GMC may be open to accusations of racial bias

BMJ 2003; 326 doi: (Published 22 February 2003) Cite this as: BMJ 2003;326:411
  1. Owen Dyer
  1. London

    A report commissioned by the General Medical Council claims that the council has left itself open to accusations of racial bias because of its treatment of complaints against doctors who qualified outside the United Kingdom.

    Doctors who qualified outside the United Kingdom who are reported to the GMC are more likely than UK qualified doctors to face the professional conduct committee, to be found guilty of serious professional misconduct, and to be struck off, said the report, which based its conclusions on a statistical review of cases over the past five years.

    Professor Isobel Allen of the Policy Studies Institute analysed the data at the request of the GMC's race, equality, and diversity committee. She found that overseas qualified doctors were more likely to pass through the administrative filters that reject trivial or unsustainable complaints before they reach the professional conduct committee.

    Complaints reaching the GMC are first scanned by staff in the screening section, who reject obviously unpromising cases according to strict written criteria. Cases that might involve serious professional misconduct are passed to a medical screener. The proportion of foreign qualified doctors passed on by the screening section to the medical screeners is probably not above average.

    The medical screeners, on the other hand, have over the past three years been 50% more likely to pursue a case involving a foreign qualified doctor than a case involving a UK qualified doctor. The report notes that complaints against foreign qualified doctors are more likely to come from public bodies, and screeners tend to take such complaints further. The research found, however, that while some medical screeners pass on almost the same proportion of UK qualified and foreign qualified doctors, other screeners are three times more likely to recommend further action in the case of a foreign qualified doctor.

    Cases that pass the medical screeners come before the preliminary proceedings committee. Here, too, the data show that foreign qualified doctors have been 50% more likely to be referred to a full hearing than UK qualified doctors over the past three years, though not in the two previous years.

    Professor Allen also said that the professional conduct committee itself had a record of giving sterner punishments to foreign qualified doctors, while UK qualified doctors were more likely to receive a reprimand. She wrote, however, that without analysing the decisions themselves she could not determine the cause.

    “It is possible,” she wrote, “that the complaints about overseas qualifiers are simply more serious and that their disproportionate referral rates and outcomes of hearings are fair and reasonable. However, until there are some objective measures which can demonstrate this, the GMC remains open to accusations of bias.”

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