BMA threatens GMC with new legal action for ‘blurring lines’ between PAs and doctors
The BMA has threatened the GMC with new legal action over the regulator’s use of the term ‘medical professionals’ to cover both physician assistants and doctors, following the Government-commissioned review into the role by Professor Gillian Leng.
In April, the High Court dismissed the BMA’s claims the GMC was ‘blurring the lines’ between PAs and doctors and that making its guidance applicable to both ‘conflates the professional roles’.
But a Court of Appeal judge has now given the BMA permission to appeal the ruling.
The BMA’s council chair Dr Tom Dolphin has written to the GMC saying that that ‘if necessary’, the union will continue with the legal challenge over the use of the term ‘medical professionals’.
It said that the regulator’s decision to use the Good Medical Practice document to provide professional standards for doctors and non-doctors was ‘a clear error’ that must now be rectified, and that the Leng review has found that blurring the lines between doctors and non-doctors ‘is a basic patient safety matter’.
It comes after the Leng review recommended that the GMC should revise the text in its Good Medical Practice document to provide ‘distinct categories for PAs’ and doctors, and that regulation ‘must not blur the line further’.
The BMA also said there was ‘no justifiable reason’ for the GMC not to immediately substitute all references to ‘associates’ with ‘assistants’ in its guidance, after the Leng review recommended the change.
The letter said: ‘The medical profession has been clear that it does not support the use of Good Medical Practice to provide standards for both doctors and non-doctors.
‘We call again on the GMC to retain Good Medical Practice as the overarching professional standards document for doctors only.
‘The decision by the GMC to use the term “medical professionals” to cover doctors and non-doctors was always misguided and added further confusion by the public and within healthcare settings.
‘If necessary, the BMA will continue in its existing legal challenge to this decision, however the renaming of “associates” as “assistants” which is being implemented with immediate effect by NHS England must surely signal the end of this dangerous umbrella term by the GMC to encompass non-doctors.’
The letter said it was ‘unfathomable’ that the medical regulator continued to use the term ‘associate’ to to describe non-medically qualified assistants.
It added: ‘Before further public funds are spent by the GMC fighting this appeal, we urge you to agree not to use this inappropriate umbrella term to describe doctors and non-doctors.’
Lord Justice Zacaroli, who granted the union permission to appeal the ruling, said: ‘The grounds of appeal as developed in the appellant’s skeleton argument are arguable with a real prospect of success.
‘They also raise an important point of principle which, having regard to public safety issues, provides a compelling reason for the Court of Appeal to hear the appeal.’
A GMC spokesperson said: ‘We note the British Medical Association has been given permission from the Court of Appeal to appeal one aspect of their recent unsuccessful judicial review claim. This appeal relates to one aspect of terminology to cover our registrant groups. A hearing will be listed in due course.’
It follows the outcomes of Leng review into the safety and effectiveness of PAs and anaesthesia associates (AAs) published earlier this month.
The review found ‘no convincing evidence’ to abolish the roles but recommended:
- PAs should be renamed as physicians assistants;
- They should have at least two years’ training in secondary care before being allowed to practise in primary care
- They should not see undifferentiated patients outside of clearly determined national clinical protocols – in line with guidance set out by the RCGP.
In April, Pulse revealed legal action associated with the regulation of PAs had cost the GMC more than £55,000 to date.
In the April High Court ruling, Mrs Justice Lambert sided with the GMC, stating there was nothing ‘irrational or inherently confusing about the use of the term “medical professionals’.
This week, the trade union for PAs announced its own judicial review against the Government after heath secretary Wes Streeting committed to implementing the Leng review’s recommendations in full.
BMA legal grounds in original judicial review
Three grounds of challenge:
i) Ground one focuses upon the use of the term “medical professionals” in GMP to describe doctors, PAs and AAs. It is argued that the legislative framework creates a clear and firm distinction between “the medical profession” whose members are medically qualified doctors and anaesthesia associates or physician associates. These terms are statutory terms which bear distinct meanings drawn from their context. The use of the term “medical professionals” as an umbrella term is inconsistent with, and in conflict with, the statutory framework to which the GMC is subject and pursuant to which it exercises its functions.
ii) Ground two concerns the promulgation of a common set of professional standards and the use of the umbrella term “medical professionals” in GMP is contrary to the statutory objectives of regulation, which is public protection.
iii) Ground three is that the GMC acted irrationally in deciding to issue a common set of professional standards and in using the umbrella term “medical professionals”.
Source: High Court ruling
