DAUK warned the proposals go against the Williams review and would ‘dismay doctors across the country’.

It said the timing of the announced reforms was ‘troubling’, coming as the GMC appeals the clearance of Dr Ghassan Abu-Sittah.

Dismay doctors

Dr Matt Kneale, DAUK co-chair, said: “Doctors across the country will be dismayed that the government has abandoned the cross-profession consensus established by the Williams review.

“We were promised the GMC would lose its power to appeal its own tribunal’s decisions.

“Instead, this consultation retains that power and creates new ones. At a time when the GMC is actively appealing the clearance of a doctor found to have committed no misconduct, the timing could not be more troubling.

“The framing of this announcement – as though the GMC has been too slow to punish doctors – ignores everything we know about how the GMC operates.

NHS Staff Survey results

“Its own data shows ethnic minority doctors are disproportionately referred.

“The recently-published NHS Staff Survey shows one in 10 doctors were physically attacked at work.

“The safety crisis in the NHS is not that doctors are getting away with misconduct.

“It is that doctors are being attacked, burned out and driven from the profession while a regulator with a proven track record of bias is handed yet more power.”

Human impact

DAUK also pointed to the human impact of the current regulatory process. The GMC’s own rolling three-year data shows that 36 doctors died while under investigation or being monitored between 1 January 2021 and 31 December 2023. The GMC reported fewer than three suicides to protect individual identification.

Dr Shonnelly Novintan, DAUK’s Learn Not Blame lead, said: “The framing of the reforms focus on individual doctors rather than addressing systemic pressures, and this contributes to a worsening blame culture at a time when doctors under investigation already face high suicide rates.”

The reforms, the Government said, are a major modernisation of medical regulation, describing them as the most significant changes since 1983.

Rapid review

They follow a rapid review conducted by Lord John Mann into antisemitism and other forms of racism in the health service.

Alongside wider proposals, the Government is consulting on the first tranche of recommendations from Lord Mann’s review.

The GMC Order will consult on delivering these recommendations into law, introducing three key changes:

• The GMC will retain its existing right to appeal decisions made by the Medical Practitioners Tribunal Service (MPTS) to the courts.
• The Professional Standards Authority (PSA) will receive new powers to challenge interim decisions made by the MPTS, and the GMC will receive equivalent powers.
• Regulators will be required to share information with the PSA when requested.

Charlie Massey, GMC chief executive and registrar, said: “This is an important and long-awaited step towards a more responsive and compassionate approach to healthcare regulation.”

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Suspension

The High Court has now extended Mr Gilbert’s suspension to 12 months following a successful appeal brought by the (PSA) and the General Medical Council (GMC). The case drew national media attention due to the seriousness of the proven misconduct, the widespread concern expressed by professionals, and the questions it raised about the fairness and structure of medical regulation in the UK. Mr Gilbert was found guilty of multiple counts of serious professional misconduct over a period of more than ten years, including repeated incidents of non-consensual physical contact, sexually motivated remarks and behaviour, harassment, and the use of racially offensive language. These actions were directed at multiple junior colleagues, took place in professional settings, and constituted a significant abuse of power and position.

High Court

The High Court upheld the original findings of fact made by the Medical Practitioners Tribunal, concluding that the conduct had seriously undermined public confidence in the profession and failed to uphold professional standards. Dr Kneale said: “While we are disappointed the sanction remains a suspension rather than erasure from the medical register, we accept the court’s reasoning. “We maintain that such sustained and inappropriate behaviour has no place in the NHS. “In our view, the public is unlikely to be reassured by an additional four-month suspension, and concerns remain about the doctor’s return to unrestricted practice after just one year.”

Reform

DAUK is now urging ‘long-overdue’ reform of the fitness to practise proceedings in line with the Williams Review. Dr Kneale said: “We also believe the GMC should not have appealed the tribunal’s original verdict. “As the body responsible for investigating the case and referring it to the tribunal, it cannot simultaneously function as an impartial appellate challenger. “This dual role undermines the credibility of the process and reinforces longstanding concerns about conflicts of interest within the UK’s medical regulatory framework. “The PSA’s intervention in this case was timely and principled, and demonstrated that fair and independent oversight is not only possible but essential.

Williams Review

“As recommended in the Williams Review, DAUK urges the Government to accelerate long-overdue reforms to ensure that fitness to practise proceedings are conducted independently of the GMC. “DAUK remains committed to standing up for those affected by misconduct in the workplace and campaigning for a regulatory system that prioritises fairness, transparency, and the protection of patients and professionals alike.” Please support our work by contributing to our crowd funder or by becoming a member.

Thirteen healthcare organisations have repeated a call for the Government to deliver on a commitment to remove the General Medical Council’s (GMC) power to appeal fitness to practice decisions.

In a letter to Matt Hancock, Secretary of State for Health and Social Care, the Medical Protection Society urged the Government to use the forthcoming Health and Social Care Bill as an opportunity to remove the GMC’s ability to appeal such decisions made by the Medical Practitioners Tribunal Service (MPTS).

The letter – also signed by the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP) – said that this would help to address the mistrust of the GMC amongst doctors and contribute to cultivating a culture of openness.

Removing the GMC’s right to appeal

In 2018, the Government accepted ‘in full’, the recommendations of the Williams review into gross negligence manslaughter in healthcare, which included removing the GMC’s right to appeal FTP decisions.

The review was set up to look at concerns among healthcare professionals that simple errors could result in prosecution for gross negligence manslaughter, following the case of Dr Hadiza Bawa-Garba.

It concluded that removing the GMC’s power would not reduce public protection, as the Professional Standards Authority (PSA) would retain a similar right to appeal.

A consultation document published by the Government in March 2021 outlined its recommitment to removing this power.

The Medical Protection Society said that data it obtained via FOI indicates the GMC has challenged at least 14 MPTS decisions since the start of 2018.

The letter to the Secretary of State said: ‘We were pleased to see the recent white paper confirm that the Government plans to consult further on its broader reform proposals with the aim that these be delivered through secondary legislation.

‘The forthcoming Health and Social Care Bill seems an excellent opportunity to amend the Medical Act 1983 by removing section 40A. We urge you to include such provisions in the Health and Care Bill and bring forward a timetable for reform.’

Pandemic highlighted high-pressure workplaces

‘Now more than ever, the regulator needs to be able to operate in a way that instils confidence amongst patients and doctors,’ said Professor Dame Jane Dacre, Medical Protection Society president.

‘The GMC’s power to appeal decisions made by the MPTS has led to fear across the medical profession and a lack of confidence in the GMC. It is also unnecessary as the PSA has the authority to appeal decisions. The GMC is the only UK health regulator that has such a right of appeal.’

While she welcomed the Government’s recommitment made in March this year, she flagged that it has been ‘almost three years’ since the review was published.

More recently, the Covid-19 pandemic has ‘sparked discussion about the extent to which individuals should be held to account when working in pressurised and extreme circumstances,’ she said.

‘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,’ she commented.

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Thirteen healthcare organisations are calling on the government to follow through on its 2018 promise to strip the General Medical Council (GMC) of its power to appeal decisions made by the Medical Practitioners Tribunal Service (MPTS).

The organisations include the British Medical Association, the Royal College of Physicians and the British Association of Physicians of Indian Origin.

In 2018 the government accepted in full recommendations made by the Williams review into gross negligence manslaughter in healthcare, following the case of Dr Hadiza Bawa-Garba – this included the main recommendation that the GMC should have its right to appeal fitness to practice decisions removed.

The review also said that the Professional Standards Authority (PSA) would retain its near identical right of appeal to MPTS decisions.

However, as relevant legislative changes have not been made to the Medical Act, the GMC continue to appeal decisions. According to data obtained through an FOI (freedom of information) request, since the start of 2018 it has challenged at least 14 MPTS decisions.

Commenting on the strength of feeling on the issue from across healthcare, professor Dame Jane Dacre, president at the Medical Protection Society who coordinated the letter, said: “The GMC’s power to appeal decisions made by the MPTS has led to fear across the medical profession and a lack of confidence in the GMC. It is also unnecessary as the PSA 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 do 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.”

The letter to health secretary Matt Hancock calling for section 40A of the Medical Act 1983 to be removed as part of the upcoming Health and Social Care Bill, has been signed by Medical Protection Society, The Doctors’ Association UK, Hospital Consultants and Specialists Association, British Medical Association, Royal College of General Practitioners, 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.

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A coalition of medical organisations is calling for the GMC to swiftly be stripped of its powers to appeal fitness-to-practise tribunal decisions, as an FOI revealed this has happened in a further 14 cases since the Bawa-Garba fallout.

It comes as GPs were last month given 12 weeks to respond to plans for sweeping GMC reforms, including quashing the GMC’s powers of appeal. Under those plans, the law may be changed by spring 2022.

But a letter to health secretary Matt Hancock, signed by ‘coalition’ of 13 medical organisations including the Medical Protection Society (MPS), BMA, RCGP and Doctors’ Association UK (DAUK), called for this legal change to instead be included in the forthcoming Health and Social Care Bill.

The Bill is also due to start being implemented from 2022, but an MPS spokesperson told Pulse that this route would give greater certainty that the changes will actually take place, as well as likely being much quicker.

Reforms to professional regulation are often delayed and there are limits on how much reform can be introduced via secondary legislation – the proposed mechanism for the GMC reforms – while the Bill could complete its passage through Parliament by the middle of 2022, they said.

Any legislative change would deliver on a Government commitment made in 2018, when the Williams review into gross negligence manslaughter in healthcare following the case of Dr Hadiza Bawa-Garba recommended that the GMC should lose the right. 

Although the Government accepted the review’s recommendations ‘in full’, relevant legislative changes have yet to be made.

The MPS revealed that the GMC has challenged ‘at least’ 14 MPTS decision since the start of 2018, according to data obtained through an FOI request. This comes after Pulse exclusively revealed in March 2018 that the GMC had launched appeals against its own tribunal 23 times in the 10 months since gaining the right to do so in 2017 – with seven doctors struck off as a result.

MPS president Professor Dame Jane Dacre, who coordinated the letter, welcomed renewed Government commitment that the GMC should be stripped of the power but argued the move ‘should not be held up while a wide range of other complex proposals go through a round of further consultation’, almost three years after the original commitment. 

Professor 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 MPTS has led to fear across the medical profession and a lack of confidence in the GMC. 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.’

The powers are ‘unnecessary’ as the Professional Standards Authority (PSA) also has the authority to appeal MPTS decisions’, while the GMC is ‘the only UK health regulator’ to have such a right, she added.

She concluded: ‘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.’

Meanwhile, Commons health select committee chair Jeremy Hunt this morning Tweeted his endorsement of the call for the ‘vital change’, saying it should be ‘actioned ASAP’.

‘[The] Bawa-Garba ruling had a chilling effect  & undermined efforts to create a learning rather than blame culture’, he said.

Last month, the Government published its plans to update legislation to enable swifter resolution of fitness-to-practise investigations, as well as quashing the GMC’s powers to appeal FTP decisions – which it has had since 2017.

A number of the proposed changes come in the wake of the high-profile case involving Dr Hadiza Bawa-Garba, which led to a review into FTP proceedings.

In 2018, the GMC said it would not halt appeals against FTP decisions until the law is changed, claiming it has a ‘statutory duty’ to do so in the meantime.

And a 2019 review found that the regulator should acknowledge its relationship with doctors has been ‘severely damaged’ from the Bawa-Garba case and that it ‘must learn’ from it.

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