GMC could lose power to appeal fitness-to-practise decisions

The GMC could be stripped of its powers to challenge fitness-to-practise decisions, in a bid to boost patient safety and ease the ‘mistrust’ with doctors fomented by the Bawa-Garba case.

The move is one of many recommended by a review into the use of gross negligence manslaughter by Professor Sir Norman Williams, a former president of the Royal College of Surgeons.

Doctors and the MPS (Medical Protection Society) have welcomed many of the review’s recommendations, and several were suggested by the BMA in evidence to it.

The GMC has said it is ‘disappointed’ about the plan to remove its right of appeal, claiming the move would ‘significantly reduce our ability to protect patients’. Sixteen out of 18 of appeals cases heard in court had been upheld, it said in a statement.

BMA council chair Chaand Nagpaul said the association had long opposed the GMC’s right to appeal fitness-to-practise decisions.

‘We know that doctors going through this process find it stressful enough, in many cases leading to anxiety and depression, without the added worry that any decisions made by the Medical Practitioners Tribunal Service can be overridden by the GMC taking the case to a higher court,’ he said.

‘If we, as doctors, and the wider health service are to learn from these mistakes and to prevent such tragedies occurring, the NHS needs a dramatic shift away from the current culture of blame.’ 

MPS education services lead Pallavi Bradshaw said the GMC’s power to appeal decisions was ‘detrimental to the interests of healthcare professionals and unnecessary’.

The Professional Standards Authority will retain the authority to appeal decisions made by the tribunal services, according to the review.

Health and social care secretary Jeremy Hunt told Parliament this week that the GMC’s right to appeal decisions had resulted in a ‘lack of confidence in their regulator as well as having an unanticipated impact on the willingness of doctors, especially trainees, to reflect fully on their practice’.

Other recommendations in the review include:

  • a revision of guidance to investigators and prosecutorial bodies to ensure a ‘clearer understanding’ that the bar for gross negligence manslaughter is for rare cases when performance is ‘truly exceptionally bad’
  • that ‘systematic issues’ and ‘human factors’ should be taken into account alongside the actions of an individual when errors lead to death
  • extra support for families bereaved by the death of a loved one
  • the GMC will no longer be able to require doctors to provide reflective material when investigating fitness-to-practise cases.

The Williams Review was prompted by the case of Hadiza Bawa-Garba, a paediatrics trainee who was convicted of gross negligence manslaughter in 2015 and suspended from the medical register for 12 months by the Medical Practitioners Tribunal Service last June. The GMC appealed the decision to the high court, and in January she was erased from the medical register.

Dr Bawa-Garba has been granted leave to appeal her erasure. The BMA has been granted permission to intervene in the appeal, as has the Professional Standards Authority.

Read more about the Bawa-Garba case and its wider implications

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