‘Urgent’ GMC reform should be next Government’s priority, says MDO

Reforming the GMC should be an ‘urgent’ priority for the next Government, a leading medical defence organisation has recommended.

The Medical Protection Society (MPS) is calling on the next Government to prioritise improvements to the ways in which doctors are held to account, including acting on ‘a long overdue commitment’ to remove the GMC’s right of appeal over decisions made by fitness-to-practise panels.

Despite the Government agreeing to the reform in 2018, the legislative amendments have yet to be introduced after being delayed several times.  

The Department of Health and Social Care said it was committed ‘to progress the legislation’ in 2023 and Pulse has asked for an update on the process.

The planned reforms would enable swifter resolution of fitness-to-practise investigations, as well as quashing the GMC’s powers to appeal FTP decisions. It would also give GPs specialist status on the GMC register.

MPS said that it is ‘vital’ this happens ‘without further delay’, as it is an important step in rebuilding trust between doctors and their regulator.

MPS president Professor Dame Jane Dacre said: ‘Doctors expect to be accountable for the healthcare they provide. They also have a right to expect that when they are held to account it is done in a way that is fair, proportionate, efficient and sensitively handled.

‘Sadly, we see first-hand when supporting doctors through various processes that this is not always the case.

‘Few areas of regulation in the UK are more overdue reform than healthcare professional regulation. Thousands of doctors go through stressful and slow GMC processes each year, with the regulator working within the confines of legislation that is over 40 years old.’

The organisation also said that a recent survey of its members who had been subject to a GMC investigation revealed that 91% found the investigation ‘caused them stress and anxiety’, 64% said it ‘impacted on their personal life’ and nearly a third (31%) said they experienced ‘suicidal thoughts’.

The MPS is also calling for action to tackle the rising cost of clinical negligence, which it said that ‘on current trends’ are set to double in the next decade to £4.6 billion.

A GMC spokesperson said: ‘We have made it clear that we are not opposed to the decision of removing our right of appeal. The Government will now decide how and when to bring in these changes. 

‘The fact that the Government has stated it intends to legislate to remove it does not allow us to ignore our statutory duties.

‘We would be acting unlawfully if we did not give due consideration to the exercise of our powers to appeal a decision where the decision could reasonably be considered insufficient to protect the public.’

The GMC has been able to appeal MPTS decisions in the High Court since 2017 but the 2018 Williams review into gross negligence manslaughter in healthcare, prompted by the high-profile Bawa-Garba case, recommended that it should lose these powers.

In 2022, the BMA and MDU complained to the then health secretary, after learning that legal reform to fitness-to-practise processes for doctors will be delayed ‘until at least 2024’.

A 2021 DHSC consultation set out plans to introduce statutory regulation of physician associates by the GMC, which has since been progressed, however it said that it would not include legislation to reform doctor regulation at the same time.

The same consultation had sought views on plans to ‘remove the General Medical Council’s right to appeal Fitness to Practise panel decision’ and ‘amend the power to require information in relation to fitness to practise cases to expressly exclude reflective practice material’.

This is expected to enable the GMC to process fitness-to-practise decisions more quickly by allowing ‘more cases to be concluded earlier through accepted outcome decisions made by case examiners’, and; ‘through a broader range of measures (including issuing a warning, applying conditions to a registrant’s practice, suspending their registration, or removing the registrant from the register’.

And it proposed that GMC should be able to suspend, rather than just erase, doctors from the medical register, for reasons including a failure to pay fees or to meet revalidation requirements.

Under the plans, the GMC’s council structure will be replaced with a board, which should hold meetings in public. The regulator should also produce an annual report on its regulatory activities.

The GMC will have a duty to cooperate’ with other health regulators, as well as a duty to be ‘transparent’ about its decisions, including in fitness-to-practise cases.