It’s time for a humane regulatory system
Don’t let GMC reform become a casualty of a change of government. The MDU’s Tom Reynolds explains why action is vital now.
A new government is set to be installed as I write and it has been far from business as usual in Westminster during the Parliamentary recess
We are halfway through this Parliament and awaiting several important pieces of legislation. This includes long-awaited reform of the GMC and its fitness-to-practise procedures. Sadly, this legislation has been derailed yet again.
When the Government published its consultation on proposals to modernise healthcare professional regulators in March 2021, chapter six set out the next steps for reform.
This promised that ‘following this consultation, we will bring forward draft legislation to implement these changes in relation to the GMC’ for consultation ‘in the autumn and for the legislation to come into force in the spring of 2022’.
This timetable was welcome, but the Government has now said that substantive GMC reforms have been shelved until 2024-25 at the earliest.
Hugely frustrating
This is hugely disappointing and frustrating. The Medical Defence Union (MDU) believes that the original timetable should be kept and is spearheading a coalition of senior healthcare organisations to make the case for that.
We co-ordinated a letter to the Health Secretary Steve Barclay, signed by leading healthcare organisations, including the BMA and a number of medical royal colleges, urging the Government to bring in the legislation this year as promised.
We all want to see a regulator that protects the public while dealing with doctors fairly and compassionately. However, the GMC’s fitness-to-practise procedures are rigid and still governed largely by outdated legislation.
While limited progress has been possible, such as the introduction of provisional inquiries, only a complete reset of the GMC’s legislation can bring about a system that is truly modern, proportionate, timely and, above all, fair.
Of course, the MDU had some concerns about some of the proposals within the 2021 consultation, such as scrapping the ‘five-year rule’ on historic complaints.
Good points
However, there is much we did support, particularly the creation of a three-tier fitness-to-practise process comprising initial assessment, examiner stage and panel hearing.
This would allow more cases to be appropriately resolved at an earlier stage, without in any way detracting from the GMC’s responsibility for protecting patients.
We agree that case examiners will need a full range of disposals available to them to conclude cases, including through the accepted outcome process. There should be sufficient oversight of fitness-to-practise decisions via the proposed ‘registrar review’ power.
It is also highly welcome that the GMC’s ability to appeal decisions by the Medical Practitioners Tribunal Service (MPTS) is to be removed.
As a medical defence organisation, the MDU has supported and defended many thousands of doctors at the GMC over the years and we have a strong track record.
In cases heard by MPTS between 2016 and 2020, MDU solicitors representing members achieved no finding of impairment in 42% of cases, compared to the average of 21.5%.
At the same time, MDU members tell us repeatedly that undergoing a GMC investigation is one of the most difficult experiences of their professional lives.
Traumatic experience
The stress of being under scrutiny during a lengthy and potentially career-ending process would have an impact on anyone, but it is particularly traumatic for doctors whose mental health is already a concern or those who do not have a support network around them.
Tragically, according to GMC statistics, at least five doctors died by suicide while under investigation or monitoring by the GMC in the three years up to 31 December 2020.
This follows the GMC-commissioned Horsfall report of 2014, which found that involvement with the regulator was one of several risk factors for suicide, particularly in cases of multiple jeopardy – concurrent investigations by different bodies.
Of course, there are usually multiple factors in such cases, but in the current climate where many doctors are already exhausted and working under huge strain, it is more important than ever to have a humane regulatory system. With the GMC powerless to properly change without the promised legislation, the status quo endures.
Further delay is not in the interests of doctors or the patients who depend on them. The Government needs to keep its promise and deliver reform without delay.
Tom Reynolds (right) is head of government and external relations at the Medical Defence Union
