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Doctors who harm patients to face tougher sanctions, GMC proposes

Doctors who cause harm to patients through clinical error or professional misconduct will face sanctions even if they can demonstrate that their practice has improved, under proposed changes announced by the GMC today.

The independent regulator has opened a public consultation to update its ‘indicative cautions guidelines’ for case examiners in Fitness To Practice (FTP) proceedings. This guidance is used by examiners to decide how to deal with doctors when serious complaints against them are upheld as well as being used to decide whether or not to refer a doctor under investigation to a FTP panel in the first place.

The consultation document, ‘Reviewing how we deal with concerns about doctors’, proposes a number of changes that will allow the GMC to ‘take appropriate action to protect the public interest without being influenced by the personal consequences for the doctor’.

It comes a month after Pulse reported on research published in the BMJ that showed how doctors involved in FTP proceedings due to ill health felt daunted, confused and anxious as a result of the GMC’s ‘accusatory tone’ in FT hearings and correspondence.

Under the proposed changes, the GMC’s Medical Practioners Tribunal Service (MPTS) panels will be able to take ‘more serious action’ against doctors who have failed to ‘work collaboratively’ or raise concerns early on.

Doctors who are shown to have known (or who it is deemed should have known) that they were were causing harm to patients will face restrictions on their practice, suspension, or could have their registration removed - even if they have subsequently retrained or otherwise improved their practice.

If the changes go ahead, MPTS panels will also be able to consider ‘specific aggravating and mitigating factors’ when deciding on what action to take in cases that involve addiction or misuse of alcohol or drugs.

The GMC say that the proposals are designed ‘to protect patients and uphold public confidence in the medical profession’. The results of their consultation will be used to update the guidelines used to decide the outcome of FTP hearings in a way that the body’s chief executive Niall Dickson described as ‘similar to that used in courts in England and Wales’.

Mr Dickson said: ‘In the vast majority of cases, one-off clinical errors do not merit any action by the GMC. But in the small number of serious cases where doctors fail to listen to concerns and take action sooner to protect patients, they should be held to account for their actions.’

He added: ‘The guidance on which we are consulting today is vital for case examiners and the independent panels who decide on the sanctions doctors should face, both to protect patients and uphold the reputation of the profession.’

Other proposed changes include giving MPTS panels the power to force doctors to apologise to patients they have harmed. Those who take part in the consultation will be asked to consider whether a failure to do so may be considered as evidence that the doctor lacks insight into their shortcomings.

Doctors who wish to take part can do so on the GMC website. A report on the outcomes of the consultation will be published in 2015.

 

Readers' comments (42)

  • 96 doctors have died whilst under investigation by the GMC. Who is going to hold this organization to account?

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  • I was investigated by the GMC for 18 months following a malicious allegation by a patient. We ended up involving the police to end the harrassment by this patient. I was completely cleared. No one ever apologised to me.

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  • Another stick. How about some carrots?

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  • Why on earth do doctors have to pay for the GMC? It stopped being self-regulation a long time ago. The public should pay.

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  • Una Coales

    Keep the comments coming! Sky News has invited me to debate 'against' this sanction of a forced apology vs CG arguing 'for' at 1:30 pm today!

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  • The GMC continually hide behind the mantra that they are protecting patients but they are in fact contributing to a nasty culture of fear that is becoming quite pervasive within the UK medical profession of late. The irony is that the GMC may well be doing more harm than good and undermining public trust in the NHS.

    Throughout history doctors are often targeted as scapegoats and for other peoples failings. There are good examples of this to be found in recent armed conflicts. The reality is that most medical professionals are really decent people trying to do their best with the resources available. Doctors are on the whole honest and moral people who are often quite vulnerable as a consequence and sometimes in need of protection from the very people they are trying to assist. Medicine is increasingly complex but nobody I know gets up in the morning to intentionally make mistakes. Serious errors usually arise from system faults, something that the airline industry has done well to recognise and nurture people to improve safety. Sadly the GMC is pushing in the opposite direction.

    We already have a strong judicial system to protect the public and uphold the rule of law. There are good mechanisms to deal with a small number of people who are letting our side down which raises the question of what the GMC is for.

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  • Una I would point out the sharp rise in complaints that the GMC is receiving despite no evidence of an increased frequency of poor care - ie more nonsense complaints. In such instances, the patient should be asked to apologise to the doctor.

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  • "The irony is that the GMC may well be doing more harm than good and undermining public trust in the NHS."

    "Another stick. How about some carrots?"

    Exactly! GMC is only interested in it's own power and importance and not at all interested in Supporting Doctors. It is just another brick in the wall of regulation, threat and demoralisation that GPs have to get over in order to do their jobs.

    Who went to medical school to Help People and who went to medical school to be scrutinised, bullied, undermined and fill in forms and tick boxes?

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  • Abolish GMC ,all cases to go to courts which have publically funded medical tribunals and if accusations are proved unfounded then doctors can sue the patients and claim damages so it's fair for every one

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  • Dear Una

    please read this http://www.civitas.org.uk/pdf/GMCFittoPractise.pdf

    It will help you and is a good read. Best of luck to you!

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  • 10.34 You are right. Good Medical Practice guidelines have become too wide reaching. The GMC have created a quasi judicial monster without all the checks and balances that the law has developed over the centuries to protect the rights of the innocent. Complaints against doctors have risen enormously though the amount upheld remains low in a system that is now way out of control.

    This cannot be allowed to continue because it tramples over doctors human rights and ignores fundamental ethical principles. The GMC is in urgent need of reform.

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  • Most patients who have been harmed just want an APOLOGY - why is it so difficult for doctors to say Sorry? The crux of the manner is many just think they're too high & mighty - a little humble pie won't hurt

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  • Anonymous | Other healthcare professional | 22 August 2014 11:38am

    forcing doctors to apologise isn't exactly the solution to the problem, is it?

    what we're talking about is when patients maliciously complain about doctors, making things up, either because they are in search of money or because they have a vendetta against the doctor.

    I think it should be more than fair for a doctor to complain back or take civil action.

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  • I seriously doubt "other health care" is in health care of any form.

    Just because patient complain, it does not mean the doctor was wrong. Is that a hard concept for you to grasp?

    I'll give you an example. I had a complaint not too long ago about "missing" bacterial tonsillitis. My record clearly shows low Centor score, explanation of this and the reasoning and safety netting pointing out to contact OOH if symptoms worsen. Despite this, the patient was adamant I have done wrong and caused harm. If I was to be sanctioned (which I wasn't) we will need to cease all medical practice as no one will be able to make any sense of treatment then.

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  • GMC is only creating fear and I don't think this will help General Practice. Lot of my friends are leaving to other countries. Some of my friends who have already moved are much happier. They have got better lifestyle, more pay and less red tape to work with. My feeling is that it will get worse for us in future. I suppose UK is the only country in the world where average salary for doctor's is going down in real terms. Doctor's are starting to earn even better in developing countries now. On the other hand our work load is increasing. Medicine is becoming more patient centred. There is something in the media everyday about doctor's- why so much of doctor bashing. I have worked in other places in the world. I do not see this happening anywhere else. Why so much of doctor bashing culture? It is clear from recent MDU & GMC's booklet that complaints are on the rise. It's amazing when you look at this- GPs are working under immense pressure. We are advised not to refer, save money, reduce admissions. But on the other hand patient expectations are increasing and if something is missed, no one is going to save us. I am planning to move abroad - salary will be better, less red tape, better lifestyle, less stress

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  • doctors do indeed say sorry - but when they do it seems to be not enough. the complaints process seems to be a form of leverage over doctors for them to be punished when they do not do what the patient wants. e.g. a patient might ask for antibiotics and the doctor say no because it is not needed. the complaints system at present is heavily biased against the doctor and a malicious complaint can be easily started against him without any punishment for the instigator. Given that it can result in suspension of the doctor this is not a matter to be taken lightly. the fact this has lasted so long shows how much society hates doctors despite all their hard work. Doctors are second class citizens in the uk

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  • Dr Syed that link is excellent. It makes for really good reading and perfectly describes the way I and most other GPs I know feel about the GMC. I urge everyone to read it:

    http://www.civitas.org.uk/pdf/GMCFittoPractise.pdf

    Thank you Dr Syed for posting that.

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  • GMC should take money from Public fund not from doctors

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  • Una Coales

    I managed to speak up for our 96 fallen comrades @8:52 and @9:00. Your anonymised case was heard internationally on Sky news! I asked why no apology to you after an 18 month investigation and you were found innocent! Forgot to mention more carrots, not more sticks. Anyway I think the 96 number of suicides will stick in the public's mind as if for some reason a doctor's life has no value? There should always have been an external public enquiry not yet another internal partial review!

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  • Coincidentally 96 deaths is the same as the number of people who died in the Hillsborough disaster. Sadly our own tragedy has not had the same attention and publicity. Granted these doctors didn't all die at once but the final count is the same. Doctors lives are it seems more disposable.

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