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Dr Michael Fitzpatrick

Second Opinion

Only two years ago Clive Froggatt was struck off the medical register following his conviction (and 12-month suspended sentence) for obtaining heroin by forging prescriptions. During his trial it was revealed that this successful doctor, a top advisor to Tory health ministers and a leading advocate of health service reforms such as GP fundholding, had a long record of drug abuse. This stretched from taking amphetamines as a junior doctor at St Bartholomew's Hospital, through cocaine to heroin, culminating in an attempt at suicide with a massive overdose when his habit was exposed. It seemed a grim end to a flourishing career.

Yet, after a period of residential therapy at a private clinic favoured by celebrity addicts, Froggatt is back. In September he was the star speaker at a conference at St George's Medical School in London on the theme 'Doctors and their health: who heals the healers?'. His speech was published in full in the weekly magazine Doctor distributed free to all GPs, and he was all over the media. Froggatt appears to be planning a new career as representative of suffering doctors and campaigner for their needs.

The key theme in Froggatt's rehabilitation is his claim that he resorted to illicit drugs because he was ill. In other words, he should not be held responsible for his past behaviour because he was in the grip of a physical and psychological dependency, for which he needed expert help, not criminal prosecution. It is striking that, in his account to the conference, Froggatt blamed everybody - his former colleagues, the psychiatrists, even his long-suffering wife - rather than himself. It is equally striking that his audience, largely made up of doctors presumably familiar with evasions of responsibility by alcoholics and junkies, should take such pathetic attempts at self-justification as legitimate.

The medicalisation of drug abuse is a quite recent development. I well recall 20 years ago a fellow medical student whose flair in the biochemistry lab extended to the synthesis on a grand scale of LSD. He ended up serving a substantial prison sentence. His problem was that he was interested in illicit drugs, like many of his colleagues then (and no doubt today), because he liked to spend his weekends getting 'out of his head' (as the expression went). If only he had waited a few years and discovered the Froggatt defence - 'I was ill, m'lud' - he could have served his time in group therapy rather than high security confinement.

Froggatt is adept at exploiting every aspect of the prevailing victim culture. In a two-page feature in the Guardian - 'My journey back from heroin hell' - he elaborated further on the 'inner despair' that drove him to drugs (24 September 1996). He was sexually abused at public school (wasn't everybody?), exhausted by work as a junior hospital doctor and stressed by life as a GP (particularly by his association with the government's unpopular reforms).

Poor Clive! When reading of his torment it is easy to forget that, during his years of hell on cocaine and heroin, he lived in a £300 000 house in Cheltenham, with a private tennis court and two children at public schools. He had regular meetings with Margaret Thatcher, Virginia Bottomley, John Major and others, and enjoyed rising social prestige. A more richly deserving candidate for the 'short, sharp, shock' treatment once recommended by the Conservative government for young offenders would be difficult to imagine.

It is perhaps not surprising that Froggatt should try to dodge the blame for his grossly self-indulgent and irresponsible behaviour by claiming to be ill. What is truly shocking is the implication of his rehabilitation - that the medical profession and the public should accept this self-justification.

But then the medical profession is wallowing in self-pity and morbidly preoccupied with its own members' physical and mental health. A much-quoted British Medical Association survey of 800 doctors reported in April that 69 per cent had experienced 'stress-related' health problems and 20 per cent had contemplated suicide. The survey claimed to reveal 'the terrible toll stress has taken on doctors' professional and personal lives'. Staffed by trained counsellors, the BMA's new stress helpline claims to have been receiving 300 calls a month from doctors on the edge.

An objective observer of Britain's medical profession might well find all this angst rather puzzling. Doctors are well paid (average GP income £40 000+ a year), and have much more interesting, secure, prestigious and rewarding jobs than most of their patients. Yet they continually complain that 'unreasonable patient demands' are making their working lives a misery.

Doctors of an older generation occasionally write to the medical press expressing bemusement at the moans of today's doctors. Junior hospital doctors now enjoy much easier rotas and more restrictions on working hours. Old GPs recall the harsh realities of full 24-hour availability, without deputising services, mobile phones and all the benefits of modern group practice and team-working. If it is true that workloads have increased, doctors have largely themselves to blame for trying to extend medical control over all areas of life from the kitchen to the bedroom, through the fashionable practice of 'health promotion'.

So what's up doc? Stress is not new to medical work - indeed, as the proliferation of medical television dramas confirms, it is part of what makes it a fascinating and exciting field in which to work. Nor are alcohol and drugs new hazards of medical life: the proximity of drugs in particular has always tempted a few. What is new is the abject self-abasement of the medical profession to the victim culture it has helped to foster. The increasing tendency to ascribe people's problems to psychological syndromes - from attention deficit hyperactivity disorder in children to post-traumatic stress disorder and chronic fatigue syndrome in adults - is one illustration of this trend. The expansion of the category of addiction from alcohol to opiates to other drugs, then to tobacco, and on to gambling, sex, shopping, etc, is another.

It seems that, having prepared a bed for the entire nation to lie in, doctors are now taking to it themselves. When in the past the medical profession felt threatened by outside forces - whether by the Labour government in the late 1940s or the Conservatives in the early 1960s - it mobilised forcefully and effectively to defend its position. Today it offers the infantile Clive Froggatt as a symbol of its despair and sets up a helpline for its members.

Reproduced from Living Marxism issue 95, November 1996



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