This decision follows concerns from DAUK, the British Medical Association (BMA) and others that the original consultation presented the recommendations of the Lord Mann Review in a misleading and legally flawed way.

DAUK acted before the original consultation deadline.

On 9 June, solicitors acting for DAUK, Leigh Day, wrote to the Secretary of State for Health and the Department of Health and Social Care (DHSC) seeking a one-month extension to the consultation.

Lord Mann Review

The request highlighted that Lord Mann’s Review had been published on 4 June, leaving doctors and representative organisations less than three weeks to consider its recommendations before the consultation was due to close on 23 June.

DHSC initially refused DAUK’s request for a formal extension, although it agreed that DAUK could submit further material concerning the Mann Review by 30 June.

The Government later revised its position, extending the consultation by four weeks to 21 July.

However, DAUK made clear that an extension alone could not correct the underlying problem with the consultation.

Withdrawn and reissued

On 29 June, Leigh Day wrote again on our behalf, arguing that the consultation remained misleading and calling for the sections dealing with the GMC’s appeal powers to be withdrawn and reissued.

DAUK has worked closely with other representatives of the medical profession during this process and supported the legal challenge brought by the BMA.

DAUK’s draft consultation response and legal position were informed by detailed work from our members, and we will refine this further for the new consultation.

The Government has now confirmed that it will consult again on the proposals, a decision DAUK believes is welcome and necessary. It also demonstrates the impact that coordinated legal, professional and public pressure can have.

DAUK continues to oppose the GMC retaining a separate right to appeal MPTS decisions.

Independent oversight

The Professional Standards Authority already provides independent oversight and has its own power to challenge decisions.

Giving the GMC an overlapping appeal power risks undermining the independence of the tribunal system and perpetuating the mistrust identified following the case of Dr Hadiza Bawa-Garba.

Dr Matt Kneale, DAUK co-chair, said: “The government initially rejected DAUK’s request for a proper extension, before extending the consultation for everyone and now accepting that it must consult again

“That sequence shows why it was essential for doctors’ organisations to challenge this process.

“DAUK was clear that additional time alone would not cure a consultation that presented the arguments unfairly.

Collaborative work

“Through our legal team, our consultation response, and our work alongside the BMA, we helped maintain the pressure for the affected proposals to be withdrawn and reconsidered.

“This is an important result for doctors, patients and fair regulation.

“We will continue to argue that independent oversight should rest with the Professional Standards Authority, rather than allowing the GMC to act as investigator, prosecutor and appellant.”

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DAUK took legal advice on the Department of Health and Social Care’s consultation on the draft General Medical Council Order 2026.

The association is now weighing its position alongside the British Medical Association (BMA), which has begun legal proceedings against the government over the same issue.

The draft Order proposes preserving and widening the GMC’s right of appeal against MPTS decisions, which is a significant reversal of the policy consensus reached after the Bawa-Garba case.

Williams Review

Following the independent Williams Review in 2018, the government accepted that the GMC’s right of appeal against MPTS decisions should be removed, in order to strengthen the independence of medical adjudication and rebuild doctors’ trust in the regulator. The draft Order abandons that commitment.

DAUK also shares the BMA’s concern that the consultation misrepresents the findings of Lord Mann’s review and fails to give consultees enough information to respond meaningfully – raising questions about whether the consultation process is lawful.

DAUK co-chair Dr Matt Kneale said: “Eight years ago, after the Williams Review, the government accepted that the GMC should lose its power to appeal tribunal decisions – the very power used against Dr Bawa-Garba, which did such lasting damage to doctors’ trust in the GMC.

Broken promise

“For ministers now to quietly retain and even extend that power, through a consultation that doctors say misrepresents the evidence and gives them too little to respond to, breaks that promise.

“We have taken legal advice and, alongside the BMA, we are actively considering our next steps.”

Meanwhile, DAUK has joined 12 other medical organisations urging the government to reconsider its plan to retain the GMC’s right to appeal the decisions of its own tribunal service.

Coalition of medical organisations

In a joint letter to Minister of State for Health, Karin Smyth MP, the coalition argues the GMC’s right of appeal risks seriously undermining the profession’s and the public’s trust in the independence of the tribunal process, and the regulator itself.

Read more about the coalition’s calls.

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Under the Government’s current proposals, the GMC would retain its ability to appeal decisions made by the Medical Practitioners Tribunal Service (MPTS) and gain additional powers to appeal interim decisions.

The move to keep the GMC’s right of appeal goes against reviews by Sir Norman Williams and Dr Leslie Hamilton – which both recommended its removal in favour of a single, independent route held by the Professional Standards Authority (PSA).

These recommendations were supported by the then government and the GMC.

Public trust

In a joint letter to Minister of State for Health, Karin Smyth MP, coordinated by the Medical Protection Society (MPS), the coalition argues the GMC’s right of appeal risks seriously undermining the profession’s and the public’s trust in the independence of the tribunal process, and the regulator itself.

The letter also states that ‘providing both the GMC and the PSA with parallel rights of appeal creates unnecessary duplication, inconsistency, and complexity to the regulatory system’.

It quotes evidence from a Freedom of Information request by MPS which shows that 88 per cent of PSA appeals have been successful since 2016, compared with 70% for the GMC over the same period, rejecting the argument that the GMC’s right should stand due to its high record of successful appeals.

Independent oversight

“This demonstrates that an additional, overlapping GMC right of appeal is unnecessary given the existence of an established and effective independent oversight mechanism through the PSA,” the letter says.

The letter was signed by: Medical Protection Society, British Medical Association, Doctors Association UK, Association of Anaesthetists, Royal College of Paediatrics and Child Health, British Association of Physicians of Indian Origin, Royal Medical Benevolent Fund, British International Doctors Association, Faculty of Forensic and Legal Medicine, Hospital Consultants and Specialists Association, Medical Women’s Federation, The Medical and Dental Defence Union of Scotland and the Medical Defence Union.

Read the letter in full.

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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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The General Medical Council (GMC) today (Tuesday 24 March) launched its annual survey on medical training.

The anonymous survey is the UK’s largest annual insight into postgraduate medical training, with more than 71,000 respondents last year.

National Training Survey

Dr Matt Kneale, DAUK co-chair, said: “The National Training Survey is one of the most important tools we have for understanding the pressures facing doctors in training.

“We do encourage every trainee and trainer to complete it, as responses can lead to real change.

“But year after year, the data tells the same story. Burnout is endemic, rota gaps undermine training and too many doctors do not feel safe raising concerns.

“The GMC must demonstrate that collecting this data leads to enforceable action, not just another report.”

Specialty training

Dr Kneale added: “With the Medical Training (Prioritisation) Act now law and specialty training applications at record levels, the survey must evolve to capture the full reality of the training crisis, including the impact of the bottleneck on morale and career uncertainty.”

For the first time, doctors will be asked if their employer encourages a culture of shared learning and knowledge between different healthcare professionals.

The GMC said this was ‘to capture how well trainees feel supported to engage in multidisciplinary communication, which is critical for safe patient care’.

Dr Kneale said: “We note the introduction of a new question on shared learning between healthcare professionals.

Patient safety

“DAUK supports effective multidisciplinary working, but the GMC must ensure this data is not used to advance workforce substitution agendas without addressing scope of practice and patient safety.”

The survey takes around 20 minutes to complete and runs until midday on Wednesday 6 May. It includes questions on discriminatory behaviours, quality of teaching and supervision, workloads, burnout, and training opportunities.  

The results will be published later this year. Find out more about the National Training Survey. 

Professor Pushpinder Mangat, GMC medical director and director of education and standards, said: “The results of this survey are vital for supporting doctors and protecting patients.

Real-life action

“They translate into real-life action when it comes to patient safety, and the environments doctors work and train in. 

“Therefore, it is important that trainees and trainers take the time to share their perspectives.

“The results will be used to improve doctors’ experiences, as well as those of their peers and patients, by highlighting areas of good practice and those where action is needed.”

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The GMC’s interim perceptions survey also found that more than three-quarters (77 per cent) of doctors were not confident in how the GMC regulates physician assistants and physician assistants in anaesthesia.

Dr Steve Taylor, Doctors Association UK (DAUK) GP co-lead, said he was not surprised by the survey results.

GMC

He said: “The GMC was set up by doctors for doctors to provide a safety check and regulation of safe patient care. 

“Given the well publicised disregard of doctors views on PAs and AAs, and ongoing concerns about the way the GMC investigates doctors, it is not at all surprising that confidence in the GMC has been falling. 

“Doctors have been an afterthought despite the fact that they are the ones paying for the GMC’s existence and are the vast majority of registrants.

Wake-up call

“The current board is failing and has failed to listen to the voices of the majority of doctors, and this survey confirms this. Hopefully this will be a wake-up call.”

Read the Doctors.Net article.

Download the GMC interim perceptions survey.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

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Doctors Association UK (DAUK) has co-signed a letter to health minister Karin Smyth.

In the letter, led by the Medical Protection Society, the coalition of 32 organisations describe the proposal to remove the health category as a ‘significant step backwards’.

The proposal was put forward by the previous government in its consultation on reform of the Medical Act.

Health category

Currently, in cases where doctors are investigated under the health category of impairment, the GMC can use language which acknowledges the health concerns about the doctor without having to use pejorative terminology around misconduct.

It is able to put in place measures to protect the doctor such as some, or all of the hearings, being held in private and the focus is on aiding recovery and return to practice in addition to patient safety.

Under the new plans, concerns about doctors with a health issue would have to be investigated on the grounds of ‘inability to provide care to a sufficient standard’ and/or ‘misconduct’.

This is language the group claim is inappropriate and could deter doctors from seeking early help.

GMC concerns

The GMC has also outlined similar concerns.

GMC data shows that it recorded health as a category of impairment in nearly 1,000 of the investigations it conducted over the last six years.

This amounts to almost one in five (17%) of all investigations. In half of these cases (49%) the doctor self-referred to the GMC.

The letter, said: “Our intention is to highlight one small but important step that the Government could take to protect the most vulnerable doctors during a regulatory investigation.

“Our focus on this area, is based on a shared view that supporting the wellbeing of doctors is an essential component of maintaining high quality, safe patient care.

“The impact of a GMC investigation on doctors’ mental wellbeing is well documented.”

In an MPS survey of nearly 200 doctors who have been investigated, 78% said it harmed their mental health and almost 31% reported experiencing suicidal thoughts during the process.

This impact will be even greater for doctors who have existing health concerns.

“Significant progress has been made by the GMC to reduce the impact on doctors facing a fitness to practise investigation, and reduce the number of suicides during the process.

Investigate doctors

“Current provisions within the Medical Act, particularly the ability to investigate doctors under the health category, have been central to this progress.

“It was therefore a significant step backwards when proposals for reform were put forward by the previous government that would have the effect of removing it.

“We strongly urge you to retain health as a distinct category. This would protect doctors at one of the most challenging moments of their lives, improve their retention in the workforce, while safeguarding patients. Crucially, it would help towards ensuring that doctors who are unwell feel supported rather than driven out.”

DAUK committee members are all volunteers and campaign on issues facing frontline doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Supervision

However, the Doctors’ Association UK is concerned that the guidance is poor and does not address issues around supervision. These issues include the supervisor retaining responsibility and accountability for patient care. This means supervising doctors will be liable for mistakes, said Dr Steve Taylor, DAUK’s GP spokesperson. Dr Taylor said: “Doctors need to be sure that the task they are delegating is within the scope of the PA. “In many cases the supervisor will not have sufficient knowledge of the PA’s training, knowledge, or capabilities.

Patient safety

“Because the supervisor retains responsibility and accountability for patient care, the supervisor will need to be confident the patient is being treated appropriately, safely, and has been thoroughly assessed. “Supervision is not straightforward and currently there are no training requirements for supervisors. “This means patients primarily, as well as PAs and doctors, are being placed in positions that are not ideal at best and unsafe at worst. “The delegating doctor retains responsibility for patient care, and therefore will be liable for mistakes. Patient safety and care needs to be paramount.

Medico-legal minefield

“This effectively places doctors in a medico-legal minefield and open to GMC referrals for mistakes, as medical defence organisations such as the MDU make clear.” Dr Taylor added: “Doctors will remain responsible for the overall management of the patient, decisions around transfer of care, and the processes in place to ensure patient safety. “Although AAs and PAs remain accountable for their actions, a doctor will retain responsibility for the overall management of the patient and the system of supervision.” Dr Taylor said the guidance lacked certainty for doctors, failed to address significant patient safety concerns, and did not provide a comprehensive framework for supervision of PAs and AAs.

Certainty and clarification

He said: “More certainty and clarification is needed, and employers need to be aware of the significant implications of supervision, including training, assessment and monitoring. “This was highlighted by Nuffield Trust in respect to general practice supervision of other roles, but can also be extended to hospitals.” Please support our work by contributing to our crowd funder or by becoming a member.

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.