Saturday, 13 October 2012

RCGP Exposed for Bullying (including Cyberbullying); the RCGP must change

Having watched the you-tube video of Amanda Todd I have decided it is not okay to keep silent about bullying (including cyberbullying). I have endured years of bullying and harassment from the Royal College of GPs in performing my role as South London Faculty Honorary Treasurer and then National Council Rep. It is time to expose an institution for bullying. I am grateful to the female asian IMG GP trainee who shared how she stood up to her difficult white GP trainer and declared 'You are a white racist. You must change.' And he did. I am grateful to a male asian IMG GP trainee who reported his GP trainer for saying 'you will never pass CSA.' That GP trainer is no longer a GP trainer. And now it is my turn to challenge institutional bullying. The RCGP must change!

Whistleblowing as Hon Treasurer of South London RCGP Faculty
In 2007, when I blew the whistle as Treasurer of the South London RCGP Faculty on a member of the faculty board overcharging for his services as the MRCGP course facilitator (charging £1000-1250 a day ie £12,000 a year when the board agreed for nominal compensation which was minuted), instead of applause, I was falsely charged with bullying and harassment by the faculty administrator who was the only one who knew of this overcharge which I uncovered as treasurer and checked over the accounts. I followed due process and informed the Chair Dr John Spicer (now Head of School for London Deanery) who said we would have to honour the last invoice but make it clear that we would not pay this fee again. Treasurer Colin Hunter and President David Haslam summoned me to a closed central College meeting to discuss the administrator's 'bullying and harassment' charge and President Haslam asked me to apologise as it would make life easier for the College as there was always a divide between them (administrators) and us (doctors). I decided to play along with the institution, met with the administrator in a meeting with a HR mediator and apologised for upsetting her. In hindsight, I should not have compromised my principles. I had done nothing wrong. College decided to ensure all RCGP MRCGP course facilitators were examiners and increased their fees fron £300 to £750 and asked all faculties to report any expenses of over £10k to Colin Hunter.

In 2007, Dr Ese Stacey, Pastest, Doctors Net and I were invited by the College to a meeting to discuss the new MRCGP exam. It transpired that it was a meeting to ask us to join the RCGP Franchise of MRCGP courses and teach the same 20 cases as that of the RCGP course! Dr Ese Stacey and I both declined as we wished to remain independent course providers.

Emails smearing my name and courses sent by the RCGP to Deaneries
In the Spring of 2008, I listened to a KSS GP trainee (a British Chinese) describe his ordeal in front of a Deanery review panel. I listened as he explained how humiliated he felt as they demanded to know why he kept failing his AKT (applied knowledge test), a computerised MCQ exam. I could see how shaken and depressed it had made him feel and he shared he was not allowed to bring his trainer or an advocate. So I wrote to 4 Deaneries and suggested if they ever had any resits to mention my course as an option as I specialised in re-sitters. What I did not know was that one of the GPs at KSS was the lead for the RCGP MRCGP Course franchise. By June 2008, I received a forward of a trail of emails starting from the RCGP administrator Ruth Palmer to up to 44 Deaneries naming me and smearing my course. The trail had made it to Belfast, Northern Ireland and an alumnus GP sent it on to me as he was appalled. In the trail, Trent Deanery had commented that they were now withdrawing funding for my course. I was shocked that the RCGP would write such an awful email to ensure a private competitor did not get any trainees. 25 Jun 2008 'can you forward this email to all our Trainees telling them attendance at any course organised by Una Coales will not be supported or funded.' Medical Education Manager, Bassetlaw Hospital. 13 June 2008 'Dear all. Please see the email below from Ruth Palmer,' Regards, Sarah, Manager, National Office of Summative Assessment.

From Ruth Palmer, cc Colin Hunter 13 June 2008 to Sarah Robinson 'Dear Director, some of you may recently have received an e-mail from Dr Una Coales advertising her nMRCGP courses and urging you to encourage your course organisers to send trainees on it to 'end up with a 100% deanery pass rate'. I would like to emphasize that Dr Coales is not an authorized College nMRCGP course provider and the information contained in her emails has not been provided to her by the College. The statistics that are contained in some of the e-mails we have seen should be treated with great caution. The College is very concerned about the impression given by these e-mails and by the confidential information contained within them and will be taking appropriate action. I have already been forwarded emails received by KSS, Wessex and East Midlands. If any other deaneries have received similar e-mails I would be grateful if they would forward them to me so that we have the complete picture. Please disseminate this e-mail as appropriate. Many thanks for your help.' Yours sincerely, Ruth Palmer, Director Professional Development and Standards, RCGP.

Malicious GMC referral by the RCGP to shut down my MRCGP Courses.
That summer I had applied for Fellowship of the RCGP. My referees were the then RCGP Vice Chair Clare Gerada, Chair of the South London Faculty Board John Spicer and Lambeth LMC Chair Jenny Law who I had worked for since I was a training GP SHO.Two months later, October 2008, I got a letter in the postbox, it was from the GMC! Honorary Secretary Maureen Baker had maliciously referred me to the GMC in the name of the College, without knowledge or consent of the RCGP Council (who were also the Trustees of the College)! I was shocked. It was RCGP administrator Ruth Palmer who had penned pages of malicious and false accusations about my courses! I contacted the MPS and I was represented by a barrister who had also been a former Honorary Secretary of the Royal College of Physicians. I was appalled that the RCGP would go behind my back as an Hon Faculty Treasurer and refer me to the GMC so I ran for RCGP President and national Council Rep. My colleagues knew what was going on and they voted for me. They wanted to change the system. My mentor Dr Law explained I had been referred to the GMC because I was 'competing with the RCGP' by running courses. Dr Ese Stacey retired from teaching shortly after I shared with her how the RCGP had treated me. This was not a level playing field.

Closed meeting to intimidate a Presidential Candidate
In the Spring of 2009, I put in my application with signatures from 25 GP sponsors for President. The College asked me to remove 13 so I did with much difficulty. During the voting period, I was summoned to a closed meeting at the RCGP. The CEO Hilary De Lyon explained that it was an 'induction meeting for President'. How could this be an induction if GPs were still voting? I brought an advocate with me but Hilary blocked him from sitting in and I was taken upstairs to meet with President David Haslam and Hilary. They both explained that the role of President was to be mute. 'Do not speak to press. Do not answer any questions. If a question is directed to you, refer it to the Chair. You are not allowed to write any articles. You will have to give up your teaching.' I asked if I was allowed to continue to be a GP. Hilary replied yes. Dr Haslam added that 'no one remembers the President.' I was not sure why he even mentioned this. I was not running to be remembered but I ran for President to clean up this institution! After the meeting I transcribed the conversation and emailed it to my barrister who was still representing me in this GMC investigation. Interestingly she said that the Royal College of Physicians had debated the conflict of interest in administering the MRCP exam and running courses and had held off on running courses for many years until recently.

By the summer of 2009, the results came in and I placed as runner-up but first for National Council Rep. My role was to begin November 2009. In August 2009, the Honorary Secretary Maureen Baker withdrew the GMC complaint. I had yet to meet this GP! Ironically when I taught the oral module of the old MRCGP exam I would teach how GPs would respect working with colleagues and meet first with them informally, then formally, then refer to the PCT and finally the GMC. My referral had lacked the laws of natural justice and process! The GMC sent me a letter that they were not taking any action nor proceeding any further and the reason the complaint was withdrawn was for lack of evidence and the RCGP stipulated they would keep a file open on me.

Excerpts from the 'Orwellian' RCGP Dossier collected on me by administrator Mike Whelan (MW) since 2008 labelled MW1111 (Clipboard phenomenon)


Hostile male RCGP examiner council reps
November 2009, I joined the RCGP Council only to be greeted by male RCGP examiners with hostility! I was asked whether I felt it was a conflict of interest being on Council as a course provider. I said no and that our South London faculty rep on council also ran private courses as did some RCGP examiners on Council. To this day, I was never made to feel welcome on Council although did make friends in Dr Howard Bloom, Dr Peter Davies, Dr Rhona Knight and Dr Saqib Anwar.

I met with Vice Chair Clare Gerada and explained that I was going to raise this inappropriate GMC referral on Council as I felt that an officer of the College should have made the College trustees aware before she used the name of the College to refer a faculty treasurer to the GMC. She suggested I speak with Professor Mike Pringle.

College try to cover up officer's actions
13 October 2009 Ruth Palmer emails Professor Mike Pringle 'looks like she is still keen to raise this at Council.  We clearly need to go ahead with the mediation...I will pass.. the details of the recommended mediator (Philip Havers QC, One Crown Office...) He comes highly recommended for his expert mediation work, experience of mediation in other RCs (esp RCS) and charming personality (very useful?).'

He met with me and Ruth Palmer was present to minute the meeting. He offered that we draw a line and would I be happy to meet with Human Rights QC Phil Havers and that the College would pay his fees. I said I wanted an apology and that in future the College should follow due process and the laws of natural justice. Professor Pringle apologised to me personally but said he could not apologise in the name of the College. I met with Phil Havers and Hilary de Lyon represented the College in 1 Crown Row. At first Hilary did not want to agree to anything so I reminded Havers that it was the College who had offered this mediation meeting not I. She agreed she would discuss with the College lawyers about an apology and rephrasing of the letter to me which stated the case would be kept open! The RCGP never did keep their end of the mediation agreement and I never received a formal apology and a line was never drawn as promised. Phil Havers was surprised that the RCGP were paying full costs for his time as he said usually in mediation, both sides split the cost. In hindsight, I should have spoken up on Council to let the College trustees know that officers of the College were taking actions without their knowledge or consent which was against the constitution.

RCGP almost seated wrong GP in national council elections
In November I heard that the GP who placed 7th in the nationals would be granted a year on Council in place of the new President. I was puzzled when Hilary announced Steve Mowle. I knew he had seated 8th, not 7th and that a female GP Dr Alison Hill should have been offered the seat on Council. I googled and traced Dr Hill and made contact through Dr Gillian Braunold. She too had thought she had seated 7th but was told on the phone by the returning officer administrator that she had read the STV results incorrectly and had seated 8th after transfer of votes. I contacted the Electoral Reform Service and confirmed the copy of STV results that I had received were accurate. I duly informed the new Honorary Secretary Amanda Howe who investigated and Dr Alison Hill was offered her rightful seat on Council. She declined as it was now several months since the election results and her life circumstances had changed. I was fortunate to have met her at a focus group in her role as Medical Director for North London. The College performed a SEA led by a charity lawyer Andrew Dobson and this was made public on their website with an apology, as Alison's constituents were owed an explanation and Alison a formal apology.

'One day there will be no IMG GPs.'
On Council, I ran for Vice Chair, I applied to sit on the International Committee twice, the Trustee Board, yet was unsuccessful. It seemed as a national council rep, I could not even join any internal committee without applying separately! What exactly was my role then but to attend 4 meetings a year and speak for no more than 5 minutes? I asked to sit in a postgraduate meeting as an observer. Dr Bill Reith was chairing. It was the Spring of 2010. I had no idea that what was being discussed would change the course of the CSA and life for non white GP trainees! One white male GP sitting on the left hand side of the tables arranged in a rectangle spoke up and announced 'one day there will be no IMG GPs.' I was shocked and puzzled. How?

I was asked to coffee a few months later and Clare Gerada shared she was worried the bar was being set too high. It was all very cryptic and still I did not know to what she was referring.

September 2010 CSA bar set too high
September 2010 will go down in history as the worst CSA results for non white GP trainees! The marking system had been changed. The bar had indeed been raised to a point competent non white UK trainees were also failing CSA. The RCGP had conducted an exam with a different marking system without pre-approval of the GMC! Council, the BMA GPC and GP trainees were in an uproar. Scottish Council reps argued that the 27 GP trainees who should have passed if the bar had been set at the November 2010 level, should be given automatic passes. I argued they should be passed and receive compensation. The College leaders decided to offer them the November sitting for free. Sadly not all 27 GPs ever did pass their CSA despite repeated attempts.

AiT Chair Motion to Council to ask why there was such a big difference in CSA pass rates
November 2010 the CSA was scored out of 117 or 13 stations with a maximum of 9 marks per station. The pass mark ranged from 73 to 77 each day so a comfortable pass of 78 could be achieved by passing in all 13 stations, ie 6/9 marks x 13, as 5/9 was a fail. The pass rate between white UK graduates and non white UK graduates and an even greater difference between white UK graduates and IMGs caught the eye of Dr Saqib Anwar (chair of the AiT committee). He and I drafted a proposal to Council to ask why? Dr Rhona Knight, a Christian examiner and Leicester faculty rep to council, seconded the motion.

Unconscious bias vs blatant denial
In February, I took the motion to my South London Faculty to ask that our faculty second the motion to ask why as the Chair of the AiT Committee was just an observer to council so needed a proposer and seconder. There was clearly a divide between the white GPs on the board and the non whites. The whites interrupted the non whites, denied bias and got angry. 2 non white GPs resigned the board after witnessing this meeting. Needless to say the white leadership outvoted the non whites and South London did not support the motion. On Feb 2011, Council had a heated debate. The motion received enough support to be put to the vote but the President (a alleged 'mute' role, spoke up and reworded the motion!). I was shocked that Dr Anwar's motion could be railroaded and rewritten! The examiners were adamant they were not biased and Council were asked to vote that College would spend £300k for Kings Fund to explore the differences between UK and IMG GP trainees. Somehow the fact that nonwhite UK GPs were fairing worse than white UK GPs was sidelined.

High Exam Costs
By 2012, I decided I needed to run for RCGP President again as the College still had issues. I had raised on Council why the CSA exam was so costly when in 2007 we charged trainees £300 for Simulated Surgery. The response was that it had been run at a loss. I raised on Council that since we had made a £2 million profit on the sale of Princes Gate, could we not now reduce CSA fees? Colin Hunter replied there would be other costs. At the next Council meeting he announced the cost of renovation would be £34 million and at the following it would be £40 million as this now included VAT! I was stunned that we had purchased a building for £34 million and were now spending £40 million on renovations and attempting to recuperate a portion of funds by opening Euston to wedding receptions and 'study room' bedrooms for guests? I raised on Council could College assure members that they would not have to pay for Euston? I was told that members subs would not be used for Euston. Sadly I saw CSA fees go up from approx £1100 in 2007 to its current fee of a staggering £1525 for each attempt! I raised concerns with the costings and was told to meet in private with Treasurer Colin Hunter. I again drew his attention to discrepancies but he said the Ait Committee had approved. I spoke to the Chair of the AiT committee Greg Irving (2010) who said they were shown the confidential costings at the end of an AiT meeting and it was taken back so they could not take away and review.

Charities Commission regulator
I wrote to the Charities Commission to ask for help as I was being bullied and being given a hard time for performing my role as College rep and trustee. The advisor was very sympathetic and guided me in advising the College to put a back statement on their Capital Appeal. This Colin Hunter complied with.

'Not fit and proper'
I ran for President in 2012 only to receive in April 2012, an emailed letter from Dr Tony Mathie (former Dean of Mersey) accusing me of not being 'fit and proper' to stand! I had 48 hours to lodge an appeal. My colleagues were as stunned as I was. In fact 84 GPs across the country put their names down on a list ready to call for an Extraordinary General Meeting to challenge this decision by the Chair of the Nominations Committee. I asked the then Chair Clare Gerada for advice but she said she did not want anything to do with the Presidential election (yet she had been tweeting about the Presidential election!) So I asked former Chair Steve Field for advice. He said look at the process. I rang up a leading charity lawyer and he too confirmed that the process was flawed. That the byelaws clearly stated that 12 sponsors vetted the Presidential candidates and not the Nominations Committee whose role was just to confirm the 12 sponsors were members in good standing.

3 Presidential Candidates refused a formal College apology and external unbiased SEA
After 3 virtual appeals meetings were rescheduled, 2 weeks later, I received an email from Neil Hunt, the new CEO, that I and others were back on the ballot. I was curious to find out which of the GPs had been banned also from running. I had to wait until the names were announced and then it became a matter of contacting each to ask. I made 2 new friends, 2 good and virtuous Presidential candidates who had also been mistreated by the RCGP. I called for an SEA on Council, June 2012, only to have my mike turned off at 2.5 minutes. I distributed the appeal reply by the other Presidential candidate who had also been a faculty chair but Clare demanded they be collected up as I had not asked her permission. Dr Bloom advised me to announce these were not tabled but personal papers. Each of the 65 council reps received a copy of my 5 minute speech (edited by the other Presidential candidate) and his appeal. I was giving him and myself an opportunity to speak up and ask for an apology from College like the one I freely gave publicly on the College website for mistaking that the current President had not sat MRCGP when I had been told by an examiner that she had not undergone VTS training. GPs make mistakes and to apologise is part of the process. Yet College was not prepared to make a formal apology to all 3 Presidential candidates!

By September 2012, I was still waiting for what they agreed to have, an internal SEA headed at first by one of Professor Pringle's sponsors. This was changed to a lay person, who had worked at the Alzheimer's Society charity with Neil Hunt, prior to Neil's appointment as our Chief Executive.

Chair of the Trustee Board - between a rock and a hard place
In October 2012, as Council rep I received an email to vote for the new Chair of the Trustee Board. The 2 choices were Dr Colin Hunter (there is a possibility that he may have colluded with Maureen Baker and Ruth Palmer to refer me maliciously to the GMC and that he may have been involved in stalling my fellowship application for 2 years (administrator emailed me his and Maureen's names as being in charge of my fellowship application) vs Dr Tony Mathie (the chair of the Noms Committee who has yet to apologise to me and the other 2 Presidential candidates). The Trustee Board was to take over supreme decision-making powers for the College and Council would no longer serve as college trustees!

During my 3 years on Council, I have received numerous emails and letters from College with veiled threats of using the Code of Conduct on me since 2009. Today I speak out.


Cyberbullying by doctors
From October 2011-current I received the worst form of bullying to date....cyberbullying! I saw doctors smear me in doctors net, mock me and saw cyber lynching. I wept all night as I read male doctors from all specialties mock me on the GP forum of doctors net. I reported the posts to the forum moderators. I took pictures as evidence to show to the police. I posted the pictures on my facebook asking what should I do? I was being cyberbullied. Doctors net responded by banning me from their site! The cyberbullying spread outside doctors net. Suddenly I saw my photo on medical bloggers sites with words like 'another woman with her head up her arse' and comments 'analcoursed is an anagram of Una Coales' 'she likes to lie on a bed of nails' 'must be her time of the month'. The abuse spread to my books on Amazon and twitter. By Feb 2012, I rang Chair Clare Gerada in tears. I was on the verge of suicide. I asked her to stop tweeting an impersonator account @drlacunaeso (an anagram of my name) put up by doctors to mock me running in a Presidential election. Other doctors would tweet Clare asking her how to stop me from running. Clare suddenly realised that she had some responsibility for not stopping the cyberbullying and met with me that evening with my husband at her PHP clinic in Vauxhall. She spoke with my husband while I was taken away to have CBT counselling. I went every day until I was stable. The Brixton police had tried to stop the cyberbullying but instead doctors were taunting me that I should be charged with wasting police time.

Cyberbullying goes viral
I thought it had stopped but in September 2012, one of my internet doctor trolls @welsh_gas_doc (whose last tweet to me had been deciding on what name to call me from Roget's Profanosaurus) decided to act as an incendiary and posted an excerpt from a 2010 CSA book publication. This went viral, on national media and facebook sites across the world. I could not believe how now the media was involved in cyberbullying me. I wept, continued to lose weight and could not show my face on Council. My daughters were approached by schoolmates at school over the Daily Mail article. My husband and I tried to regain control of our lives. It was awful to be hounded by emails and calls from press for interviews. Gay GPs I had helped with my CSA book and courses wrote emails of support for me to the Honorary Secretary Amanda Howe but still she thought it was a matter to be discussed on the RCGP Council, even in my absence! I even had to write a response to a complaint letter from GLADD's co chairs Dr Stuart Sutton (AiT Chair) and Dr Rafik Taijbee (Secretary of South London RCGP Faculty). They published a letter to the Indy of their complaint before the College even made me aware! The first complaint was to have me removed from Council on a code of conduct. The constitution however stated that complaints should be made within 3 months and the article/book predated this code of conduct. So GLADD tried again and complained I had put the 2009 article on my blog which made it current. I sent back a formal reply in hopes this would draw the line and close this malicious complaint. Yet the College still ask to summon me to a closed informal yet 'minuted' meeting and if I refuse I will be referred for a formal code of conduct disciplinary. And for what????? None of the 30,000 GPs who had read the Pulse article in 2009 on my CSA tips had complained. Why now? I was comforted reading the public comments in the Daily Mail and gay press as I was tearful almost every day. Yet the College would not let it drop? Why?

I am tired of these closed 'informal yet minuted' meetings. I am tired of being cyberbullied. I do not want to die like Amanda Todd. My BMI is 17.4. I want to be happy and be able to serve as National Council Rep without threats, intimidation, and malicious complaints. Here is just some of the cyberabuse I have received from RCGP leaders. I have 4 inches of cyberabuse evidence and with the DPA subject access I uncovered the RCGP had even kept a dossier on me and the internal emails were shocking to read!

Dr David Haslam, past President of the RCGP, 'I was shocked and appalled to read the story about Dr Una Coales. She should be deeply ashamed. Attitudes like this have no place in medicine.'

Dr Kirsty Baldwin, soon to join the RCGP Council as National Council Rep and current Chair of her RCGP Yorkshire Faculty, 'that 'senior GP' needs to be shut up and 'divorced' from the rcgp PLEASE'
Professor Trisha Greenhalgh, national Council Rep, tweets she is happy to lead a GMC referral and the journalist who wrote up the story in the Indy which went viral, Patrick Strudwick, encourages her by tweeting 'please do.'
My Letter of Resignation from the RCGP Council due to constructive dismissal
Dear Honorary Secretary Amanda,                                                       14 October 2012
I am sorry that your response is that you still feel the need for us to meet at a minuted meeting with you and Chair Clare Gerada and later answer in person to President Mike Pringle, or else face a formal code of conduct disciplinary.
I have been bullied and harassed by the RCGP even before I joined the RCGP Council and now take this action to be one of constructive dismissal. My health has suffered significantly since I joined the RCGP Council in 2009. I have suffered from heartburn, anxiety, panic attacks, stress, palpitations, depression and more recently anorexia with suicidal thoughts, as well Chair Clare knows. Most of my comments at Council meetings have not been minuted. I have been marginalized and excluded from internal committees. I have been asked to apply with CV and statement and more recently with interview and still am not allowed to participate in any College committees. My mike was turned off mid-sentence in June. I have been interrupted not only in June’s Council but also in past Council meetings. I have been constantly criticised by College on every minute detail of what I do within and outside College with incessant emails and letters from College, and even when the College has promised to draw a line with mediation with a QC, it has not. You still feel the need to bring up an event that was closed with a public apology in your most recent correspondence. Yet you omit all the good work I have done as a College Trustee.
I have followed due process repeatedly and alerted you, the executive committee, the Chair, the Chief Executive, the Treasurer and the Chief Examiner of member concerns as and when, yet my concerns on their behalf are not actioned in some instances. I have not received a College formal apology for the malicious GMC referral of 2008 despite mediation, nor one for the unconstitutional attempt to remove me and 2 other Presidential candidates from the ballot in 2012. I was saddened to see that we were not even given an external unbiased SEA and still await several months later for the results of an internal SEA instead, an SEA in which I was specifically asked not to provide comment on the unconstitutional mistake which I uncovered but only about use of social media? I am even more saddened to see the College has been collecting a dossier on me since 2008 to present, almost on a monthly basis, and the trail of College emails and documents about me disclosed by the DPA subject access show clear evidence of sustained bullying and harassment from central College.
I see no option but to tender my resignation, albeit unwillingly and under severe duress. However the College’s bullying, harassment, intimidation, public humiliation and threats of Code of Conduct have made it impossible for me to carry out my duty as a nationally elected Council Rep from 2012-2015, despite seating first again by the members.
Dr Una Coales