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GMC to offer GPs ‘plea bargain’ to avoid prolonged hearing process

GPs could be offered the chance to avoid a publically stressful panel hearing by accepting a suspension or removal from the performers list during a fitness-to-practise investigations, Pulse has learned.

The GMC is seeking a change in legislation to allow suspensions and erasure from the performers’ list at an earlier stage rather than having to wait for a panel hearing, its chief executive Niall Dickson has told Pulse.

However LMC leaders have likedned it to a ‘plea bargain’, warning that the change could see GPs accepting a ‘superficially attractive’ offer which might amount to them admitting impairment for something they didn’t do – in order to avoid ‘an absolutely soul destroying’ hearing.

GPs can currently only accept a sanction to avoid a hearing for a lesser complaint which at the most would see them given a warning or restrictions on their practise.

But Mr Dickson told Pulse that it was currently running a pilot which involved dealing with doctors before a hearing who faced more severe complaints and therefore more severe sanctions. The pilot had already been found to be ‘useful’ by doctors and defence bodies, he said.

He explained that the the move was in addition to providing more support for doctors and working to close cases at an earlier stage.

The proposed changes come in response to calls for more support and streamlined investigations to minimise the burden on GPs under investigation. In one case a GP’s four year ordeal cost £100k and left his children ‘living below the poverty line’ and in several tragic cases doctors have committed suicide while under investigation, an issue which the GMC is currently reviewing.

Mr Dickson told Pulse: ‘We have this pilot, looking at whether having a meeting with the doctor at the end of the investigation can help us agree the way forward between us and the doctor. This will avoid the need to go forward to a panel hearing and will reduce the stress for everyone involved’

He added: ‘At the moment we can only do that with lesser complaints, those that would result in a warning or conditions on their practice. We can’t do it for suspensions or erasures.

‘In the future we hope we can get the legislation changed so that doctors can avoid going to a panel hearing, and the process could be curtailed, which is a really big ambition for everybody with this reform.’

LMC leaders have however told Pulse that the prospect of a drawn out fight to clear their name could, in some cases, see doctors accepting a stricter sanction than would have been found at a hearing.

Dr Robert Morley, chair of the GPC’s contracts and regulation subcommittee said the scheme could be likened to ‘plea bargaining’, and the proposal could not be a substitute for addressing the ‘appalling’ GMC hearing process.

He said: ‘What they should be doing is sorting out their existing processes, making them fit for purpose and putting an end to the appalling stresses that they put on doctors.’

‘Whilst this might be all well and good in some cases, it inevitability will be that doctors will be tempted to accept a sanction simply to avoid going through an appalling process where they might well, at the end of the day, be exonerated.

He added: ‘This could very well be discriminatory, particularly against doctors who are less robust psychologically, and may even have a definite mental health issue.

Dr Tony Grewal, medical director at Londonwide LMCs told Pulse: ‘It’s the same care that you have to take when accepting a police caution, while it’s superficially attractive in terms of a pragmatic solution. You’d need to be very sure that you weren’t ending up with a worse case.’

‘The trouble is the stress of hanging around waiting for a GMC hearing is awful, and going through a GMC hearing is absolutely soul destroying – it’s a terrible thing to go through.’

Dr Peter Holden, a GPC representative in Matlock, Derbyshire warned: ‘You should only do this following expert legal advice, because there are ramifications for accepting a penalty from the GPC, which can be very long-standing.’

‘Including you may have great difficulty getting malpractice insurance, and if you can’t get malpractice insurance you may as well be off the register.’

A GMC spokesperson said that if a doctor did accept a sanction they would ‘never know what sanction a panel would have imposed if the case had gone to a hearing’.

‘However, as the purpose of the meeting is to ensure we have a full view of the case, including any evidence of mitigation that the doctor holds, the sanction we propose is likely to be consistent with the sanction that a panel would impose.’

‘But it means that the doctor doesn’t have the potential additional stress of a hearing and the process can be concluded much more quickly,’ the spokesperson added.