This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

GMC to offer GPs 'plea bargain' to avoid prolonged hearing process

GPs could be offered the chance to avoid a publically stressful panel hearing by accepting a suspension or removal from the performers list during a fitness-to-practise investigations, Pulse has learned.

The GMC is seeking a change in legislation to allow suspensions and erasure from the performers’ list at an earlier stage rather than having to wait for a panel hearing, its chief executive Niall Dickson has told Pulse.

However LMC leaders have likedned it to a ‘plea bargain’, warning that the change could see GPs accepting a ‘superficially attractive’ offer which might amount to them admitting impairment for something they didn’t do - in order to avoid ‘an absolutely soul destroying’ hearing.

GPs can currently only accept a sanction to avoid a hearing for a lesser complaint which at the most would see them given a warning or restrictions on their practise.

But Mr Dickson told Pulse that it was currently running a pilot which involved dealing with doctors before a hearing who faced more severe complaints and therefore more severe sanctions. The pilot had already been found to be ‘useful’ by doctors and defence bodies, he said.

He explained that the the move was in addition to providing more support for doctors and working to close cases at an earlier stage.

The proposed changes come in response to calls for more support and streamlined investigations to minimise the burden on GPs under investigation. In one case a GP’s four year ordeal cost £100k and left his children ‘living below the poverty line’ and in several tragic cases doctors have committed suicide while under investigation, an issue which the GMC is currently reviewing.

Mr Dickson told Pulse: ‘We have this pilot, looking at whether having a meeting with the doctor at the end of the investigation can help us agree the way forward between us and the doctor. This will avoid the need to go forward to a panel hearing and will reduce the stress for everyone involved’

He added: ‘At the moment we can only do that with lesser complaints, those that would result in a warning or conditions on their practice. We can’t do it for suspensions or erasures.

‘In the future we hope we can get the legislation changed so that doctors can avoid going to a panel hearing, and the process could be curtailed, which is a really big ambition for everybody with this reform.’

LMC leaders have however told Pulse that the prospect of a drawn out fight to clear their name could, in some cases, see doctors accepting a stricter sanction than would have been found at a hearing.

Dr Robert Morley, chair of the GPC’s contracts and regulation subcommittee said the scheme could be likened to ‘plea bargaining’, and the proposal could not be a substitute for addressing the ‘appalling’ GMC hearing process.

He said: ‘What they should be doing is sorting out their existing processes, making them fit for purpose and putting an end to the appalling stresses that they put on doctors.’

‘Whilst this might be all well and good in some cases, it inevitability will be that doctors will be tempted to accept a sanction simply to avoid going through an appalling process where they might well, at the end of the day, be exonerated.

He added: ‘This could very well be discriminatory, particularly against doctors who are less robust psychologically, and may even have a definite mental health issue.

Dr Tony Grewal, medical director at Londonwide LMCs told Pulse: ‘It’s the same care that you have to take when accepting a police caution, while it’s superficially attractive in terms of a pragmatic solution. You’d need to be very sure that you weren’t ending up with a worse case.’

‘The trouble is the stress of hanging around waiting for a GMC hearing is awful, and going through a GMC hearing is absolutely soul destroying – it’s a terrible thing to go through.’

Dr Peter Holden, a GPC representative in Matlock, Derbyshire warned: ‘You should only do this following expert legal advice, because there are ramifications for accepting a penalty from the GPC, which can be very long-standing.’

‘Including you may have great difficulty getting malpractice insurance, and if you can’t get malpractice insurance you may as well be off the register.’

A GMC spokesperson said that if a doctor did accept a sanction they would ‘never know what sanction a panel would have imposed if the case had gone to a hearing’.

‘However, as the purpose of the meeting is to ensure we have a full view of the case, including any evidence of mitigation that the doctor holds, the sanction we propose is likely to be consistent with the sanction that a panel would impose.’

‘But it means that the doctor doesn’t have the potential additional stress of a hearing and the process can be concluded much more quickly,’ the spokesperson added.



Related images

  • Niall Dickson GMC chief exec 1

Readers' comments (13)

  • It is a rational proposals for those who are in retiring age and would just like to get over and done with. However, if a Doctor feels he/she has been accused unfairly he or she should never succumb to proposals of a quick fix. It's one thing accepting a way out but another having to live with a bad taste in your mouth for the rest of your life. So, deal with the stress and don't cave in.

    Unsuitable or offensive? Report this comment

  • Surely, the problem here is lack of support and inappropriate time period for hearing. Instead of improving the process, they are going to put pressure on us to take a deal.

    So we are being offered the same treatment criminal prosecutors and police give out to criminals in order to avoid lengthy court process. Doctors are now truely considered guilty until proven otherwise. Great GMC, you are just getting better and better!

    Unsuitable or offensive? Report this comment

  • More truly shameful behaviour from the GMC though sadly this has become the norm for this organisation.

    Ple bargains are not allowed in UK courts because of the costs to innocent parties. This is yet another prime example of why the GMC is in desperate need of reform.

    Unsuitable or offensive? Report this comment

  • This comment has been moderated.

  • The GMC is at risk of becoming the "lap dog" for The Daily Mail and Jeremy Hunt. Participating in their thuggery will be a downward spiral for the GMC.

    Unsuitable or offensive? Report this comment

  • Still no open and transparent report into the GMC internal investigation re doctors who tragically died while under the unsympathetic care during FTP hearings .
    Is this do as we say not as we do.

    Unsuitable or offensive? Report this comment

  • Took Early Retirement

    "Dr Peter Holden, a GPC representative in Matlock, Derbyshire warned: ‘You should only do this following expert legal advice, because there are ramifications for accepting a penalty from the GPC, which can be very long-standing.’"

    Note the large Freudian slip in there!

    Unsuitable or offensive? Report this comment

  • Took Early Retirement

    Yes- Editor: PLEASE DO AN ARTICLE on the GMC's failure to produce their report. I have written to them and am still awaiting a reply. They are hiding.

    Unsuitable or offensive? Report this comment

  • Corporate Manslaughter and Corporate Homicide Act 2007

    1The offence

    (1)An organisation to which this section applies is guilty of an offence if the way in which its activities are managed or organised—
    (a)causes a person's death, and
    (b)amounts to a gross breach of a relevant duty of care owed by the organisation to the deceased.
    (2)The organisations to which this section applies are—
    (a)a corporation;
    (b)a department or other body listed in Schedule 1;
    (c)a police force;
    (d)a partnership, or a trade union or employers' association, that is an employer.
    (3)An organisation is guilty of an offence under this section only if the way in which its activities are managed or organised by its senior management is a substantial element in the breach referred to in subsection (1).
    (4)For the purposes of this Act—
    (a)“relevant duty of care” has the meaning given by section 2, read with sections 3 to 7;
    (b)a breach of a duty of care by an organisation is a “gross” breach if the conduct alleged to amount to a breach of that duty falls far below what can reasonably be expected of the organisation in the circumstances;
    (c)“senior management”, in relation to an organisation, means the persons who play significant roles in—
    (i)the making of decisions about how the whole or a substantial part of its activities are to be managed or organised, or
    (ii)the actual managing or organising of the whole or a substantial part of those activities.
    (5)The offence under this section is called—
    (a)corporate manslaughter, in so far as it is an offence under the law of England and Wales or Northern Ireland;
    (b)corporate homicide, in so far as it is an offence under the law of Scotland.
    (6)An organisation that is guilty of corporate manslaughter or corporate homicide is liable on conviction on indictment to a fine.
    (7)The offence of corporate homicide is indictable only in the High Court of Justiciary.

    Unsuitable or offensive? Report this comment

  • Una Coales. Retired NHS GP.

    John, Niall Dickson wrote me on 6 October, that he hopes the report will be out before the end of the year.

    I wonder if plea bargaining for voluntary removal or GMC suspension is one way government may get rid of single-handed GPs or GPs in smaller partnerships to pave the way for APMS/feds. I can see revalidation officers using revalidation as a scrutiny tool to then haul up a GP before a panel. The stress may push a GP over the edge and he or she may very well accept a plea bargain to hand in their licence, than face a drawn out process lasting years!

    Unsuitable or offensive? Report this comment

  • I would be slightly worried about the impactions from a defence organisation point of view. My understanding is that part of the 'discretion' offered by MDOs means that you have to follow their advice. For example if taken to court by a patient that is lying they can make you settle for a small pay out (which they pay). If you decide to go against their advice you have to pay your own legal costs and the final settlement if you lose.

    Correct me if I am wrong.

    Could the same apply here? Could the MDO say you must accept the plea bargain for a suspension otherwise they would not represent you?

    Unsuitable or offensive? Report this comment

  • I am always nervous of so called plea bargains as it does not serve justice - if the perpetrator is guilty, they get off with a more lenient sentence and the victim is badly served; conversely, if the so-called perpetrator is innocent, or only guilty of a lesser misdemeanor, then they are the ones badly served by accepting a punishment which may be too harsh. Don't accept this - it is only the thin end of a very big wedge!

    Unsuitable or offensive? Report this comment

  • out of interest - if i am wrongly accused of something and lose money whilst waiting for the GMC hearing - can i take legal action against the accuser and GMC to redress loss of income?

    Unsuitable or offensive? Report this comment

  • American plea bargaining is widely viewed as flawed system, why would we want to adopt it. Niall Dickson is a sensible man, has he been misled?
    Time to shoot the advisors? Or a badly released idea? Shoot the PR.

    Unsuitable or offensive? Report this comment

Have your say