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Medical defence bodies issue warning over fitness-to-practise overhaul

By Gareth Iacobucci

Proposals for the GMC to establish an independent tribunal to decide on a doctor’s fitness to practice could prove costly for GPs and would not guarantee true independence, medical defence experts have warned.

In its response to the Government’s consultation on fitness-to-practise adjudication, the Medical Defence Union (MDU) expressed concern at the Government’s preferred option which would see the GMC continue to adjudicate on doctors’ fitness to practise through a separate disciplinary tribunal.

The previous Government had tabled proposals for an independent tribunal called the Office of the Health Professions Adjudicator (OHPA), but the coalition looks set to halt the plans in a move it claims will save the NHS more than £60 million by avoiding an unnecessary new layer of bureaucracy.

The MDU said it was vital that any tribunal was genuinely independent from the GMC, and said it was sceptical of how this could be achieved without an independent tribunal.

Dr Mike Devlin, head of advisory services at the MDU, said: ‘We welcomed the setting up of OHPA as recognition that the body that investigates and ‘prosecutes’ cases against registrants should not also sit in judgement. We were disappointed therefore to learn that OHPA might be a casualty of the government’s spending review.’

‘While we support the motivation for the suggestion that the GMC could set up a separate disciplinary tribunal, we do not see that such a body, which would remain under the auspices of the GMC, will ever be sufficiently independent. We are also concerned that attempts to try to make it independent will be more costly than the current system, with doctors having to bear these additional costs.’

The Medical Protection Society (MPS) also expressed concerns in its response, stressing that ‘significant changes’ were required to current GMC processes in order to achieve efficiency and fairness.

MPS director of policy and communications Dr Stephanie Bown said: ‘The MPS is concerned that the current proposals do not go far enough in achieving an adjudication system for health professionals that is fair, independent and fit for purpose. Without greater reform to the current fitness-to-practise system, public and professional confidence could be undermined.’

‘An overriding objective of the OHPA model was to deal with cases in ways that were proportionate to their importance. We would like to see the GMC take this objective forward and provide a more proportionate approach to investigation and sanctioning.’

Dr Bown added: ‘We recognise the importance of gaining costs efficiencies from the fitness to practise system, but this cannot be at the expense of fairness to doctors.’