Exclusive The GMC has launched appeals against its own tribunal 23 times in less than a year, reveal figures obtained by Pulse.
As a result, seven doctors have been struck off the medical register against the advice of the GMC’s own Medical Practitioner Tribunal Service (MPTS), including Dr Hadiza Bawa-Garba.
The figures reveal that the regulator has regularly appealed against MPTS decisions in the 10 months since it was allowed to pursue appeals in the High Court.
The appeals have all sought stricter sanctions or to block a doctor from being registered to practise in the UK. No appeal was for more lenient treatment.
The GMC gained the right to appeal MPTS decisions in December 2015, and the first test case was only heard in May last year, because the High Court requested it was held in a senior divisional court.
But the regulator has faced a storm of criticism from the medical profession after its treatment of Dr Bawa-Garba, a junior doctor convicted of manslaughter for negligence resulting in the tragic death of a six-year-old boy.
Following the controversial High Court ruling in January, LMCs have passed a no confidence vote in the GMC and demanded advice for GPs to stop written reflections, while the health secretary said he was ‘perplexed that the GMC acted as they did’.
Concern has also led the GMC and the health secretary to launch reviews into manslaughter convictions in medicine.
The GMC has to date launched 23 appeals against MPTS rulings:
- It was successful in relation to 14 of the 16 cases whose appeals reached the High Court
- It was also successful in relation to two of the other five doctors whose appeals had been issued but did not ultimately proceed to hearing because they were concluded by consent prior to a hearing
- This reflects an overall success rate to date of 16 out of 21 (76%)
- In relation to appeals relating to allegations of impaired fitness to practise only (excluding restoration cases, of which the GMC lost two in the High Court) the success rate is 100% – 15 of the 15 doctors
- Six doctors were struck off following High Court rulings and an additional doctor chose voluntary erasure, which led the GMC to drop the appeal.
Source: Data supplied to Pulse by the GMC
A GMC spokesperson said: ‘Wherever a tribunal decision is different from our sanction submission, we will consider whether to appeal that decision. We do not make these decisions lightly and we have a set of criteria we have to go by, which we publish on our website.
‘We have been successful in relation to 14 of the 16 doctors whose appeals have proceeded to a hearing in the High Court and two of the five doctors whose appeals have been concluded by consent.
‘This suggests that, since we obtained our right of appeal, we are correctly and lawfully applying those criteria.’
GP Committee sessional chair Dr Zoe Norris said: ‘These figures show that Dr Bawa-Garba’s case is the tip of the iceberg. The GMC seem to have no confidence in the MPTS, and are prepared to appeal its decisions and seek to overturn them entirely.
‘The process of establishing a doctor’s to fitness to practice is extremely unclear. After often a prolonged and distressing investigation, a doctor faces the MPTS and now may find their situation is prolonged by an appeal from the GMC against its own body.
‘Doctors are frightened. We are vulnerable and increasingly put in situations that are unsafe and unfair.’
BMA chair Dr Chaand Nagpaul said: ‘The BMA made its concerns clear when the GMC was granted its right to appeal such decisions three years ago, a change which risked undermining doctors’ confidence in the independence and fairness of the MPTS.
‘We know that fitness-to-practise investigations can be stressful enough experiences for doctors, in many cases leading to anxiety and depression, without the added worry that any decisions made by the MPTS can be overridden by the GMC taking the case to a higher court.’
The Bawa-Garba case
The case of Dr Bawa-Garba, whose ‘catalogue of errors’ a court said contributed to the death of six-year-old Jack Adcock from sepsis, has prompted concern from the health secretary,the medical royal colleges and the BMA. The concern has focused specifically on the use of Dr Bawa-Garba’s own reflections in her e-portfolio – although these particular documents were not used in the case.
It most recently prompted delegates at last week’s UK LMCs Conference to declare a vote of no confidence in the GMC. The conference also called on the BMA to advise GPs to ’disengage from written reflection in both appraisal and revalidation’ until new safeguards are put in place.
Following the case, the GMC is set to carry out a review into how gross negligence manslaughter is applied in medicine, which will also look at ‘diversity matters’. Health secretary Jeremy Hunt also ordered a ‘rapid review’, led by former Royal College of Surgeons president Professor Sir Norman Williams, due to report back to the House of Commons next month.
N.B. This article was changed on 20 March 2018 to specify that Dr Hadiza Bawa-Garba’s written reflections in her e-portfolio were not used in the legal case.