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GPs retain right to self-regulation after Government scraps new fitness-to-practise adjudicator

By Gareth Iacobucci

The Government is to abandon plans to strip the medical profession of the right to self-regulate and instead insist the GMC introduces reforms to streamline its procedures and make them more transparent.

Ministers this week formally decided to scrap the Office of the Health Professions Adjudicator, which had been due to become operational from April 2011, and instead hand the GMC full responsibility for establishing an independent tribunal to decide on doctors' fitness to practise.

The GMC will now consult on changes to its adjudication processes, including fast-tracking fitness-to-practise procedures to cut costs and improving panellists' performance through a new ‘tribunal', reporting directly to Parliament.

The moves come as new RCGP chair Dr Clare Gerada criticised the GMC's existing procedures in a Pulse opinion piece, warning that ‘intolerable' delays were placing the health of doctors under investigation at risk.

The OHPA was established in law by the previous government following the Shipman Inquiry, which highlighted concerns over the GMC's ability to separate its adjudication and its investigatory roles. But the coalition has scrapped the fledgling body in an attempt to save the NHS more than £60 million by removing an unnecessary new layer of bureaucracy.

The GMC will aim to improve efficiency with enhanced pre-hearing case management, which could see fines for delays or cases that collapse.

It will discuss providing greater support for panellists through a ‘tribunal-style' model, and reducing the number of panellists required. And the number of charges that can be levelled at GPs may be limited, to include only those likely to being ‘a finding of impairment and secure the appropriate sanction'.

Niall Dickson, GMC chief executive, said: ‘We are committed to taking forward a programme of major reform to create an efficient, modern adjudication function which operates independently from our other work.'

Dr Krishna Korlipara, a GP in Bolton, Lancashire, and a council member of the GMC for 25 years, welcomed the move: ‘The idea the GMC does not serve the needs of justice by being both a prosecutor and adjudicator is completely flawed. The profession should be in charge.'

But medical defence experts warned the plans could prove costly for GPs, and would not guarantee true independence.

Dr Michael Devlin, Medical Defence Union medico-legal adviser said: ‘We want to be reassured the GMC's proposals will result in sufficient independence of adjudication, without additional costs for doctors.'

Dr Stephanie Bown, director of policy and communications at the Medical Protection Society, said: ‘It's disappointing recommendations to enhance independence of healthcare adjudication have still not been implemented.'

Dr Krishna Korlipara How the GMC plans to reform

- Enhanced pre-hearing case management procedure to ensure more efficient use of resources at hearings, with possible cost sanctions for delay or failure

- More active case management through introduction of legally qualified chairs for certain types of cases

- Reducing the number of panellists required to sit on some panels

- Enhanced performance management and support for panellists through a ‘tribunal-style' model

- Reduced hearing length through introduction of specimen charges, which will limit the number of charges that could be made against GPs

Source: GMC's Response to the Department of Health (England)'s Consultation on Fitness to Practise Adjudication for Health Professionals:


Click here to read RCGP chair Dr Clare Gerada's concerns over the burden of GMC investigations on doctors' mental health