Doctors have always looked out for one another. Even if there are professional rivalries along the way, collaboration is an underlying principle of clinical practice, from mentoring trainees to supporting someone going through a difficult time.
This issue includes a story that perfectly captures that feeling of professional camaraderie and the wider benefits it brings. Dr Anand Kanani, a consultant paediatrician and MDU member, talks about how he helped a colleague in his department through the GMC fitness to practise process.
From listening to them talk about their worries to suggesting practical steps to demonstrate their reflection and remediation to the GMC, Dr Kanani's support played a big part in achieving a positive outcome.
However, he makes the important point that getting involved was a worthwhile experience for everyone in the department, prompting open and honest conversations and effective teamwork to enable the doctor to continue working safely.
The moral of this story is that we are stronger when we work together. And that speaks directly to the 'doctors for doctors' ethos of the MDU as we approach our 140th anniversary in 2025.
In the beginning…
Back in the 1800s, it wasn't uncommon for doctors to support a fellow professional's defence against an allegation of malpractice when there was an appeal in the medical press. However, when Dr David Bradley was sentenced to two years hard labour for attempted assault of a patient in 1884, it galvanised the profession to go further.
Although Dr Bradley had maintained his innocence, he was unable to afford a legal team and served eight months before the home secretary concluded the conviction was unsafe. By this point, however, he'd lost everything, and was only able to re-establish his career when his fellow doctors rallied round with some 19th century crowdfunding.
The case highlighted the risks that doctors were running in their day-to-day practice, and the need for an organisation with the authority to defend their reputations and livelihoods.
The origins of the MDU
The MDU was set up in 1885 as a members' mutual society, and Mr Lawson Tate, a distinguished surgeon, was later elected our first national chairman and president. Over 400 members joined in the first four months, each paying an annual subscription of 10 shillings towards the MDU's founding objectives:
- to support the character and interests of medical practitioners practising in the United Kingdom
- to promote honourable practice and to suppress or prosecute unauthorised practitioners
- to advise and defend or assist in defending members of the Union in cases where proceedings involving questions of professional principle or otherwise are brought against them.
While rooting out medical quackery is now the GMC's responsibility, our essential purpose as a mutual remains to guide, support and defend our members when they find themselves in medico-legal difficulty.
Back in 1891, for instance, our annual report says we offered to "defend a member against whom an action was threatened for damages due to the bolting of his horse while he was making his professional rounds." During the First and Second World Wars we assisted members in the armed services who were under threat of court martial.
And in 1943 we successfully appealed to the House of Lords on behalf of Dr Eric Spackman, who had cited in a divorce case involving a patient and summarily struck off by the GMC for infamous conduct. Dr Spackman was restored, and the GMC abandoned its custom of accepting the findings of civil courts without allowing the doctor to submit evidence in their own defence.
Then and now
The types of incidents and allegations may have changed over the years, but we're still working hard to ensure MDU members receive expert advice and a fair hearing, whether it's the GMC, an employers' disciplinary process, coroners' enquiries or police (and sometimes all at once).
Nor have we stopped looking for different ways to support members in their practice, which has led us to a number of firsts. For example, in response to rising damages awards against doctors, we began offering indemnity (through an insurer) in 1909, extending this to discretionary, MDU-funded indemnity in 1924 after damages of £25,000 were awarded against two doctors in the case of Harnett v Bond and Adam.
In 1983, we launched our 24-hour medico-legal helpline to provide members with one-to-one expert advice from a fellow professional when they needed it (we took more than 22,000 calls in 2023 from members seeking advice and assistance).
And as more members found themselves facing criminal allegations such as manslaughter arising from their practice, in 1993 we established a dedicated in-house legal team with experience in criminal law as well as civil litigation.
More recently, we've joined forces with other organisations to help members with other aspects of their professional lives, including Peninsula for employment law advice (2021) and the independent charity Doctors in Distress to provide access to health and wellbeing services (2023).
We're also supporting doctors as they adjust to clinical practice in the UK, with initiatives for international medical graduates (IMGs) like November's recent conference, and dedicated online hubs for IMGs as well as for students at the beginning of their medical careers.
The types of incidents and allegations may have changed over the years, but we're still working hard to ensure MDU members receive expert advice and a fair hearing.
Through thick and thin
The last 140 years have seen a transformation in doctors' professional lives, clinical practice and social attitudes. There's been huge progress in clinical care and outcomes and the enormous potential of genetic medicine and technology, but we're currently facing some big challenges too.
An ageing population with more complex health conditions and the pandemic have put pressure on the health system. Meanwhile, there's less money to go around, higher patient expectations and doctors are under greater scrutiny than ever before.
In this context, I'm reassured that the MDU now has more than 220,000 members, like Dr Kanani, who recognise the value of supporting each other through thick and thin. For me, this shows that the ethos of doctors for doctors is as relevant today as it was in 1885.
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Dr Matthew Lee
Chief executive, the Medical Defence Union
Dr Matthew Lee
Chief executive, the Medical Defence Union
BM, MBA, FRCP, MRCPCH, FFFLM
Matthew has been chief executive of the MDU since September 2021.
He has worked at the MDU since 2000, initially as a medico-legal adviser assisting members facing complaints, disciplinary procedures and criminal investigations before becoming professional services director (with responsibility for claims handling, underwriting, legal services and the medical and dental advisory services) in 2009.
He joined the MDU from a background of working as a clinical fellow in paediatric intensive care in Southampton, having trained in both anaesthetics and paediatric medicine.
See more by Dr Matthew Lee