In the UK…

After I returned from a short four-day trip to the UK in March 2015 I wrote a blog post (see “Consequences”) lamenting the fact that as I no longer have a “licence to practise” medicine in the UK (although I am still a registered doctor) I was unable to purchase a few prescription medications to bring here with me that are not available in Ethiopia. Basically any registered UK doctor working overseas is unable to get the appraisals and revalidation done that’s demanded by the General Medical Council (GMC) to have their “licence to practise” in the UK renewed. The GMC told me to surrender mine in May 2014. Without it I cannot see or treat patients in the UK.

Not being able to bring a small supply of a few medications with me was very disappointing, although I accepted the advice from both of the UK pharmacies that I had approached that because of my lack of a licence they could no longer sell me prescription medications, even though I was not intending to use them in the UK.

What happened next was totally unexpected. On 30th April 2015 I received the letter every British doctor dreads – from the GMC telling me I was now under investigation. Without having received a single complaint about me the GMC decided to accuse me of “dishonesty” and “attempting to mislead”. The basis of this accusation was that the two pharmacies I had sought advice from had phoned the GMC to check my registration (I had given them both my GMC number for this very purpose) and when they found out I did not have a licence to practise (which I had already told them both) they declined to sell me medication. The GMC, having had two pharmacies phone to check on me, decided I must be doing something wrong (which is of course their default position for all doctors, post-Shipman) and, nearly two months after I’d visited the UK they sent me the horrible letter. Any of my medical friends reading this will understand how I felt. I knew a long, stressful, tedious and slow process was in front of me.

Ironically my medical indemnity organisation had slashed my annual fee from several thousand pounds to £450 or so as they assumed, now I was working in Ethiopia, that I would never need them again. Well now I did, for the first time in my 30 year career, and believe me did I get my money’s worth!

The “investigation” involved the indemnity organisation, their solicitors, six colleagues who provided “testimonial references”, numerous letters and emails, and in the summer a trip from my holiday location in Pembrokeshire to a meeting with my advisors and their solicitors in London. And no doubt my hair is now a bit thinner than it would otherwise have been.

On 14th October I received a seven page letter advising me of the outcome of the “investigation”. Expressing great regret that they couldn’t find any evidence with which to convict me of “dishonesty” and “attempting to mislead”, in their very last sentence the panel of anonymous investigators reluctantly declared : “This case can be closed”.

In Ethiopia…

In order to work as a doctor in a clinic here in Ethiopia I need four things – professional registration, a resident’s ID, a work permit, and a clinic licence. My professional registration lasts for five years (three to go); the others are all annual and have to be renewed. SIM Ethiopia has a “Government Relations” department that takes care of it all for me. They currently have my passport as well as my resident’s ID and work permit so I am waiting with bated breath for the new ones to appear. It’s unlikely to be a problem, as I have just received a new clinic licence for another year and the other documents hinge on this. However there are strings attached, and getting the renewed licence involved another trip into the heart of incomprehensible Ethiopian bureaucracy.

On Friday afternoon two weeks ago Fikre from “Government Relations” and I set off for a 10 story tower block on the road to the airport (a different building from my adventures a couple of years ago reported here). Parking took a while, but we eventually made it up to the 8th floor and entered a mystifying complex of offices (passing a huge pile of scaffolding on the way.) Rapid Amharic conversations; jumping from desk to desk and then room to room; people fudging through huge piles of paper and saying contradictory things; two hours later we had the necessary yellow piece of paper compete with my picture that had been stamped and signed by several people of varying degrees of authority. On the way out of the building our new clinic licence in hand Fikre whispered “Praise God!” I could but agree.

I said there were strings attached. Read this post from April. We have to comply with the results of that inspection – i.e. amongst other things do worse medicine and get a gardener despite having no garden. Speechless? Me to. Onwards and upwards.