(View the letter in full here)
Healthcare leaders have urged the government to speed up plans to halt GMC appeals against fitness to practice decisions – warning the regulator has used its powers more than a dozen times since its controversial appeal in the case of Dr Hadiza Bawa-Garba.
The government accepted a recommendation in 2018 from the Williams review to strip the GMC of its power to appeal against decisions by the Medical Practitioners Tribunal Service (MPTS).
The move was seen as a key step towards promoting a culture of transparency and openness in the NHS in the wake of the case of Dr Bawa-Garba. However, the regulator has yet to be stripped of its power of appeal and has continued to use it – with figures obtained by the Medical Protection Society revealing 14 appeals in total since the start of 2018.
A group of 13 healthcare organisations have now called on the government to speed up removal of the GMC’s appeal powers.
GMC appeals
The government set out plans earlier this month to press ahead with removing the GMC’s power of appeal as part of a wider programme of changes to healthcare regulation.
But the group behind the call for faster action – co-ordinated by Medical Protection Society president Professor Dame Jane Dacre – say it should be pushed through as part of the health bill currently going through parliament, and not slowed down while complex decisions are made about wider changes to regulation.
The Williams review recommendations followed the GMC’s controversial handling of the case of Dr Hadiza Bawa-Garba, a junior paediatrician convicted of manslaughter following the death of a six-year old child at Leicester Royal Infirmary in 2011.
A medical tribunal ruled that Dr Bawa-Garba should face a 12-month suspension, but the GMC appealed the ruling in the High Court and struck her off the medical register at the start of 2018 – although this was later reversed on appeal.
NHS culture
Then health and social care secretary Jeremy Hunt said at the time he was ‘totally perplexed’ at the GMC’s handling of the case – warning along with a number of healthcare organisations at the time that he was ‘deeply concerned’ about the impact it would have on efforts to create a culture of openness and transparency in the NHS around mistakes.
In a letter to current health and social care secretary Matt Hancock, 13 leading healthcare organisations have called for section 40A of the Medical Act 1983 – which sets out the GMC’s power of appeal – to be scrapped as part of the health bill currently going through parliament.
The letter was signed by Medical Protection Society, The Doctors’ Association UK, Hospital Consultants and Specialists Association, BMA, RCGP, Royal College of Surgeons of England, Royal College of Physicians, Royal College of Paediatrics and Child Health, Royal College of Surgeons of Edinburgh, Medical Women’s Federation, Association of Anaesthetists, British Association of Physicians of Indian Origin, and Medical Defence Shield.
The letter highlights the conclusion set out in the Williams review that removing the GMC’s right of appeal would help to tackle mistrust of the regulator among doctors and help to build a culture of openness – and with it improved patient safety.
Fitness to practise cases
MPS president Professor Dame Jane Dacre said: ‘The strength of feeling on this issue from right across the healthcare community is clear to see. The GMC’s power to appeal decisions made by the Medical Practitioners Tribunal Service (MPTS) has led to fear across the medical profession and a lack of confidence in the GMC.
‘It is also unnecessary as the Professional Standards Authority has the authority to appeal decisions. The GMC is the only UK health regulator that has such a right of appeal.
‘The government agreed that the GMC should be stripped of the power in June 2018, following the Professor Sir Norman Williams review into gross negligence manslaughter in healthcare. However, until the relevant legislative changes are made to the Medical Act, the GMC can and does continue to challenge decisions.
‘The government’s recommitment to removing the GMC’s right to appeal within the recent consultation on broader professional regulation reforms is welcome. It is however almost three years since it committed to making this change, and it should not be held up while a wide range of other complex proposals go through a round of further consultation.
‘Implementing this change as part of the forthcoming Health and Social Care Bill would give the profession confidence that their concerns and the recommendations of the Williams review are now being acted on.
‘There has never been a more important time to address this shortcoming. COVID-19 has sparked discussion about the extent to which individuals should be held to account when working in pressurised and extreme circumstances, and now more than ever, the regulator needs to be able to operate in a way that instils confidence amongst patients and doctors.’
A GMC spokesperson said: ‘We have made it clear that we are not opposed to this decision [to remove the power of appeal]. The government will decide how and when to bring in these changes. As the Williams review acknowledged, we have used these powers proportionally. To protect the public we will continue to use them while our legal obligation to do so remains in place.’
