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The waiting game

Analysis: GMC is dealing with its image problem

The GMC has a problem with its perception - but it is doing a good job of addressing this

Rightly or wrongly, the perception of the GMC among international medical graduates is poor. There is an obvious reason for this perception – overseas, black and minority ethnic (BME) doctors are well over-represented in front of fitness to practise panels and as subjects of complaints. Up-to-date figures are not currently available, but figures from four years ago showed 60% of FTP hearings featured BME doctors.

The GMC has pointed out that they do not make the complaints themselves, only respond to them; and it is a sad fact that the number of complaints against all BME professionals, and not just doctors, is significantly higher than against their white colleagues.

However, the GMC did have a problem – at the start of this year, only 16% of members of its fitness to practise panels classed themselves as black or from minority ethnic groups. This compares with the 28% of doctors who are BME.

This was an issue that had to be addressed. The GMC was eager not to give the impression it was involved in positive discrimination –favouring BME doctors ahead of white doctors - when appointing panel members.

So it stepped up its engagement with international doctor groups. Its BME Diversity Committee has been commended by representatives of the various groups.

Through this, it called on the international doctor groups to advertise opportunities to sit on fitness to practise panels. By increasing the number of BME applicants, it has been able to increase the percentage of BME panellists without actively favouring candidates based on race. It might be a coincidence, but 42% of people appointed to the FTP panel were BME; and the percentage of BME applicants to the panel was… 42.

It has also set up a series of focus groups, currently ongoing, to understand why BME doctors have a poor perception. Its chief executive, Niall Dickson, appeared before the British Association of Physicians of Indian Origin conference last month.

This attempt to understand perceptions is to be welcomed. There are very real concerns from IMGs and BME doctors in many areas – such as the high failure rate of the MRCGP exam by these groups - and the GMC’s approach could represent a template on how to rebuild relations.

Jaimie Kaffash is a senior journalist at Pulse

Readers' comments (9)

  • High MRCGP failure rate of IMG's compared with British graduates.

    IMG's over-represented in GMC complaints and fitness to practice hearings.

    Experience at the coalface: some registrars are excellent and some less good. Are IMG's 'over-represented' in one of these groups?

    I have posted this anonymously as I do not wish to be castigated as a bigot, but isn't it just possible that graduates of British universities are generally better prepared for general practice than IMG's?

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  • No, GMC is not doing a good job in addressing the problem of discrimination against ethnic minorities. When evidence of discrimination is presented to GMC other than results of FTP hearings they refused to look at it. Willful blindness.

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  • Has PULSE got a new DADDY?

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  • Or is Jaimie Kaffash looking for spending money over Christmas?

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  • Vinci Ho

    The issues faced by GMC and RCGP are different:
    (1) ' making a complaint against the doctor' has become a popular and 'normal' behaviour especially some people are pushing forward the belief that patients are customers and hence customers are always right. It is a lot easier to trigger a FTP inquiry these days , particularly after GMC changed the threshold to investigate. Patients can go all the way to the top more easily. Transparency is the norm in 21st century . Whether you like it or not , I still think that is very important in a democratic society. Unfortunately , in a time of poor economy globally , right winged idealism always tends to creep back into mainstream society. History has already repeated itself time to time. The government has to be extremely careful on this phenomenon especially the latest census demonstrated a very different make up of the population compared with 10 years ago. There is no doubt about fighting against discrimination or marginisation of all types.
    However, the vital issue for GMC is to uphold the spirit of common law-- the defendant is presumed innocent instead of guilty until proven otherwise . And the evidences to prove somebody guilty have to be undisputed . That is a principle for all types of FTP panels , whether they are made of different ethnic groups or not .
    (2) RCGP , on the other hand , has got a really serious issue. While we may complain about statistics interfering with our life, the figures of percentage of IMG doctors passing CSA part of MRCCG are too outstanding for anyone to ignore. This is way beyond one will expect from normal distribution . Once again , transparency can only be fulfilled by proper investigation into the system and mechanism of the examination . I am glad , the RCGP chair has been upfront and in touch with colleagues making comments in PULSE .
    (3) As a profession , we have been up against a lot of battling from the government and media already . If there is more complications due to disputes among different factions amongst ourselves , we are seeing the beginning of the end
    (4) there is a Chinese saying,' If you do not want to be treated in certain way , do not treat other people the same way.'..........

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  • Vinci Ho

    ... marginalization ..... instead of marginisation.

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  • Very well said Jaimie! GMC's actions and willingness to listen BME/IMG doctors and do something about these perceptions can be an example for others like RCGP and other NHS institutions to learn. But this is not simply a perception but sad reality that most decision makers, experts, FTP panel members, many leaders like Medical Directors, HR Directors, CEOs and College examiners and all are non-BMEs and leaders must always be fair and action taken must be proportionate. But sadly NHS is also known for its ‘club culture and old boy’s network! These are some of the reasons as to why disproportionately more BME/IMG doctors are being disciplined.
    Colleges, GMC and others should listen to BME/IMG doctors and make sure that these issues are addressed rather than being defensive about them and blaming IMG/BME doctors and these perceptions.
    None of us can afford to ignore patient safety, quality and their wellbeing. But by not tackling bad doctors just because they belong to a particular club or network, NHS is not only discriminating but also putting patients’ lives at risk! Shipman, Ledward, Richard Neal, Kerr and Haslam, Clifford Ailing and many other high profile cases where all non-BME doctors who should have been stopped many years earlier but allowed to continue to harm patients for many many years!
    Leaders’ job is to protect patients and to maintain professional standards but any regulation must be fair, equal and proportionate and should not depend on race, gender, ethnicity or place of qualification or their legions or club or network. Most doctors need help, support and guidance and not blame punishment, humiliation or discipline. Anyone who is unfit to be a doctor (they are very rare) should be removed but it should be done for the right reasons.
    Irrespective of ethnicity of the doctor we must get professional regulation right.

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  • Took Early Retirement

    The only way for the GMC to "improve its image" is for it to ask Parliament for it to be abolished and replaced with a competent body.

    Some of it so-called guidance is impossible to implement in the real world. - Look at what they say on chaperones, for example.

    They once told me I should not, as a GP, put anything about a patient's Family History in a referral letter without getting consent first!

    Of course, they do this so they can entrap doctors and thus "legitimize" their existence by saying, "Look at all these terrible doctors- we must be here to stop them".

    In the interim, the standard of proof for FTP should be raised to the criminal standard beyond the current, which seems to be, the balance of probability. After all, it can result in loss of livelihood.

    And never forget what a High Court judge said in the Prof Meadow appeal- the GMC's behaviour "bordered on the irrational".

    Need one say more?

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