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A faulty production line

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)

  • It's the price we pay for being doctors.If you don't like it don't go into medicine and don't encourage others either.It's that simple.Society isn't going to change.

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  • 16.56 That's the most depressing defeatism I've seen for a while. Doctors of all people have a responsibility to stand up for human rights and their own dignity, even if the abuse is at the hands of their own regulator.

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  • Many of us WOULDNT go into medicine now, if given a chance to go back to University choices. Largely because the job has moved away from patient care and is now about appeasing The Man with his clipboards. It's not medicine now, it's conveyor belt expectation management.

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  • " Under the proposed changes, the GMC’s Medical Practitoners Tribunal Service (MPTS) panels will be able to take ‘more serious action’ against doctors who have failed to ‘work collaboratively’ "

    ... the Cultural Revolution began and I was transferred to another labor camp.... Two years after I had been in this new camp, I received a parcel from my family. Immediately, an inmate accused me of giving something out of it to another prisoner. I was dragged to the office. Without any investigation, the officer assembled the entire camp to start a struggle session against me. In the session the officer suddenly asked me whether I had committed my alleged original crime leading to my 8-year sentence. I was stunned. It then dawned on me that this session was in fact prearranged. The parcel was only a pretense.

    Their real motive was once again to force me to admit all my alleged crimes. "I did not commit any crimes," I asserted firmly. Immediately two people jumped on me and cut off half of my hair. The officer screamed again: "Are you guilty?" I replied firmly again, "No." Two people then used a rope to tie my hands back tightly. It was connected to a loop around my shoulder and underneath my armpits. It was knotted in such a way that a slight movement of my hands would cause intense pain. This struggle session lasted for two hours. Afterwards, they untied me and handcuffed me instead. The handcuffs became a part of me for the next one hundred days and nights..."

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  • The link posted by Dr Syed regarding is a breath-takingly refreshing review on the GMC's lack of fitness for purpose. The executive summary succinctly describes all that is wrong with the way the GMC currently functions - almost unilaterally against doctors despite doctors paying entirely for it's existence. A body whose board is predominately populated by lay people, with a lack of accountability and transparency in it's decision-making function. Publishing raft after raft of bureaucratic mumbo- jumbo that is suppose to represent good medical practice but is more akin to a "how to become a saint for dummies" manual yet which seems to grow exponentially by the week. Whatever happened to basic principles of decency, trust and honesty, and the Hippocratic oath fundamentals of DO NO HARM?

    It is amazing that the BMA has not intervened to at least stop doctors having to pay the £400 fee. Is this not akin to a criminal paying for the police and judicial system!!
    We as doctors should be funding the GMC. If its a body whose sole responsibility is to protect patients from dodgy doctors, then fine. But then it is the public who should fund it. The government should then set up an actual registration body to which we doctors can pay a one off fee to confirm our details as practitioners of good standing without the need to feel being extorted on an annual basis for the privilege.

    Disillusioned GP Partner (1.5yrs)

    p.s. I attach a copy of the link kindly highlighted by Dr Syed for those who have not yet seen the report. It's a must read for anyone who feels the GMC is anti-doctors rather than our regulator. http://www.civitas.org.uk/pdf/GMCFittoPractise.pdf

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  • This will never get better. I live every day in fear of 'what next?'. Refer and admit every patient you can. They are far less likely to get you for doing that. I'd rather face a bean counter any day.

    Meanwhile I plot my exit from the NHS. After only 17 years in GP and 43 years old. I may start my own business, but this is a big leap into the unknown. I see all these bright young kids getting their GCSEs this week, many of whom want to pursue a career in medicine. They have no idea....

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  • I referred one of my former Partners to the GMC a few years ago.

    A stressful enough experience as it was... imo, it had to be done. The individual requested 'voluntary erasure' (and it was granted) in advance of a FTP hearing.

    He then submitted a 'counter-referral' against myself and other partners to the GMC. For 12 months (despite knowing that the whole 'complaint' was ill founded, ill written nonsense) the GMC, eventually, after 12 months, let me know that there was 'no case to answer'. It appeared to me that there was very little cross referencing within the organisation and that even vexatious (in my view) complaints are taken at face value - i.e. guilty until proven innocent.

    The key question for me, after several years of this hoohaa, is would I go through it all again, notwithstanding recent potential 'fail to blow the whistle, and you'll be in front of the beak' discussion papers via the GMC?

    Short answer. No. I wouldn't.

    And that is a sad indictment of where the GMC is at this present time. BTW - after all of this 'life experience' or however you want to describe it, I am now a freelance GP. And enjoying every minute of my job again.

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  • A fundamental problem with the gmc is that it focuses on the individual as the guilty party while in most cases of medical errors the issue is system faults and patient are themselves to blame to some degree in some cases such as non engagement or following advise. . Failure of the gmc to consider this and the suboptimal working conditions, stress, lack of resources etc and only finding a doctor as a scapegoat is a farce. Personally I feel many national doh and NHS England directives are responsible for the system errors but there is no accountability for individuals in the said organisations. Gmc completely unfit for purpose. I dread the day I ever have to deal with the gmc.

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  • I have just received an invitation from the BMA, yes, the British Medical Association, OUR TRADE UNION(!), to attend a meeting on behalf of GMC.
    It reads : The General Medical Council is consulting on the actions we can take against doctors who don't meet professional standards and we'd like to hear from you, attend this event and have your say!

    I suggested that the BMA also organises another one at Albert Hall to tell the GMC what we think of it.

    But the scary power of the GMC is shown by the stream of ANONYMOUS comments.

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  • A death-row of turkeys - paying for Christmas.

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