Proposed reforms risk giving GMC ‘one-sided powers’, BMA warns

The Government’s proposed reforms to the GMC fail to address ‘fundamental’ issues raised by doctors and risk giving the regulator ‘one-sided powers’, the BMA has warned.

In a response to the planned reforms to the regulator, the union said it ‘strongly disagrees’ with the retention of the GMC’s right to appeal fitness to practise decisions, and the extension of this right to cover interim measures.

The Government is currently consulting on reforming the GMC, including 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.

This has been criticised by doctors and experts, who have described the proposed legislation as ‘profoundly concerning’ and ‘a missed opportunity’ for wider reform.

The BMA said it supported the findings of the previous Government’s 2018 ‘rapid review’ which said the GMC should be stripped of the powers, in the aftermath of the Dr Hadiza Bawa-Garba case. 

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 had been expected that the proposed legislation would strip the GMC of this right, before the Government’s apparent U-turn on the issue earlier this year.  

The BMA also launched a petition demanding the Government enacts a series of changes to the regulator’s powers, including that it cannot appeal medical tribunal determinations and that it regulates doctors only.

The draft regulation also says that the GMC ‘may revise a specific fitness to practise decision made by a case examiner’.

In response, the union said: ‘We disagree with the GMC being afforded an additional, one-sided power to revise decisions. While the GMC is independent from government, we have seen the regulator come under significant political pressure to appeal certain tribunal decisions.

‘While there is the potential for revision to be used in order to avoid lengthy tribunal cases for doctors, the draft Order does not contain sufficient limits to this power. For example, there is no time limit by which a revision must be issued, which leaves doctors at risk of having to revisit concerns previously thought to have been resolved.’

BMA head of regulation, education and training Laura Russell said: ‘It is our longstanding position that confidence in the MPTS is predicated on its independence.

‘Expanding, rather than removing, the GMC’s right of appeal threatens professional confidence in its decisions. The Professional Standards Authority (PSA) already holds a right of appeal and should be the sole body with this function.’

The consultation also proposes protected titles in law for both the ‘physician assistant’ and ‘registered medical practitioner’ roles, in response to the Leng review into the safety and effectiveness of the physician associate and anaesthesia associate roles, published last year. 

The BMA said while renaming physician associates was ‘a welcome step towards reducing confusion’, the legislation should go further by creating ‘separate regulatory arrangements’ rather than a single register in separate parts.

It said: ‘Physician assistants are not doctors, and it is essential that this distinction is made clear to patients.

‘We have significant concerns that a single, annotated register will list physician assistants and anaesthesia assistants (PAs and AAs) alongside doctors. The BMA strongly opposed, and continues to oppose, the GMC regulating PAs and AAs, as it blurs the distinction between doctors and non-doctors.

‘We maintain that the best way to address patient confusion is by returning the GMC to being a single-profession regulator, with PAs and AAs regulated by the Health and Care Professions Council (HCPC).’

The union also argued the renaming process was too slow, with the specific change of title not scheduled until June 2027. It called on the Government to rename the role ‘at the earliest opportunity’ given ‘the patient safety implications’ of using the ‘associate’ term.

The BMA petition, created by the professional regulation committee’s (PRC) chair Dr Tom Kane, says: ‘We believe the proposals fail to deliver necessary changes to a system of regulation that is failing doctors and their patients. Instead, we urge the Government to fix the system.’

Specifically, according to the petition, the reform should ensure that the GMC:

• legally protects the working titles of doctors
• becomes a single-profession regulator for doctors only
• has a legal duty of care to the doctors it investigates
• applies the criminal standard of proof
• cannot appeal medical tribunal determinations
• is subject to investigation when complaints are made against it
• and returns to a governing body with a majority of members elected by doctors.

The petition currently has almost 2,000 signatures. If it receives 10,000 signatures, the Government must respond to it. 

Responding to the petition, a DHSC spokesperson told Pulse: ‘We agree with the BMA that the current regulatory landscape is outdated and too bureaucratic, which is why this Government is launching the biggest reform of the GMC for over 40 years. Reforms to the GMC are open for consultation, and we welcome stakeholder views on this matter.

‘Using a civil standard of proof in fitness to practise cases lets regulators take action on poor conduct or performance even when it isn’t serious enough for a criminal conviction – helping protect patients and maintain public trust in healthcare professionals.’

A GMC spokesperson told Pulse it would be for the Government to make decisions on the legislation. 

The consultation closes on 23 June.