It can’t be easy regulating the medical profession. Medicine is a complicated business and when it comes to probity and performance there’s a lot of grey areas. The GMC, however, is well resourced to do the job with an £85m budget - a fair chunk of which comes from the profession - and has ambitious new leadership.
What do doctors want in return? Not much, just a fair, transparent and consistent approach to fitness-to-practise procedures. Is that too much to ask?
Apparently so if you consider a couple of recent cases.
I admit to being perplexed by the decision making around ‘voluntary erasure’ from the register. The GMC has said that it wants to try and reduce the proportion of doctors who end up in hearings, which is admirable, and clearly voluntary erasure is one way of achieving this.
But if this is to be encouraged, then it must be done transparently. Why is one doctor allowed to slip quietly into retirement when facing a heap of allegations, and another is not? It’s not at all clear.
Mr Nigel Sacks, or example, erased himself from the register - on the grounds of ill health - when facing 19 allegations of fraud only to pop up and continue practising as a surgeon in Australia. In contrast, Dr Sabah Al-Zayyat, who is accused of failing to spot that Baby P was being abused, has been refused voluntary erasure. She claims to be suicidal and is challenging the ruling in the High Court and, on the basis of consistency, I don’t blame her.
The process of voluntary erasure is clearly open to abuse and needs to be better defined or scrapped.
Then there’s the allegations themselves. What level of alleged misconduct should the GMC be dealing with?
Dr Katharine White is up in front of a GMC fitness to practise panel this week. She’s facing allegations that while working as a F2 in Southampton she offered car parking tickets, with which she had been provided, for sale on the internet. She is also alleged to have made some untrue accusations about her tutor.
Now there may be more to this story than meets the eye and, if true, there are probity issues, but does a case like this really deserve the full GMC treatment? Could this not have been sorted out locally with some firm but sensitive management?
In contrast, the GMC chose not to investigate the ‘architects’ of the MTAS disaster - former CMO Professor Sir Liam Donaldson and Professor Sarah Thomas, who chaired the MTAS recruitment and selection steering group - which stymied the careers of a generation of trainees. When challenged by Remedy, the High Court decided their work was too removed from the clinical coalface to face such proceedings.
Now I know these senior figures were acting in good faith, but is that enough to overcome a basic message - the alleged abuse of parking tickets is a more pressing and clinically relevant issue than the failure of a huge medical recruitment system that ruined the careers of hundreds of junior doctors?
I support the principles of revalidation, but I worry that with the extension of the regulatory framework that it encourages we’ll see more trusts passing on seemingly petty cases to the GMC, regardless of whether the regulator wants to reduce the number. The number of ‘official warnings’ (for minor offences like motoring offences and public disorder) dished out to doctors by the GMC has risen by nearly 50% in the past two years, and I can’t see that trend changing.
Until doctors start to see a real move away from the heavy-handed use of hearings, and a more consistent approach to assessing public safety and clinical relevance, the GMC will remain a much vilified organisation among the profession.
Read a related news story.
Tags: fitness to practise, GMC
Well said Mike. Just imagine what our MPs got up to last year! Imagine if they had GMC - General MPs Council! 40% of them would have been suspended and many Millions of MPs fees would have been spent on lawyers! The case example which you have given is the right one. I am not condoning what this F2 doctor did but there is no need to waste my hard earned money which I pay as the GMC fees on lawyers to argue that this F2 doctor has brought the profession to disrepute! What really annoys me is that few years ago some of the GMC Council members travelled standard class and claimed first class! Imagine these are the members who set the standards for the professional regulation!
I think at least 30% of cases which appear before the GMC can be dealt locally and most doctors need help, support, guidance and mentoring so that they can be better doctors for the future! The only people who benefit from today’s professional regulation are the lawyers!
Mike Broad appears to blame the GMC for two decisions made by the High Court and multiple decisions made by Trusts who opt not to sort things out themselves. I’m not saying the GMC is perfect but they should only be held responsible for their own actions.
I am not, nor ever have been a GMC Council Member; nor do I want to be.
The sooner this revalidation nonsense is kicked into the long grass the better. We are over-regulated and have to spend far too much time in box ticking bureaucracy to satisfy our numerous lords and masters.
As to the GMC, I’m sure many members of that august body are hard working and well meaning, but i don’t doubt that some of the more senior members may have axes to grind.
There are those who do, and those who wish to control those who do.
I have followed the antics of the GMC for many years having been “removed” and “not-removed” from the register simultaneously several years ago after a vexatious complaint which was eventually not upheld. But the damage was done. Many years ago the GMC held an election for Council but omitted a large proportion of candidates from the ballot paper. The election went ahead nevetheless. What other organisation could have done this? The Bristol enquiry was a scandal. They did not even have a paediatric cardiac surgeon on the panel! What is annual sub of several hundred pound used for? Glossy pamphlets such as Revalidation. We don’t even get a membership card. When I recently asked about the role of “audit” in revalidation the GMC could provide no answer. They should be disbanded and replaced. “Quis custodiet ipsos custodes?”