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Government Criticised for Delay in Removing GMC Appeal Power

A letter urging the Government to fulfil its 2018 commitment to strip the General Medical Council (GMC) of its power to appeal Medical Practitioners Tribunal Service (MPTS) decisions has been delivered to England's Health Secretary Steve Barclay. The letter, coordinated by the Medical Protection Society (MPS), was signed by a coalition of 19 prominent healthcare organisations.

The Government had promised to relieve the GMC of its right of appeal before the end of this parliament, following the recommendations of the Williams Report, commissioned in response to the case of Dr HadizaBawa-Garba, a junior doctor charged with gross negligence manslaughter following the death of a child under her care. 

The GMC had sought to remove her from the medical register. The MTPS rejected this, saying erasure was "disproportionate", and the GMC appealed the MTPS decision. Dr Bawa-Gaba eventually won and was reinstated following a Court of Appeal ruling. 

GMC Labelled 'Dysfunctional'

That case, and a subsequent one in which the GMC had accused Dr Manjula Arora of having 'lied to obtain a laptop', brought accusations of racism and contributed to the GMC being labelled 'dysfunctional' in the BMJ

The Government had accepted "in full" the recommendations of the review chaired by Professor Sir Norman Williams in the wake of the Dr Bawa-Garba case, which included the central recommendation that the GMC should have its right to appeal fitness to practise decisions removed. This was to "address the mistrust of the GMC amongst doctors and contribute to cultivating a culture of openness that is central to delivering improved patient safety".

Last July, the Government said that it would progress legislation to achieve this in 2023, alongside legislation to bring physician associates (PAs) and anaesthesia associates (AAs) into statutory regulation. "While the Government has now consulted on draft legislation to bring these professions into regulation, it is unclear when the Government will progress with the removal of the GMC's right of appeal," the letter said.

'Continuous Delays in Implementing this Crucial Change'

The Doctors' Association UK (DAUK) was one of the co-signatories of the letter. Asked to comment by Medscape News UK, Matt Kneale, DAUK co-chair, said: "DAUK joins 18 other healthcare organisations in urging the Government to uphold its 2018 promise to strip the GMC of its power to appeal MPTS decisions. The continuous delays in implementing this crucial change have compounded the culture of fear and mistrust in the medical profession, unnecessarily extending stressful fitness to practise proceedings, with 24 decisions challenged by the GMC during this period.

"While we acknowledge the need for statutory regulation of physician and anaesthesia associates, the uncertainty surrounding the removal of the GMC's right to appeal underlines the pressing need for consistency across all medical practitioners. We strongly call on the Government to expedite this much-needed reform."

The letter called on the Government to remove section 40A of the Medical Act 1983 "before the end of this parliament". Other signatories were: 

  • The MPS
  • British Medical Association
  • Royal College of General Practitioners
  • Royal College of Physicians
  • Royal College of Emergency Medicine
  • British Association of Physicians of Indian Origin
  • Association of Anaesthetists
  • Hospital Consultants and Specialists Association
  • Royal College of Anaesthetists
  • Medical Women's Federation
  • Royal College of Surgeons of England
  • Royal College of Obstetricians and Gynaecologists
  • Royal College of Physicians of Edinburgh
  • British International Doctors Association
  • Royal College of Paediatrics and Child Health
  • Royal College of Physicians & Surgeons of Glasgow
  • Royal College of Surgeons Edinburgh
  • Royal College of Pathologists.

Professor Dame Jane Dacre, MPS president, said: "This month marks 5 years since the Government first committed to removing the GMC's power to appeal fitness to practise tribunal decisions. During that time the GMC has challenged 24 decisions. The delay is disappointing and frustrating, and doctors will have this hanging over their heads until the relevant changes are made to the Medical Act.

GMC's Power to Appeal has 'Generated Distrust'

"The GMC's power to appeal has generated distrust between the medical profession and the regulator and has contributed to a culture of fear. Fitness to practise proceedings are stressful and lengthy enough for those involved, without the additional worry that the GMC can seek to override the decision made by the MPTS if it does not agree. This is and has long been the Professional Standards Authority's (PSA) job.

"The added concern now is that when PAs and AAs are brought into statutory regulation, the GMC will not be able to appeal panel decisions relating to their fitness to practise, but they may still be able to challenge decisions on doctors' cases - parity is key.

"Nineteen leading healthcare organisations have signed this letter – the strength of feeling on this issue and the ongoing delays is clear. This important change must not fall behind."

Asked to comment by Medscape News UK, the GMC repeated verbatim the statement it made in January, which read: "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."