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UK ethnic minority GPs twice as likely to face GMC sanctions than white UK GPs

Exclusive Black and ethnic minority doctors from the UK are 30% more likely than white UK medical graduates to have a complaint made against them and twice as likely to face sanctions from the GMC, according to a new report from the regulator.

The GMC’s fourth annual State of Medical Education and Practice report looked at the differences between UK graduated BME and white GPs for the first time, and found that some 16% of BME GPs had been complained about, compared with 12% of white GPs between 2010 and 2013.

The regulator said it was going to take action to look at the reasons why BME doctors were more likely to be complained about, and said that the ‘latest evidence suggests that some of the issues surrounding the practice of these doctors are more likely to result in tougher sanctions’.

Ethnic minority GPs have previously said that they felt fitness-to-practice proceedings were unfair, and the BMA said the information was ‘concerning’.

The report covered over 25,000 complaints and 10,000 investigations that were made over the four-year period, and showed 14% of all GPs practising in the UK received a complaint and less than 1% were subsequently handed down a sanction or warning by the GMC.

It also found that complaints against UK-trained BME GPs were 17% more likely to be investigated than UK-trained white doctors and the complaints were 25% more likely to lead to a sanction or warning.

As a result, 0.8% of UK BME GPs had faced a sanction or a warning over the four-year period – double the proportion of white GPs who had faced sanction (0.4%).

A similar pattern was seen for BME doctors who graduated outside the UK, either within the European Economic Area (EEA) or outside the EEA.

The GMC concluded that BME doctors as a whole were more likely to receive sanctions or warnings because they had disproportionately high rates of complaints brought by their health authorities, including PCTs, and investigations related to criminal fraud - both of which are more likely to be upheld than complaints made by the public or relating to clinical competence.

Niall Dickson, chief executive of the GMC, said the regulator was looking in the reasons why BME doctors are more likely to have complaints made against them.

He said: We depend on BME doctors and on international medical graduates – the health service would have collapsed long ago without their skill, dedication and professionalism.

‘We know too that the overwhelming majority of doctors provide good, compassionate care for their patients. There are more than 260,000 practising in the UK and we have to take action in just a small number of cases.

‘But we do need to understand why the pattern of complaints and the outcomes of cases vary – and the latest evidence suggests that some of the issues surrounding the practise of these doctors are more likely to result in tougher sanctions.

Professor Aneez Esmail, a professor of general practice at the University of Manchester and an international expert on racism, who led a major GMC study of international graduate doctors’ failure of the MRCGP clinical skills assessment, called for more work to understand and address the disparity.

Professor Esmail told Pulse: ‘I commend the GMC for doing this and recognising the disparities. This has been a consistent pattern really, so I’m not sure where it gets us but the data are better now than it used to be – so it’s good they are putting in out in the public, but my only question would be why?

‘I don’t think that BME people are any more criminally minded than white people, or BME doctors are any worse than white but when a white doctor does something wrong, the threshold for following it up is higher.

‘It’s not that these doctors with complaints are not guilty necessarily – it’s always been the case I believe white doctors are not complained about or dealt with with the same seriousness.’

Dr Krishna Kasaraneni, a GP and the chair of the BMA’s equality and diversity committee, said: ‘The differences between the number of complaints aimed at BME doctors compared to other doctors is concerning. As the GMC’s report highlights, these differences are not restricted to healthcare, and it is clear that further investigation is needed to better understand the reasons for this.’


Readers' comments (25)

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  • Vinci Ho

    I thought Mr Stevens had told us the reason :
    Because our English is not so 'good' , we have misunderstood the meaning of ' duty of candour ' ( perhaps freedom of speech as well as freedom from fear)and keep 'MOANING' all the time .
    I told my LMC secretary yesterday I am always ready to have a cup of tea in GMC.

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  • @0:38
    it is precisely the attitude that you exhibit that fuels the tensions that are becoming increasingly obvious in GP recruitment and the NHS as a whole. Do bear in mind what Professor Esmail says
    ‘It’s not that these doctors with complaints are not guilty necessarily – it’s always been the case I believe white doctors are not complained about or dealt with with the same seriousness.’
    It's just that you don't like to hear the truth do you?

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  • one cannot change people's hearts with Legislation. It has to come from within and it will only do so when education and openness take over. That will take centuries. That there is an improvement, is good. As always discrimination is sub-concious and ingrained. It takes an effort to be level-headed and fair.

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  • I'm a British born asian GP and have attended two universities - one ranked 2nd and and the other ranked 16th best in the world. I also have a mixed race child (asian/white). I've worked all my life in the UK and have paid my due of tax. I've done my fair share of clubbing, consuming alcohol and one would say 'having a good time' like typical UK men. In fact I have done everything that UKIP / conservative voters say 'foreigners' need to do to integrate in my 'own' country. As such I feel justified in commenting.

    From first hand experience I can categorically state that the public are prejudice. I am sick of white middle aged patients constantly asking 'where are you from Doctor' or 'your english is so good'. I've heard patients refer to colleagues as 'that foreign Doctor'. It is one of the reasons I won't take on a partnership unless I can choose my patients i.e. control the list as why should I kill myself caring for a bunch of ignorant *****.

    We had an excellent BME who did everything by the book - someone who even Steve Field would have approved of as he doesn't dish out antibiotics. He received an unjustified complaint from a patient as he refused to prescribe antibiotics for a viral infection. The patient stated 'she wanted that foreign doctor's job' and the stress, hassle and lack of support during investigation of that complaint resulted in him leaving.

    We are simply not being treated fairly, however, what you reap you sow. Most if not all BME I know are now so fed up they are considering private practice and leaving the UK. Because of the poor support and lack of respect this country is going to lose it's doctors.

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  • Una Coales. Retired NHS GP.

    Why should race affect the outcome of a GMC investigation? Why are UK BME GPs twice as likely to face GMC sanctions than UK white GPs? Time to address subconscious bias?

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  • Una Coales. Retired NHS GP.

    @9:09 am I wish I could edit all written responses made to the GMC by BME doctors denied legal representation by their subscribing medical defence org as MDOs may reserve the right to discretionary representation. It would not surprise me then, if more BMEs or IMGs go unrepresented, than white doctors. And many NHS doctors cannot afford £10k for a private solicitor to respond back to the GMC.

    This means it begins with the inital written response which is forwarded to a lay (often with legal experience) case examiner and a medic. The lay person has more weight in deciding whether to close a case at initial investigation or refer up to a face to face fitness to practice panel.

    In a face to face encounter, a BME or IMG doctor who has waited anxiously 6 months or more for the outcome of an initial investigation is now left waiting often unsupported and unrepresented for over a year waiting for his or her FTP date. Who could withstand such legal scrutiny without any legal background, up against the finest barristers the GMC can provide paid for by us?

    I just wonder how fair this is for a doctor of BME or IMG background. Surely now after 'failing" the written response, he or she must now face an 'oral' inquisition. The emotional torment would turn any human being into a nervous and agitated wreck under face to face scrutiny in unfamiliar legal territory and I can see how this may come across to the GMC, mental health issues, unable to cope with stress, not fit to treat patients, lack of insight for not apologising to a false accusation? I wonder why criminals have more legal rights to a court appointed lawyer than doctors who may be denied representation by their own medical defence org they have been loyally paying £1000s a year in subs to?

    I await the GMC's final report on the deaths of 99 doctors under GMC investigation and ask how many were UK BMEs or IMGs and how many were denied medicolegal representation by their subscribing MDO?

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  • Its a shame doctors are treated on the basis of their colour not capability. It is obvious even Asian doctors been born/ brought up in UK are more likely to be complained of and face GMC FTP
    I think that is the reason so many doctors are emigrating

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  • This is the inevitable consequence of a quango being allowed to develop a complex quasi-judicial system that operates without the usual checks and balances of the law-courts.

    The structure and scope of the GMC has developed considerably over last decade and yet there has been little by way of scrutiny or democratic debate to safeguard it from prejudice and hold it to account. We are left with a system that can utterly destroy doctors only on the balance of probability and is able to operate outside of established ethical and legal principles.

    Things will only get worse if this is allowed to continue. The GMC must be reformed.

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  • A Consultant Psychiatrist once wrote to me to arrange a white British GP for a mentally ill patient who felt deserted as her white GP had left. Another wrote to the GMC - This Doctor does not know how to treat the British people.

    I must give credit to the GMC that they have been quite rational and logical in dealing with the complaints I have had. However, the fear in ingrained in us 'ethnic' doctors.

    A flashing example of this was a consultation meeting fortnight ago in Medway with the GMC local representative regarding GMC Sanctions. Of the 30 odd GPs who attended, not one was white British.

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