stop Dr Rae seeing patients at his surgery: that would be a sanction poorly targeted at this particular irresponsible behaviour. However, the GMC has the option to issue a warning and could have limited Dr Rae’s freedom to make public statements as a professional doctor until he has acquainted himself with the evidence related to the issues he is discussing.

Dr Rae or the BMA are welcome to reply to justify Dr Rae’s statements or put his case on the record. Space is reserved below for a reply.

31 comments to Regulator gives irresponsible doctors green light to say false and harmful things to the public

  • Guy Eaton

    Brillant Clive,
    Well you simply cannot trust what Doctors say. They hastened my Father’s death (by refusing to give him a chest x-ray despite having a history of heavy smoking) ruined my son’s health and did not correctly diagnose me with eczema 30 years!!! Many are worse than useless. I think I would be a better medical Doctor than many with a years training and good google research techniques! The above utterly despicable.

  • irish Lass

    Clive, thanks for another good attempt to attack the rubbish being spouted against e-cigs by those who should know better. I’m not a bit surprised by the GMC response, but all those who want vaping to continue to be a harm reduction option need to take every opportunity to fight the propaganda against e-cigarettes. So good for you!

    By the way, travelling home from Zurich airport yesterday, I was delighted to find an e-cig stand in the middle of the cigarette section in the duty free shop. But when I looked more closely, all the e-cigs and refills were zero nicotine. Is this a joke?? Are they not allowed to sell e-liquids containing nicotine, when they ARE allowed (and happy, it seems) to sell normal cigarettes to passengers by the cartload? Is this the influence of the medical “experts” at work??

    Fauch! When is good sense going to prevail over the madness into which modern life is descending?

  • john

    Clive Hi
    The false statements were broadcasted , are there avenues via some sort of UK ‘media ombudsmans’ office , re significantly ,factually untrue statements, aired on the BBC?

    • Clive Bates

      The BBC Trust is the regulator for the BBC. But I don’t think it is worth going down that road – and the GMC suggested that’s what we do as a way of ducking its own responsibilities. The issue is with the capability and trustworthiness of a doctor who chose to put himself forward as a spokesperson on this issue, but without having even the slightest grasp of the subject. I’d like to keep the issue on accountability of medical professionals, not on the impartiality of broadcasters.

  • Bemused

    its quite clear cigarettes need to go and ecigs is the first ever product that actually works,through time maybe something will pop up that’s proven to mean they are not safe but in the meantime the amount of interest and energy going into the panic should be redirected into actual factual and structured studies.

    People need to wake up and look closer at whats really happening behind the scenes at the same time we still do need regulations in place to protect ourselves but we do not need the absurd ways that are being actioned on.

    the fact is vaping is here now and many people have chosen it there is a major voice but this major voice is mostly sitting back and reading about it rather than standing up for something they believe in get your arse in gear and make a stand or you may just lose,TPD is going to happen but damage limitation is what people need to start addressing do we really want to see businesses closing people out of work and millions returning to cigs.
    ecigs do not renormalise smoking,ecigs are a safer harm reduction politics,greed and pride have no place in telling me what is good for my health

  • The various ‘doctors’ who represent the BMA all seem to be saying the same thing. They repeat the same mantras. One cannot help but think that the whole anti-ecig programme is orchestrated. And yet, the RCP (and its creature, ASH) is not with the BMA on this. I wonder why the RCP has broken ranks?
    One cannot help but think that, since the GMC is primarily a body which avoids striking off doctors if it can possibly do so (and rightly so I imagine), then it would not wish to be antagonistic to the BMA.
    I think, in a sense, the GMC is right not to get involved, even if that means doing a lot of squirming. Their role involves actual malpractice, which may also include verbal malpractice of a clinical nature.
    The real problem is that there is no one to turn to. There is so much corruption of an idealogical kind that propaganda and truth become interchangeable. No public body is immune.
    I can understand Nisakiman’s frustrations. One could apply the arguments which Clive and others are levelling at Dr Rae to SHS. Gosh! The McTear Case (2005) showed that Tobacco Control could not even prove, even merely on the balance of probabilities, that smoking itself causes lung cancer, never mind SHS.
    OK. That is not the subject here, and I accept it. However, it does illustrate how hard it is to counter propaganda and dogma when there is no public body to turn to.
    It is almost as though criminal courts did not allow the accused to defend himself.

    • Dodderer

      It is rather a shame that all Tobacco Control output can’t be “peer-reviewed” by Judge Nimmo Smith although I guess this would put an end to Tobacco Control output!

  • Nigel D

    Fascinating post Clive, and well done on your efforts.

    I find it staggering that a doctor could go live on air to the public with this, especially with absolutely no proof on offer to back up his so called “facts”

    It seems there is a lot of scaremongering going on internationally with regards to vaping/ecig use with little to no evidence to back it up. I can’t help but wonder if this is merely the start of a campaign to bring in a high tax on vaping products to fill the tax gap left by the falling number of analogue smokers?

    I think that quite understandably there should be continued studies conducted into ecig use and eliquid ingredients, but this kind of negative, unsubstantiated nonsense is worrying to say the least.

  • Steve T

    Like many professions, that years ago were populated by honest, upstanding individuals, the medical world has become corrupted by money. Many, many doctors enjoy expensive hospitality provided by the big drugs companies and are therefore “guided” in their preference for treatments. These companies sell, at vast profit, a range of gums, patches etc. that are practically ineffective when compared to vaping. Hence the attacks on e-cigarettes in the media and at the EU to name but 2.

    Well done to Clive for trying to take on the GMC but they have proven to be only interested in protecting their own and the lifestyle benefits that sucking up to pharmaceutical companies provides.

  • David Moger

    I would like to thank Clive for his efforts on our part. I have been through the same process with the BBC and I know how frustrating it is. It was about a program called Pedigree Dogs Exposed and contained completely false statements about the dogs I breed, Cavalier King Charles Spaniels. After many escalations of my complaint they decided that a vet could say anything they like and we have no right to put a different opinion. The one thing I learnt was don’t do it on your own as one member of the public is easy to fob off. At least take a whole bunch with you if you cannot get an organisation or person of note to do it for you. Incidentally time has proved me right but all too late to stop enormous damage to be done to the breed.

  • Chris Price

    See:

    GMC Promotes Mass Murder By Doctors
    https://www.facebook.com/groups/VapersNetwork/

  • Dragonmum

    Nisakiman,
    We are all on a massive learning curve with non-combustible tobacco products; as one who has always doubted the validity of the SHS argument I can have some sympathy with your viewpoint. That said, however, what Clive is supporting here is a product offering a 99% safer alternative to smoking with absolutely no evidence against it at this time. Had Phillipe Even been able to voice his views while still employed http://cagecanada.homestead.com/InterviewWithPrEven.html then many might have seen things differently – as it is we work with what we have and I cannot sufficiently express my gratitude to people like Clive who are prepared to take on Officialdom with a gravitas that the “lay” advocate cannot aspire to.He has been the cornerstone in all this (when it was a very unpopular thing to be) and I hope for all our sakes that he remains firmly in our corner.
    Just a thought, it is possible, indeed likely, that the views expressed by Dr Rae could be responsible for more deaths than the misdemeanours of the late Dr Harold Shipman – wonder if they’d have supported him too?

  • Adam Williams

    Nisakiman.
    Taking a pop at clive is unwarranted IMO. (Although I do agree in part with your sentiment over SHS) I think you’ll find that Bill Godsall was also a perpetrator. However, that was then and this is now. God help us if we didn’t have them on our side today. Leopards can change their spots and I’m happy for them to do so.
    Clive, as ever, thank you for your efforts thus far, I for one appreciate them, along with many others.
    As an aside. My wife suffers from pulmonary fibrosis. So SHS seriously effects her breathing when she’s in contact with it,(To the point of collapse) if it were’t for cleaner air in supermarkets etc she’d be totally housebound. That said, second hand vapour from e-cigs has no adverse effect on her. so perhaps, a case in point?

  • Roger Hall

    Reading the above should I ever require a doctor’s professional advice I will always be mindful of one simple fact: Is the doctor treating me actually making his decisions based on scientific and legitimate medical advice or simply ignoring any such crucial evidence and just stating his opinions? If I wanted unqualified opinions then I’d simply visit the pub. This sets a highly worrying precedent and ultimately it will affect the public’s perception of all medically qualified professionals. The integrity of the majority of ethical medical professionals is being seriously eroded by the organisations that supposedly represent them and this fact surely cannot be welcomed by their rank and file membership? Perhaps a copy of this should be sent to Dr. Sarah Wollaston, I believe a previous supporter of ecigs, a GP and now an MP and chairwoman of the All Party Health Committee.

  • nisakiman

    I don’t know why you express surprise or exasperation at the refusal of the medical profession to admit to the facts, Clive. This isn’t about health, it’s about ideology, and has been since the ‘Godber Blueprint’ took shape.

    After all, you yourself took part in leading the charge regarding the completely unsubstantiated myth of ‘Second-Hand Smoke’, which has had a devastating effect on the lives of millions of decent people and the businesses which catered to them. Hundreds of thousands lost their jobs and businesses in UK alone, and for absolutely no health gain. And as for the social costs, they have been horrendous. A wedge has been driven into the heart of communities; bigotry and discrimination are officially sanctioned and hatred and contempt are encouraged; children are being used as political tools to divide families and ever more restrictive and illiberal laws are being passed. We are now told that the greatest health problem the elderly face is loneliness – a direct consequence of driving out of business the majority of social venues like bingo halls, working men’s clubs, pubs etc etc where the elderly would go to socialise. And all to further the warped ideological agenda of a small coterie of zealots.

    I shudder to think what damage this falsehood of the ‘dangers’ of SHS has done to the economy worldwide, with the bans and restrictions that have been enacted as a result of the FCTC’s rulings. And you were part of it, Clive, so spare us the crocodile tears for the trials and tribulations that e-cigs are suffering at the hands of Tobacco Control now. You helped create this monster, this poisonous ideology. Now you must learn to live with it.

    • Clive Bates

      Hi – grumpy rejoinders always welcome here! But sadly I’ve no time to spend on arguing about these issues – though I’m sympathetic to some of what you say. I’d rather focus on what little I can do in the limited time I have – in my case that means promoting low-risk alternatives to smoking as an option for smokers, or what some call ‘tobacco harm reduction’ as a public health strategy.

      “Public health” is not one thing and never has been. There are many different perspectives in the people who work in this area and they change over time – sometimes in response to evidence.

  • Jack Dawson

    Well done Clive for trying to get the GMC to address this; I have often wondered about reporting a public representative of the medical profession in this way. I am not surprised that logic and evidence were overlooked by the GMC as there remains a large body of ‘orthodox’ medical opinion which is viscerally and incorrigibly opposed to vaping. The tide is turning now as the evidence is coming in and these anti-science doctors will be judged by history as being in the same category as those quacks who persisted with cupping and bleeding when scientific medicine had superceded these procedures.

    • Fiona

      At least bleeding by leeches accidentally had some therapeutic benefit (albeit not for the reasons they originally thought).
      This medical approach is wholly inaccurate and dangerous.

  • RobC

    What can we take from this?

    Many Medical Practitioners appear to be either ignorant, deluded or corrupt. They are regulated by their peers who may exhibit the same qualities.
    Therefore any proclamations made by the above, unless they can be substantiated by other means, should be disregarded or at the very least treated with the deepest of suspicion.

  • Simon Thurlow

    It is often the case that such public bodies will try to sweep such complaints under the carpet – despite whether that complaint is right or wrong. What generally forces them to consider the complaint more seriously is where the complaint has come from. In this case, the GMC considers it a complaint from the general public (rightly or wrongly) so feels it has nothing to answer for (such is the arrogance of such a body).

    I wonder if their reaction would be the same were an MP to start demanding answers. To that end, I wonder if asking an MP such as Mark Pawsey to request answers from the GMC might have more effect. When a public figure such as this starts asking questions, then such bodies are more inclined to take the complaint seriously.

    One to consider maybe ?

    • Clive Bates

      Simon – what you say is all too true sadly. My experience is that you have to try to use the options that are available in good faith, and only when and if those are exhausted, then try other means or people. But if you haven’t first shown that the formal path is blocked (and with feeble reasoning as in this case) then I think it is harder to justify escalation. I’m so appalled by this that I’m inclined to find a way to hold GMC to account for being asleep and supine in its role.

    • john

      HM the difference between a Profession, and a conspiracy against the public good (or simply a more ‘innocent’ restraint of trade) is often simply Whats in a Name.

  • Dodderer

    It has been clear since the RPC rejected the attempt of certain factions of the medical and public health professions to regulate ecigs medicinally(effectively a ban) that the focus has switched to ‘perception management’.

    Trying to manage the public’s perception of ecigs applies both to their safety and their effectiveness.When the institutions responsible for controlling these factions fail to act,it falls to our elected/appointed representatives to challenge the factions.

    Questions in both Houses would at least determine on which side our government sits.

  • No name

    A few years back a doctor that suggested a link between MMR vaccinations and autism was struck off the medical register for essentially lying to the public.

    But the doctor that today states clearly that vaping is more likely to cause cancer than smoking; he’s fine?

    Both presented poorly researched opinion as fact, both told people to stay away from something that would potentially save lives. What’s the difference?

    The cynic in me ‘almost’ thinks that one of the two did something to threaten pharma profits whilst the other acted to protect them, but it can’t possibly be that.

  • Douglas Rae Neaves

    This is most perturbing! I must state that I am not related to this chap. (Note to self, must change my name). Doctor ‘Rae’ is probably a very good doctor, although the unkind may say, that he exhibits delusions of adequacy when talking about e-cigarettes.

    There could be a very simple solution to the ‘problem’. Have you slipped or fallen at work? I do apologise, that is the wrong ‘ambulance chasing’ phrase. Have you been put off e-cigarettes by the diatribe of Doctor ‘Rae’ or any other ‘expert’ body, a pseudo-charity, or an infiltrated government department? Write the name of the person that dissuaded you from using e-cigarettes, down on paper, and the organisation that that they are associated with. It is probably a good idea to write to the chap, and the organisation, just to let them know! Apparently it focusses the mind, this is another way of saying it causes their accountants to have sleepless nights. You then have a situation that if you die from a smoking related disease. Your family lawyer can argue that it was person A, from organisation B, publicised by broadcaster C, which contributed to your death. The down side is that the BBC licence fee will end up being five grand a year and some ‘popular’ newspapers will cost one hundred quid an issue.

    To use an extreme example, if the BBC were producing a programme on say, paedophilia, they would not for sake of balance, use the diary of some ‘long dead’ Politian, to argue the counter point.

  • Fiona

    I find the final GMC statement particularly interesting and disturbing:

    “We do not believe that in making these comments Dr Rae has put current or future patient safety at significant risk.”

    The obvious question is how damaging a statement does he have to make to how many people for his assertions to be considered to pose a significant enough risk to warrant investigation?

    As smoking rates are running at 19% (I hazard a guess at higher than that in the densely-populated North East), that’s a lot of people he effectively advised to keep smoking rather than quit with ecigs.

    Given that they’re not interested in the public professional behaviour of GPs, would they have taken more interest in the case if his advice had been in consultation in the surgery and he had convinced only one patient to keep (or resume) smoking rather than quit with the most effective alternative available?

  • It’s not as if this is even an isolated incident from a representative of the BMA. Just the other day we had such gems as:

    “They’re called e-cigarettes so they are cigarettes” – uh huh

    “Nicotine is a pesticide which was withdrawn because it’s so toxic” – yes, to non pest insect species.

    And

    “Get some on a child’s skin and it will kill it” – maybe if you paint industrial strength on a large portion of the child..

    These untruths and hyperbole are getting old frankly, and it’s happening so often it begs the question whether it’s ignorance or malice.

    • Clive Bates

      Note: Sarah’s observations relate to a BMA Spokesperson, Dr Mark Temple, in an interview with BBC Lancaster going head to head with Fraser Cropper of vendor Totally Wicked. The interview was so absurd that TW wrote to the BMA President. See the correspondence and link to broadcast.

      I think the BMA is looking increasingly barmy and marginalised on this issue. The data, evidence and credible scientists are flowing past them, leaving them looking ideological and guilty of misusing their undeserved reputation for medical authority.

      • Scott Wichall

        One must never forget at the end of the day the BMA is merely a union for doctors. And as such should be distrusted as it will be full of ideology and will only seek to protect its members against any criticism.

    • truckerlyn

      Hi Sarah

      Nicotine is used in a huge number of medications, both prescribed and over the counter but it is under the name Niocine.

      Of course, it is not the nicotine in cigarettes that is harmful, it is the tar. Cigarettes were safer decades ago, before governments and other ‘public health’ bodies got involved and brought in legislation about what they contained – I believe.

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