A review into the GMC’s handling of a case against a GP accused of dishonesty after saying she had been ‘promised’ a laptop has found that the allegations should never have reached the regulator.
The review, published today, also found that there was ‘no clear or conclusive evidence’ for bias in the case.
The MPTS had suspended Dr Manjula Arora for a month for ‘dishonesty’ earlier this year after she told an IT department she had been ‘promised’ a laptop. The tribunal said that she had ‘exaggerated’ these claims, and as a result found that her fitness to practise was impaired.
But the GMC effectively overturned the ruling in June, saying the dishonesty test was ‘incorrectly’ applied. And it announced that it would undertake a review into its handling of the case following an outcry from across the profession.
The GMC-commissioned review, co-chaired by Professor Iqbal Singh CBE and Martin Forde KC, today concluded that the GMC ‘incorrectly applied the legal test when considering this particular allegation’ and suggested that the GMC should never have taken up the case.
It said: ‘[The GMC was] wrong to conclude that Dr Arora’s actions could be said to be objectively dishonest, taking account of the whole of the circumstances.
‘As such, it should not have been taken forward.’
It added: ‘We conclude that there were multiple missed opportunities for the GMC to stand back and look at this case again.
‘There were moments where people expressed misgivings about the strength of the evidence, and whether the allegations were sufficiently serious for the GMC to become involved.’
The report recommended that the GMC should encourage a culture of ‘local-first’ solutions as ‘default’ where possible, so that cases only reach the regulator where appropriate.
It said: ‘Regulators should judge their success not by how many fitness-to-practise referrals they handle but in how they support local systems towards local resolution and remediation when needed.’
Meanwhile, the review also recognised the ‘perception that the GMC’s decision-making in Dr Arora’s case was an example of bias and directly affected by her ethnicity’.
But it found that there was ‘no clear or conclusive evidence or data to suggest that biased thinking affected this case’.
It added, however, that it ‘also found no evidence or data that would definitively dispel the perception that it was affected by bias’.
The review recommended that bias ‘is proactively sought out, rather than simply looking for reassurance that it does not exist’ and that the GMC should ‘accelerate’ the action it is already taking to ensure its ‘decision-making processes are fair, consistent and free from bias’.
The report’s recommendations also included:
- ‘More rigorous’ investigation plans and assurance throughout cases to ‘ensure concerns remain issues to be pursued’
- Evidence for dishonesty allegations ‘must be credible and without nuance, and cases approached with an open mind’ – and dishonesty should not be charged where this is ‘doubt, inconsistency or the possibility of nuanced interpretation’
- The GMC must not have a culture of ‘attempting to formulate the most severe charges to enhance likely sanction’
- The GMC should ‘reconsider what constitutes “low-level dishonesty”, including whether tribunals should be able to find that something was misleading but not done with a dishonest mind’
- While the hearing process ‘may need to be adversarial at times’, challenges to doctors are part of ‘an inquiry not a criminal trial’ and should be made ‘politely, firmly but without discourtesy’
- The GMC’s policies and processes should ‘emphasise that everyone is treated with both compassion and respect’ at all stages of fitness-to-practise cases
- Greater levels of ‘cultural competency’ to ‘better understand’ the professionals that the GMC regulates so that ‘misunderstandings are not compounded by mistakes’
The GMC said it has apologised to Dr Arora following the review’s findings and that it ‘accepts all of [its] recommendations without reservation’.
GMC chief executive and registrar Charlie Massey said: ‘It is clear that there were decisions we did not get right and for those, I have apologised to Dr Arora.’
He added that he agrees that the GMC ‘must go further than simply comforting ourselves that bias is not apparent’, adding that the GMC ‘is a collection of humans, each with their own biases’.
‘The challenge for us is to continue to seek out potential bias and address it head-on,’ he said.
And he added that it is the regulator’s ‘aspiration’ that ‘modern regulation should contribute to a better health system which is compassionate, fair and supportive’.
Review co-author Martin Forde KC said: ‘At the heart of this case was a misapplied legal test around dishonesty, but there was more besides which could and should have prevented this allegation from progressing and causing the distress which it did to both Dr Arora and the wider profession.’
Co-author Professor Singh added that it is his ‘belief that we can make cases such as this into “never events”’.
And in July, Pulse revealed that the case cost almost £40,000, not including the costs incurred by Dr Arora herself.