The GMC will lose its powers to appeal fitness-to-practise decisions made by the Medical Practitioners Tribunal Service (MPTS) next year, it has emerged.
Last week, GP representatives criticised the Government for pushing legislation on fitness-to-practise process reform further into the long grass.
At the time, the Department of Health and Social Care said that legislation to register physician associations (PAs) will be laid next year but that doctor regulation reform would not form part of the same order.
However, the Medical Protection Society (MPS) today welcomed ‘a commitment’ from the DHSC ‘to progress legislation that will finally strip the GMC of its power to appeal fitness to practise decisions in 2023’.
In response to a request for clarification from MPS on where in the legislation proceedings the appeal powers would sit, a DHSC civil servant told the defence organisation: ‘Our intention is that we will remove the GMC’s right of appeal within the order that we lay in the second half of 2023.’
A DHSC spokesperson confirmed to Pulse that the Government will consult on draft legislation which it aims to lay in 2023.
Meanwhile, the GMC said that once the right to appeal is removed it will work with the Professional Standards Authority to understand how it will ensure continued oversight of tribunal decisions which do not sufficiently protect the public or confidence in the medical profession.
A spokesperson said: ‘We are not opposed to the decision to remove our right of appeal, and it is now the Government’s decision when and how to implement these changes.
‘Until our right of appeal is removed we have a legal obligation to continue exercising it, in order to protect the public.’
Long-awaited legislation to enable reform of GMC processes had finally been expected this year and the BMA and MDU wrote to health secretary Steve Barclay last week to say that plans to delay action to ‘at least’ 2024/25 would ‘be seen by the profession as a broken promise’.
New data from last month revealed that the GMC launched another 23 appeals against its tribunal’s rulings since the Government committed to disallowing GMC appeals in June 2018.
Legal advice obtained by the GMC in 2018 said the regulator has a ‘statutory duty’ to continue to appeal fitness-to-practise decisions made by its own tribunal until the Government officially strips it of its right to do so.
But it is now four years since the Government said it would process the required legislation within an 18-month timeframe.
The GMC has been able to appeal MPTS decisions in the High Court since 2017 but the 2018 Williams review into gross negligence manslaughter in healthcare, prompted by the high-profile Bawa-Garba case, recommended that it should lose these powers.
MPS medical director Dr Rob Hendry said: ‘It is extremely frustrating to see yet more delay to regulatory reform for doctors – it is now more than 11 years since the Government first set out proposals to radically reform the GMC and changes will now not be implemented until 2024 at the earliest.
‘A silver lining however is that DHSC will prioritise legislative change to remove the GMC’s power to appeal fitness to practise decisions in 2023, alongside the legislation for PAs and [anaesthesia associates]. This is thanks to long standing campaigning led by MPS and supported by royal colleges, trade unions and grassroots organisations.
‘The GMC’s power to appeal decisions made by the MPTS has created distrust between the medical profession and the regulator and contributed to a culture of fear. Fitness-to-practise proceedings are stressful and lengthy enough for doctors, without the added worry that the GMC can seek to override the decision made by the MPTS if it does not agree.’
GMC reform plans
A 2021 DHSC consultation set out plans to introduce statutory regulation of physician associates (and anaesthesia associates), meaning PAs would need to hold a GMC registration and would be subject to GMC fitness-to-practise proceedings. The DHSC has confirmed it is planning to go ahead with this piece of legislation in 2023.
However, last week it said it would not include legislation to reform doctor regulation at the same time.
This is expected to enable the GMC to process fitness-to-practise decisions more quickly by allowing ‘more cases to be concluded earlier through accepted outcome decisions made by case examiners’, and; ‘through a broader range of measures (including issuing a warning, applying conditions to a registrant’s practice, suspending their registration, or removing the registrant from the register’.
And it proposed that GMC should be able to suspend, rather than just erase, doctors from the medical register, for reasons including a failure to pay fees or to meet revalidation requirements.
Under the plans, the GMC’s council structure will be replaced with a board, which should hold meetings in public. The regulator should also produce an annual report on its regulatory activities.
The GMC will have a duty to cooperate’ with other health regulators, as well as a duty to be ‘transparent’ about its decisions, including in fitness-to-practise cases.
The same consultation had sought views on plans to ‘remove the General Medical Council’s right to appeal Fitness to Practise panel decision’ and ‘amend the power to require information in relation to fitness to practise cases to expressly exclude reflective practice material’. It now appears the long-awaited legal change could finally take place next year.