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GP leaders pass vote of no confidence in GMC

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1167 (Published 12 March 2018) Cite this as: BMJ 2018;360:k1167
  1. Gareth Iacobucci
  1. The BMJ

General practice leaders have passed a vote of no confidence in the General Medical Council (GMC) in light of the regulator’s actions in the Hadiza Bawa-Garba case.

A motion passed at the annual UK local medical committees conference in Liverpool also directed the BMA’s general practitioners committee to advise GPs to disengage from written reflection in appraisal and revalidation until adequate safeguards are in place.

In January the GMC successfully appealed to the High Court to have Bawa-Garba removed from the medical register, after the Medical Practitioners Tribunal Service had decided not to strike her off when she was found guilty of gross negligence manslaughter.1

Zoe Norris, chair of the BMA GP committee’s sessional subcommittee who proposed the motion, said that the GMC’s decision to challenge the tribunal service smacked of “an arrogance and a desire to continue to punish a doctor beyond the point of reason.”

She told the conference, “GPs have lost all confidence in the ability of the GMC to be objective and to genuinely balance patient safety against the reality of being a doctor in the modern NHS.

“When you—after your 14 hour day, in your eighth month of working [while] a partner down, with another sick, with your [practice] list going up and up—make a mistake, are you confident that the GMC will be fair, objective, and balanced in its investigation of you? GPs have no confidence in the GMC as our regulatory body.”

Some GPs have reported that they have received advice telling them not to provide written reflections in their appraisals.

Norris said, “Until there is absolute clarity over all types of reflection and GPs can be completely assured, then our role as representatives of the profession is to advise GPs to protect themselves, to not make them any more vulnerable than they already are. The statements made so far do not represent adequate safeguards—they do not protect GPs.”

The motion mandated the GP committee to urgently implement a system whereby GPs can make collective statements of concern regarding unsafe care. It also requested that the House of Commons health select committee review the GMC’s conduct in the Bawa-Garba case.

The motion was carried in full despite David Bailey, chair of BMA Wales, urging the conference not to pass the vote of no confidence.

He argued, “We have to have a regulator: the public demands it, and rightly so. While there are real problems at the top of the GMC, the people who work for it are—by and large—people who understand the problems that doctors have, have empathy, have professionalism, and are trying to do a good job.

“So, we have to try to reform the GMC from within, we have to change their policy, particularly in light of the Bawa-Garba case—but starting from scratch is not the way to do it. The way to actually engage with the leadership of the GMC is not to pass a motion of no confidence.”

But Alicia Watts, a member of the Kent local medical committee who spoke in favour of the motion, said, “The GMC do not appear to consider their duty of care to the individual they are investigating. There are now increasing fears that doctors will be scapegoated in a system that is struggling and [where] trust in the regulatory process is low.”

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