Every month, the Doctors’ Association UK looks at a GMC case that has implications for the profession that is either topical or from recent history. This time, we look at the case of Dr Sarah Benn from earlier this year, a GP who was suspended from the medical register for five months following her involvement in climate protests. Her case provides an interesting debate as to what is deemed as ‘impairment to practise.’
In April, the Medical Practitioners Tribunal Service (MPTS) ruled that GP Dr Sarah Benn’s fitness to practise was impaired due to misconduct, following her involvement in multiple peaceful Just Stop Oil protests. Although she retired in 2022 after 32 years of practice, the MPTS suspended Dr Benn’s medical licence for five months. Her case made national headlines and sparked outrage from her peers.
Case
Dr Benn was referred to tribunal by the GMC for her participation in three peaceful protests in 2022 within a prohibited buffer zone at Kingsbury Oil Terminal, breaching an injunction granted in early April. Later that same month, she and others gathered outside the main entrance to the terminal on a grass verge with placards. Refusing to move on when asked by the police, Dr Benn was arrested.
When she protested again in May – on the same day that she had been ordered to return to court to answer her bail – she was in breach of her bail conditions and arrested again. Following those two incidents, she spent eight days in custody and was fined. She took part in a peaceful protest again in September, for which she was eventually sentenced to 32 days in prison for breaching the injunction and contempt of court.
Background
Dr Benn was no stranger to being arrested or appearing in court for environmental activism. She self-referred herself to the GMC in 2019 and 2021 for nonviolent acts of civil disobedience. In 2021 the GMC Case Examiner closed an investigation into these matters with no further action, but did advise Dr Benn to reflect and remain mindful of her professional obligations, referring to paragraph 65 of Good Medical Practice (GMP): ‘You must make sure your conduct justifies your patients’ trust in you and the public’s trust in the profession.’
GMC’s case and Dr Benn’s defence
The Counsel on behalf of the GMC said Dr Benn’s conduct had brought the profession in disrepute as she had undermined the rule of law by failing to comply with the injunction. The counsel added that doctors, more than any other citizen, submitted themselves to the rule of law, and that being a regulated professional should uphold an even higher standard.
Although Dr Benn’s alleged misconduct was not connected to her clinical practice, the GMC used the approach set out by the Fifth Shipman Report to determine Dr Benn’s fitness to practise. According to the report, should misconduct be determined, impaired fitness to practise could then be shown if a doctor: has in the past brought and/or is liable in the future to bring the medical profession into disrepute; has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession.
The GMC argued that patients seeing a doctor flouting the rule of law risked the public’s trust in and respect for doctors. Dr Benn (who represented herself) relied on the concept that a member of the public, with knowledge of her motivations, would have their trust in the profession diminished if she had not engaged in this form of peaceful protest. The GMC dismissed this, saying that she had ascribed a degree of knowledge to the public as a whole that was unachievable. They maintained that actually, the public would see that a doctor was breaking the law, and that act would diminish the public’s trust in both the GMC’s regulation, and in doctors as a whole.
Dr Benn did agree that doctors should be held to higher standards of behaviour than other professions. She added that as a doctor, she had a moral duty to take action to protect life and health in the context of a severe threat to both due to climate breakdown. If she chose to stay quiet, she would be failing in her obligations and breaching the requirements of GMP. She said there was no evidence that her actions had caused a loss of public trust.
The tribunal panel members disagreed. They asserted that they did respect Dr Benn’s views, and her right to express them. But they argued that patients expected good doctors to act with integrity and within the law. Furthermore, she had not thought about her impact on the delivery of vital emergency public services, given that the incident happened around the time of Queen Elizabeth’s death, causing ‘very significant harm to the police resources in Warwickshire and beyond at a time when resources were already very stretched.’
Decision
The tribunal found Dr Benn guilty of serious misconduct. Her fitness to practise then had to be considered.
The tribunal considered what a well-informed member of the public or profession would think of Dr Benn’s actions. There would be considerable sympathy for Dr Benn’s concerns, but the overwhelming majority would not condone breaking the law repeatedly. Public confidence in the profession and its system of regulation would be undermined if a finding of impairment on Dr Benn were not made. Suspension, it was argued by the GMC, would have a deterrent effect and it could be used to send a signal to the profession and public about what is regarded as behaving unbefitting of a registered doctor.
In addition, the deliberate nature of Dr Benn’s actions alongside her clear conviction to further climate protests left the tribunal feeling that she was a doctor beyond remediation. She herself stated that she would be unlikely to engage with remediation, as she committed herself to continue demonstrating until such time as the government takes meaningful and urgent climate action.
Sanction
And so, Dr Benn was suspended from the medical register for five months in a result that the tribunal considered proportionate to her misconduct. It was deemed that this time period was appropriate and would allow for the previously stipulated tenets in the Fifth Shipman Report approach to be upheld: maintaining public confidence in the profession; and maintaining professional standards of conduct for practitioners.
Dr Benn stated that she did not want to break the law, and would not do so for any other reason than to protect life. She suggested that if these actions were so unbefitting of a registered doctor, the tribunal should erase her name from the medical register completely. However, she also said the tribunal had a choice: they could take no action against her, given the exceptional circumstances around her case and the precarious future for the planet without action.
Analysis
This is a story of a clinician being punished for raising concerns about dangerous inaction on the greatest threat to global health we have ever seen. Not all doctors, subject to a custodial sentence having broken the law, have been sanctioned by the MPTS; it can use discretion. Doctors found guilty for death by dangerous driving, assault and domestic violence have been allowed to keep their jobs in the past. But so important, it seems to the MPTS, was the deterrent message it was sending to doctors should they find themselves wanting to raise their concerns or protest. The MPTS view was the public would not have the knowledge or ability to understand the threat to the climate to support her breaking the law.
Dr Benn said the GMC was supposing it knew what the public viewed as acceptable behaviour, and supposition again in how the three Tribunal members might view how the public may want their doctors to behave. Did Dr Benn put patients at risk with her placard? Did Dr Benn bring the medical profession into disrepute? Did she put the trust of the public in their doctors at risk? We at DAUK believe, in contradiction, that Dr Benn is actively trying to protect the public and is prepared to go to prison to do so. We would argue that the profession has not been undermined by her actions, the public are not concerned about one doctor trying to protect them and the planet but more by the inadequate response of the Government and organisations, including the GMC, to our overwhelming and unprecedented climate crisis.
DAUK has surveyed the public. Through social media and our website, we have asked whether respondents agree with the MPTS that Dr Benn’s fitness to practise as a doctor is impaired, or their suspension of Dr Benn? Further, do her actions undermine the trust the public has in doctors? We will be publishing full results but to date with approaching 2,000 respondents – the majority not doctors or health care professionals – maybe those reading this article will not be surprised that only around 3% did. In fact, nearly 85% commended Dr Benn’s actions. Only 3% had confidence that MPTS was acting in the best interest of the public, and almost all – approaching 99% – expressed concern about climate change.
While DAUK in no way condones the breaking of laws, we are sorry that Dr Benn and others have had to go to such lengths to raise public awareness and trigger governmental conscience. We want action, we want to protect the health of our nation and the planet. Rather than a deterrent to doctors who may think about breaking the law it is probable the real message that the MPTS have sent doctors and the public is very different; Don’t speak out, don’t take action, oh – and don’t use up precious police resources in the week the Queen dies.
Doctors’ Association UK (DAUK) is a non-profit professional association run by volunteer NHS doctors, which advocates for the medical profession and the wider NHS.
We want a better and fairer process for all, including our patients, and will be reviewing the GMC case of the month for Pulse. Our aim is to generate debate, honest reflection and raise awareness.
Contact DAUK if you have a case you think should be reviewed.
There is no climate emergency, nothing for which the world needs to come to a halt for. There are more important things that need attention today like food, clothing and shelter, not this nonsense.
This is why many doctors feel the GMC is out of touch. This behaviour does not impact on patient trust or medical competence.
Doctors are not some separate human species that needs to be put up on a pedestal as perfect homo sapiens
This is a dreadful article. Once again this case has been misreported and DAUK should be ashamed.
The article says “This is a story of a clinician being punished for raising concerns about dangerous inaction on the greatest threat to global health we have ever seen.”
That is not true.
The MPTS statement on the case specifically says “The independent tribunal of the MPTS, after considering all the evidence, concluded that by consistently breaching a court order Dr Benn’s actions amounted to misconduct. In their determination the tribunal were clear that this case is not about Dr Benn’s right to protest or take part in peaceful protests. Their findings were as a result of Dr Benn breaching a court order on a number of occasions.”
This article should be withdrawn.
It looks like Dr Benn failed to convince the MPTS team that breaching a Court Order and showing Contempt of Court could be justifed by not showing sufficient evidence that all legal methods and routes had first been completely exhausted before taking this route of action and gaining publicity.
It could be implied from the findings that Doctors are expected to demonstrate a higher ability than the average general public to find a range of alternative more acceptable ways to achieve the goals without causing harm along the way, ( or at least, ‘least harm’), and I think this is an important lesson here for our future behaviour, generally.
There are ways to educate the general public, and even the judiciary, without insulting them.
A very one-eyed view from DAUK. They state that they do not support Dr Benn breaking the law, whilst that is exactly what the whole article intends to do. DAUK must decide whether they think Drs are above the law or not. There is only one sensible answer (in my own opinion!)
Kohlberg’s 6 Stages of Moral Development. At stage 4, individuals make moral decisions based on a sense of duty to uphold social order and respect for authority. At stage 5 individuals are also more likely to consider different groups’ perspectives and recognize the need for compromise and negotiation They may be more likely to challenge authority and advocate for change if they see laws or social norms as unjust or unfair.At stage 6 Individuals are more likely to take a principled, ethical approach to decision-making and may see themselves as part of a larger moral community. It sems that the MPTS panel was stuck on stage 4.
“The counsel added that doctors, more than any other citizen, submitted themselves to the rule of law, and that being a regulated professional should uphold an even higher standard. ” Why? Is the GMC in the UK the only regulatory body that feels this and expects a higher standard the the general public? how about other nations like Canada, New Zealand and the USA? Would they do similar? This is why most doctors I talk to feel the UK is not safe for them to practice medicine.