The BMA will financially support Anaesthetists United’s legal case challenging the GMC on its failure to ‘properly distinguish’ between qualified doctors and physician associates (PAs).
The legal case is aiming to achieve ‘clear and enforceable guidance’ defining what PAs and anaesthesia associates (AAs) ‘can and cannot do’.
Last month, the Doctors’ Association UK made a ‘significant donation’ of £30,000 to the AU’s legal case, saying it ‘underscores the medical profession’s deep-seated concerns over patient safety and professional standards’.
And two bereaved families joined the case, including the family of Emily Chesterton, a 30-year-old patient at a North London GP practice who died at the end of 2022 after seeing a PA.
Now the BMA has said it will provide an indemnity to protect the AU and the Chestertons from the risk of financial loss arising from issuing the claim.
It is also calling on the Government to confirm it will not use public money to support the GMC in its defence of the case.
BMA chair of council Prof Philip Banfield said: ‘We stand alongside the grassroots campaigners at AU as they too seek to ensure patient safety in the UK is not watered down by the headlong rush to expand the role of the physician associate.
‘Doctors are standing together to protect their patients and ensure that high quality healthcare continues to be provided in the NHS.
‘The tragic case of Emily Chesterton, among others, should by now have made clear that blurring the lines between doctors and their assistants can have fatal consequences.
‘It is unconscionable that despite so many warnings from medical professionals the GMC has forged ahead with its attempt to regulate PAs and AAs in a manner that encourages that blurring.
‘AU’s case is very clear: if you don’t set out clearly what a PA can do and can’t do in a scope of practice then you have failed to carry out your duties as a regulator.
‘The GMC enforces postgraduate training and practice for doctors but tells us that such enforcement for PAs and AAs should be left to individual employers.
‘That is an abdication of responsibility that will lead to unscrupulous and possible illegal practice within hospital trusts and general practice, as we have already seen.’
Dr Richard Marks, co-founder of Anaesthetists United, said: ‘We are pleased to say that the BMA has offered us crucial financial support to help our legal fight over PAs and AAs.
‘We are deeply grateful for their help and recognition of how vital this is to healthcare in the UK.
‘While the assistance is vital in enabling us to continue our fight, we remain significantly short of the funds required to see this case through to the end.
‘We continue to welcome donations from the public to help keep the GMC accountable in its role of protecting patients.’
A GMC spokesperson told Pulse: ‘We are very grateful to Mr and Mrs Chesterton for giving us the opportunity to meet with them and to listen to the important issues they raise, following the terribly sad and avoidable death of their daughter, Emily.
‘Regulation is a vital step towards strengthening both patient safety and public trust in these professions. It will help provide assurance to patients, employers and colleagues that PAs and AAs have the right level of education and training, meet the standards that we expect of the professions we regulate and that they can be held to account if serious concerns are raised.
‘Physician associates and anaesthesia associates are not doctors, cannot replace them, and should never be used to fill gaps in doctors’ rotas. When we begin regulating PAs and AAs later this year, we will expect them to be supervised by a doctor and to practise within their competence. In regulating PAs and AAs, we will be clear that people in these roles will have a responsibility to communicate who they are, and their role in the team.
‘Employers also need to make sure there are appropriate governance structures in place, to make sure that PAs and AAs are working under supervision.’
It comes as the case appears to have sparked internal friction within the BMA.
At the end of August, resident doctor Dr Tom Stocks, a BMA Council member, resigned in a ‘dispute’ over the BMA financial support in the legal challenge.
So far, the AU has raised over £122,000 of its £250,000 target, and Dr Stocks argued that the case may be ‘forced to fold due to insufficient funding’ without the backing of the BMA.
At the time of his resignation, the BMA had not agreed to match member donations to AU’s crowdfund, despite there being ‘a great deal of support on the council’ for this approach.
The BMA, which is also bringing a judicial review claim against the GMC over PAs, told Pulse that it is in ‘close contact’ with AU and they are providing ‘mutual support to each other’s legal cases’.
According to the union, it was categorically untrue’ to claim that they refused a request to support AU’s case.
In a post on X last week, Dr Stocks said: ‘Last month I resigned from the council of the BMA in a dispute over proposed financial support to Anaesthetists United in their landmark legal case against the GMC.
‘As a consequence of the GMC’s refusal of mediation with AU, significant sums of money are now required to pursue this case in court. Doctors have dug deep, but without financial backing from the BMA it is possible that this case will be forced to fold due to insufficient funding.
‘At the time of my resignation there was a great deal of support on the council for the BMA to match member donations to AU’s crowdfund. However, over the past few weeks it appears increasingly clear that the BMA may not support this case financially and that this decision may be being taken outside of the BMA’s normal democratic processes, over what is a mere rounding error in the BMA’s annual budget. This would be a profound mistake.’
He said the ‘reputation damage’ to the BMA will be ‘severe and lasting’ if it ‘allows this case to fold’, and he urged the council to ensure that ‘all merits’ of pursuing the case are ‘properly considered’.
‘I resigned in an attempt to focus minds on the importance of this landmark legal case, and so the next time I meet the relatives of a victim of deregulated medical practice I’ll be able to look them in they eye knowing I did my best to convince the BMA to do the right thing,’ Dr Stocks added.
In response to his resignation, the BMA said it was ‘considering all legal options’ as it continues its judicial review against the GMC over ‘its blurring of the lines’ between doctors and medical associate professionals.
A spokesperson continued: ‘We remain in close contact with AU as both organisations continue to provide mutual support to each other’s legal cases. It is categorically untrue to claim that the BMA has declined a request for support from AU.
‘Dr Stocks has been a valued member of UK Council and we are really sorry to see him go.’
GMC regulation of PAs will begin by the end of the year, and the regulator is currently analysing responses to its consultation on the proposed rules, standards and guidance for these professionals.
I thought the GMC is all about patient safety. Now AU and the BMA has to fight it to ensure this with the victim’s families. The GMC is clearly unfit for purpose. The BMA should set up an alternative to the dysfunctional GMC. One led by the profession and one that doctors can have confidence in. I don’t see any plumber or electrcian regulator being run by people who are not plumbers or electricians. It is just not sensible.