Fitness to practise process must change, says GMC chair

BMJ 2016; 353 doi: (Published 17 May 2016) Cite this as: BMJ 2016;353:i2787
  1. Abi Rimmer
  1. BMJ Careers

The United Kingdom’s fitness to practise process must be reformed, the chair of the General Medical Council has said.

Presenting the annual Stevens Lecture at the Royal Society of Medicine in London on Monday 16 May, Terrence Stephenson said he wanted to move the GMC away from being perceived as the “policeman” of the profession.

He said, “For most doctors, what the GMC is known for is tackling bad practice and striking doctors off. Unfortunately, because we are creatures of statute, we have to follow the 1983 [Medical] Act, and you will see that this is really rather a hammer to crack a nut. I’m determined that we should reform this, but we do need legislation through parliament,” Stephenson said.

He said that the GMC received around 10 000 complaints a year about doctors, 11% of which came from other doctors, 7% from employers, and around 60% from the public. The rest came from other groups such as the police, he said.

Stephenson said that complaints made by the public were the least likely to be formally investigated by the GMC. “There’s a reason for that: complaining to the GMC costs you nothing. It’s free, it’s very simple—you can do it online. And so the public sometimes use it in an inappropriate way,” he said.

“The most extreme example I know of [was] a member of the public complaining about a doctor because the trees in the [practice’s] garden were growing so high that it was taking their light away,” Stephenson said.

He said that only 250 of the 10 000 complaints made to the GMC each year went to a tribunal, and in these cases just 55 doctors were struck off. “So I think that’s a hammer to crack a nut,” Stephenson said. He added, “I think we need reforms to this procedure. I think many of the complaints are erroneous. I think many of the complaints that come to us could be dealt with locally by the trust, and many, many doctors are put through procedures unnecessarily.

“And in some sense many members of the public are misled [to believe] that by coming to us they will get redress, when in fact what they perhaps need to use is the hospital complaints procedure or the ombudsman . . . The GMC is not the correct route.”

In his lecture Stephenson also discussed his ambition to make the GMC more focused on patient safety. “The sad truth is that medicine is a high risk profession; it’s a safety critical industry, and people are harmed by healthcare,” he said.

“My vision for the GMC is to take it beyond being the policeman of the profession to an organisation that can truly help protect patient safety,” Stephenson added.

A member of the audience asked Stephenson whether he was aiming for an unattainable standard of patient safety for the NHS. “[In] any human business there will be human error that can never be eradicated, but I think it behoves us to try and fix it,” Stephenson replied. “In my education and training I can’t really think of any emphasis being put on a patient safety culture until very recently, and I think we can do better.”

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