GMC should remain dedicated regulator in reform plans

While there is need for significant improvements to the GMC’s Fitness to Practise processes and the legal framework which underpins regulation, the GMC should remain the dedicated regulator of the medical profession, the Medical Protection Society (MPS) said

In its response to the Department of Health (DH) consultation on the future of professional regulation in healthcare, MPS said change is long overdue – but warned against reform that would see the creation of a ‘super regulator’ or a similar large scale amalgamation which could result in a lack expertise and understanding of the distinct professions. It said there was a strong case for the GMC to remain the regulator for doctors as they carry out complex work with varying portfolios that carry high degrees of risk, and undertake considerable and ongoing specialist education and training.

MPS has however urged DH to use the opportunity to significantly improve the GMC’s Fitness to Practise function and ensure the regulator follows a fair process that patients, doctors and the governments of the UK can have confidence in. It said many improvements are held back by an outdated legislative framework.  For example, it said the Medical Act does not give the GMC enough discretion to not investigate in cases where the allegations clearly do not require action. The vast majority of GMC investigations are closed without action, meaning that over a thousand doctors go through a needless, stressful and slow process each year.

Other improvements MPS said should be considered include:

1. Further steps to mitigate the harmful effects of a Fitness to Practise investigation on a doctors health and avoid doctors becoming disillusioned and leaving medicine
2. Consideration of how the regulator can be mandated to conduct Fitness to Practise investigations within a given time frame, perhaps via a Regulators Charter. In 2015/16 the GMC reported that the median time to conclude a case referred for a final hearing (from receipt of the complaint) is 99.7 weeks. This is too long.
3. The GMC recently acquired the power to appeal Medical Practitioners Tribunal Service (MPTS) decisions on doctors’ fitness to practise. The Professional Standards Authority (PSA) also has this power. There should be only one body with the power of appeal to avoid unjust and unnecessary duplication.
4. Under the current framework, the GMC is the investigator and the MPTS is the adjudicator. The adjudicator must have the confidence of the profession, and the public. Further steps must be taken to ensure the MTPS is, and is seen to be, an entity with undisputable independence from the regulator.
5. While there is clearly scope to improve legislation, so the GMC can reduce the burden on health professionals, any additional freedom given to the regulators to reform their processes must be accompanied by safeguards which ensure their processes remain transparent, fair and consistent and the need to adequately consult with stakeholders.

Dr Pallavi Bradshaw, senior medicolegal adviser at MPS, said: “We welcome the government’s desire to drive forward the debate on the shape and structure of healthcare professional regulation. In many areas reform is long overdue.

“After the important question of what organisation should regulate doctors, no issue is of more fundamental importance to the reform debate than Fitness to Practise.

“We support doctors and other healthcare professionals day in day out as they go through this often long, complex process and see the physical and psychological impact. A range of improvements are needed, and this consultation presents a real opportunity to bring the legislation that underpins regulation up to date, while retaining the important statutory safeguards that ensure a transparent, consistent and fair Fitness to Practise process for all.”

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