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Ministers consider widening scope of GMC fitness-to-practise hearings

Exclusive: GPs face the prospect of being hauled up in front of the GMC for complaints based on events from many years ago or even investigated for the same incident twice, under proposals being considered by all UK health departments to ‘modernise' healthcare regulation.

A report drawn up for the Department of Health by the Law Commission has also suggested reducing the evidence threshold for assessing fitness to practise, in a move that could drive up the number of GMC cases. The GPC described the proposals as ‘very concerning'.

The report will form the basis of a draft bill to apply across the UK, after the Law Commission was asked to review existing legislation on all healthcare regulators and make recommendations for a new ‘simple, consistent, transparent and modern' legal framework. The document – published online this month – says healthcare regulators including the GMC should be more independent and ‘proactive' in identifying poor practice.

The GMC does not currently investigate an allegation if more than five years have passed since the events concerned except in ‘exceptional circumstances' where it is in the public interest.

But the report describes this rule as ‘unnecessarily restrictive', even though it admits removing the time limit could lead to ‘ill-founded and stale allegations'. It says: ‘It is at least arguable regulators should be able to consider all allegations no matter when they were made. The decision whether or not to proceed could depend in all cases on the quality of the evidence available and not on an arbitrary time limit.'

The report also questions whether the so-called double jeopardy rule that prevents regulators revisiting fitness-to-practise decisions should be removed, and suggests the current evaluation of impairment of fitness to practise could be replaced with a broader test assessing whether a doctor poses a risk to the public and if ‘confidence in the profession has been, or will be, undermined'.

The commission admits this could lower the threshold for allegations and lead to an increase in fitness-to-practise hearings, but says it would allow regulators to look at a broader range of evidence. It also says regulators should play a ‘proactive' role in using all information that comes to their attention, rather than simply acting on complaints.

Dr Richard Vautrey, GPC deputy chair, said the GMC was ‘already very independent' and it was hard to see how it could become more so: ‘Doctors already feel under pressure from ever-increasing scrutiny by a variety of bodies and would be very concerned if this was made worse by the possibility of resolved cases being reopened long into the future.'

Dr Chris Udenze, a GP in Nottingham, said it would be inappropriate for the GMC to investigate most cases which were more than five years old: ‘The practicalities of getting reliable evidence after that time might make it difficult. It should only be in exceptional circumstances.'

The DH said it would be responding to the consultation in detail, but that the current legal framework was ‘complex and expensive': ‘We asked the Law Commission to review the law because we want to modernise and simplify these complex arrangements while maintaining high standards and the confidence of the public.'

A GMC spokesperson said it would respond in due course.

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