NHS England’s director of primary care and deputy medical director has resigned after admitting to posting anonymous online comments.

According to GP magazine Pulse, Dr Arvind Madan posted ‘provocative comments’ on their site under the pseudonym ‘Devil’sAdvocate’.

This includes on an article about hundreds of GP surgeries closing over the past five years, on which the user suggested “most businesses” would be “pleased to see a rationalisation of their market”.

On Friday (3 August), Madan gave an on-the-record interview to Pulse in which he claimed GPs should be “pleased” to see smaller practices close.

This provoked anger from many general practice colleagues, and over the weekend users of the Pulse website pieced together that Madan and Devil’sAdvocate were one and the same.

In his resignation statement, Madan, said: “As part of my attempts to challenge the negative views – and even conspiracy theories – held by a small but vocal minority in the profession I posted on an anonymous online forum used by GPs. It was never my intention to cause offence but rather to provoke a more balanced discussion about contentious issues acting as a devil’s advocate.

“I wish to make it categorically clear that these comments are not a reflection of NHS England policy, and it is now clear to me that trying to move the debate on in this way is not compatible with my role as director of primary care. Supporting general practice is too important an issue to allow it to be mired in unnecessary controversy.

“I would like to apologise unreservedly to those who have been upset, particularly in smaller practices.”

Back in March 2018, Madan said a new agreed GP contract for 2018/19, which ensures an extra £10 million will be spent on the implementation of the NHS electronic referrals service (e-RS), was “positive news for patients and GPs, especially the focus on digital solutions”.

On Sunday, the British Medical Association’s GP committee deputy chair, Mark Sanford-Wood, wrote to NHS England chief executive Simon Stevens about Madan’s comments.

He said: “We feel that posting under a pseudonym in this way is unacceptable for someone in his position.”

In 2013, the General Medical Council (GMC) published guidance on doctors’ use of social media. It states that “if you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name”.

Responding to the subsequent news of Madan’s departure, Sandford-Wood said: “It is only right that he has done the right thing and offered his resignation.”


An earlier version of the story mistakenly quoted comments made by the Pulse website user ‘Devil’s Advocate’, when it appears the comments made by Dr Madan were made under the pseudonym ‘Devil’sAdvocate’. Digital Health very sincerely regrets this oversight and apologises for it.