Proposal for no public hearing in undisputed fitness to practise cases draws wide support

Most respondents to the General Medical Council’s consultation on its fitness to practise procedures back a proposal to skip public hearings where the doctor accepts the sanctions imposed.

A total of 83% of the 217 organisations and individuals who responded to the consultation, including the BMA and most of the patient representative groups, agreed that the GMC should “explore alternative means to deliver patient protection where there is no significant dispute about the facts.”

However, a small minority of respondents, mostly doctors or patients responding in an individual capacity, disagreed with the proposal to encourage doctors to accept sanctions without a public hearing, saying that doctors might feel pressured into accepting the measures or that there was a risk of “deals being done behind closed doors.”

More than three quarters (77%) of respondents believed that it was appropriate for the GMC to have discussions with doctors to encourage them to accept a sanction, which could avoid the need for doctors to be suspended for long periods while waiting for cases to go to a hearing.

“We’re very encouraged that most people who responded were positive about the principles we’re trying to put forward,” said Niall Dickson, the GMC’s chief executive. “We believe the proposed reforms would result in a system that is quicker and less stressful for both complainants and doctors, yet will still protect the public.”

A “significant” number of cases could potentially be resolved without having to go to a hearing, he added.

A quarter of respondents, including most of the patient groups, opposed allowing doctors to share “without prejudice” information that the GMC could not later use as evidence. However, 24% supported allowing doctors to share information on a without-prejudice basis, half of whom were individual doctors, and a further 35% were in favour of an alternative.

Mr Dickson said, “If you’re having a without-prejudice discussion and a patient safety issue emerged, we would not be able to take it forward, and people pointed out that that would be wrong, so we’ve decided not to do that.”

The concept of without-prejudice discussions has now been dropped from the proposed reforms.

Respondents largely supported the principle of presumed erasure from the medical register for certain serious criminal convictions—such as murder, rape, and child abuse—and the proposal to suspend doctors who do not cooperate with investigations despite repeated attempts at engagement.

More than half agreed that the GMC should publish online the sanctions accepted by doctors to help maintain transparency and public confidence in the profession.

The consultation proposals are likely to be implemented in early 2014, although in the interim the GMC plans to identify “quick wins” where it could introduce improvements ahead of any changes to the legislation.

The number of fitness to practise cases referred to the GMC has risen considerably since April 2010: by 21% for stream 1 cases (the most serious brought before the GMC) and 17% for stream 2.

The GMC consulted on its fitness to practise procedures between January and April this year with the aim of making them quicker and to avoid subjecting doctors and patients to long, stressful, and sometimes harrowing public hearings.