Government to consult on GMC gaining new powers over MPTS decisions

The Government will consult on recommendations for the GMC to gain new powers to challenge interim decisions made by the Medical Practitioners Tribunal Service (MPTS), as well as retaining its right to appeal MPTS decisions, it has announced today.

Currently, the GMC appeals in cases where it feels a Medical Practitioners Tribunal sanction of a doctor has not sufficiently protected the public – but it was expected that long-awaited new legislation would strip the regulator of this right this year.

Nearly eight years ago, a ‘rapid review’ by the Government concluded that GMC should be stripped of these powers. It had been called following the case of Dr Hadiza Bawa-Garba, who was convicted on gross negligence manslaughter charges in 2015 following the death of 6-year-old Jack Adcock in 2011, and the Department of Health and Social Care (DHSC) had previously committed to progress the necessary legislation by the end of 2023.

However, the Government said today that following a review by Lord John Mann into how regulators handle antisemitism and other forms of racism, it has launched a consultation on delivering recommendations introducing three changes:

• The GMC will retain its existing right to appeal decisions made by the MPTS to the Courts. The Government said that this would ‘ensure there remains a robust check on fitness to practise outcomes’.
• The Professional Standards Authority (PSA) — the body that oversees all healthcare regulators — will receive new powers to challenge interim decisions made by the MPTS, and the GMC will receive equivalent powers.
• Regulators will be required to share information with the PSA when requested.

The U-turn has been criticised by doctors and experts, who said that the proposals for the GMC to retain its right of appeal over MPTS decisions are ‘profoundly concerning’, as well as ‘a missed opportunity’ for wider reform.

BMA council chair Dr Tom Dolphin said: ‘The changes in today’s consultation are a far cry from what are needed to fix a broken regulator that is aggressively pursuing doctors and failing the public.

‘Rather than restoring the medical profession’s confidence in the GMC, or protecting the safety of the public, both will be further eroded. 

‘The BMA has, on behalf of all doctors in the UK, for years been calling for complete reform of the GMC, and these proposals are a missed opportunity. 

‘One key change to improving the profession’s trust in the regulator, is to remove its right to appeal decisions made by the independent Medical Practitioner’s Tribunal Service (MPTS).

‘The MPTS is supposed to be independent, so it is absurd that today we are not only seeing the GMC have their right-to-appeal retained, but actually expanded.’

The Doctors’ Association co-chair Dr Matt Kneale said: ‘Doctors across the country will be dismayed that the Government has abandoned the cross-profession consensus established by the Williams review.

‘We were promised the GMC would lose its power to appeal its own tribunal’s decisions. Instead, this consultation retains that power and creates new ones.’

The Medical Defence Union (MDU) director of policy and communications Tom Reynolds said: ‘Proposals that the GMC should retain its right of appeal over MPTS decisions are profoundly concerning. These specific proposals should be called out for what they are: a betrayal.

‘Since 2018, doctors have been repeatedly told – by successive governments – that as part of a reformed GMC legislative framework, the regulator would lose its right of appeal over tribunal decisions. Today, that promise lies in tatters.

‘Members of the medical profession can be assured that the MDU is firmly opposed to this U-turn. We have campaigned for years for the GMC to lose this right of appeal and will continue to fight for this.’

Meanwhile, Dr Pallavi Bradshaw, medical director at Medical Protection Society (MPS), said: ‘We welcome this long-awaited consultation on GMC reform. Thousands of doctors needlessly go through stressful and slow GMC processes each year, with the regulator working within the confines of legislation that is over 40 years old.

‘We are however very concerned that the consultation on GMC reform proposes to maintain and in fact enhance the GMC’s power to appeal medical tribunal decisions – despite the Government committing to removing it. Challenging tribunal decisions is and has long been the role of the PSA. The GMC is the only UK health regulator with a statutory right to appeal its own tribunal’s decisions, which duplicates the PSA’s powers.

‘The proposed changes mean that a doctor would be subject to potential appeals from both bodies following either a substantive or interim sanction which is likely to lead to more delay, uncertainty and cost. This anomaly contributes to the increasing distrust between doctors and the regulator, and this is a disappointing development for the profession.’

The Government insisted that these changes will ‘increase oversight of the GMC’ and make it easier for regulators and oversight bodies to act where decisions ‘are not strong enough’ to keep the public safe.

It added: ‘Beyond the Mann recommendations, in order to drive positive change and strengthen sexual safety in the NHS, the consultation also proposes removing the current rule which prevents regulators from being able to consider fitness to practise concerns involving allegations of historic sexual abuse after five years have passed.’   

Last year, Lord Mann was asked to lead a review into how healthcare regulators handle antisemitism and other forms of racism – from hiring practices and oversight to transparency in investigations.

The Government said that there have been ‘too many recent examples’ of doctors ‘using intolerably racist and antisemitic language’, particularly on social media, without regulators taking ‘swift enough action’. 

It added: ‘It is clear that the current regulatory landscape is outdated and too bureaucratic, hampering the GMC’s ability to act decisively when doctors contravene their code of conduct.

‘That is why the government asked Lord John Mann to conduct a rapid review into antisemitism and other forms of racism in the health service in November.

‘Alongside the wider modernisation proposals, the Government is consulting on the first tranche of recommendations from Lord Mann’s review.’

Health secretary Wes Streeting said: ‘The NHS is a universal health service, which means that everyone, regardless of race, religion, or belief, should feel safe seeking its care. It is unacceptable that this is not the current reality for many patients and staff, and I will not allow it to continue.

‘I am grateful to Lord John Mann for his rapid investigation into how we can overhaul the current system and I look forward to setting his common-sense recommendations in motion to ensure NHS patients and staff get the protection they expect.’

GMC chief executive and registrar Charlie Massey, said: ‘Patients rightly expect assurance that doctors, PAs and AAs are safe to practise and can be held to account if serious concerns are raised. These proposed reforms will allow us to respond more quickly and flexibly when patient safety is at risk.

‘They will also allow us to further improve our efficiency and effectiveness, while at the same time enabling us to help patients navigate the complaints and concerns process more easily.’

‘This is an important and long-awaited step towards a more responsive and compassionate approach to healthcare regulation.’