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LETTERS: Gerald Graham and Tony Robinson Suspension of consultant raises serious issues BMJ 1998; 316: 1677 [Full text]

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The Professional Conduct Committee needs separate forum to decide legal and factual issues

Wai-Ching Leung   (2 June 1998)

The Professional Conduct Committee needs separate forum to decide legal and factual issues 2 June 1998
Wai-Ching Leung, Senior Registrar in Public Health Medicine Sunderland Health Authority, Durham Road, Sunderland SR3 4AF Send response to journal: Re: The Professional Conduct Committee needs separate forum to decide legal and factual issues	The issues raised by Graham and Robinson (1) highlighted that separate forum to determine legal and factual issues in the GMC professional conduct hearing is necessary. The recent Bristol case (2) demonstrated that increasingly important and complex legal issues have to be decided by the professional conduct committee - for example, whether continuing to perform surgery in spite of previous poor outcomes would constitute serious professional misconduct, and to what extent doctors with a predominant managerial role are subjected to GMC disciplinary procedures. The argument that separate forum is unnecessary as legal and factual issues are already decided by different members of the professional conduct committee is not convincing. In a criminal hearings held in the Crown Court, the judge has several important roles. These include deciding whether potential members of the jury should be excluded due to conflicts of interest, hearing evidence and deciding on legal issues in the absence of the jury, and addressing the jury on the burden and standard of proof. However, in the Bristol case, it appears that the refusal of the Chair of the GMC professional conduct committee to withdraw from the case amidst allegations of conflicts of interest was not decided by the legal members of the committee. (3) Non-legal members of the committee whose primary function is to decide on factual issues are also present during legal arguments, and may have been influenced by evidence of what would otherwise be inadmissible. Furthermore, non-legal members of the committee are not reminded of the burden and standard of proof before giving their verdict, and one cannot be entirely certain that all non-legal members of the committee are familiar with these. This may account for Graham and Robinson's impression that the burden of proof appears to be on the defendant. (1) Justice must be seen to be done, and this may be facilitated by the separation of the tribunal of legal issues and tribunal of fact. Reference 1) Graham G, Robinson T. Suspension of consultant raises serious issues. BMJ 1998; 316: 1677 2) Smith R. GMC under the cosh. BMJ 1998; 316:946 3) Dyer C. Doctors facing misconduct charges accuse GMC committee of bias BMJ 1998;316:7