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Legal reforms would allow GMC to tackle “shameful” discrimination of ethnic minority doctors

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1214 (Published 12 May 2021) Cite this as: BMJ 2021;373:n1214
  1. Clare Dyer
  1. The BMJ

The “shameful” discrimination experienced by too many doctors from ethnic minorities could be tackled under government proposals for radical reform of professional regulation, the chief executive of the General Medical Council has told health leaders.

Charlie Massey told a Westminster Health Forum conference that the reforms, which are open for consultation until 16 June, would give the GMC freedom to tackle discrimination and inequality within healthcare.1 The GMC and the other healthcare professional regulators would be given greater freedom over which cases to take forward, freeing up resources to focus on improvements in culture, training, and education.

Doctors from ethnic minorities are more likely than white doctors to be referred to the GMC by employers and more likely to be struck off the medical register.2 The changes, for which the GMC has long campaigned, would move the focus from responding to complaints to nurturing and supporting doctors, Massey said.

Under the current rules, he said, the GMC is required to “fully assess every complaint we receive, even if it doesn’t raise serious fitness to practise concerns and won’t meet our legal thresholds. Reform will allow us to be more focused in deciding which cases we investigate and how we do it, ensuring fairer and faster outcomes.”

He added, “The GMC exists to protect the public, not to punish the profession. The route to delivering first class care lies in supporting doctors so they do their job well. And that’s where we want to spend the bulk of our time and resources.”

Massey said outdated legislation and onerous bureaucracy was hampering the flow of senior medical talent to UK health services. Currently, doctors from outside the EU who want to work as consultants or GPs in the UK have to go through a process requiring them to provide over 2000 pages of evidence, often taking close to a year, with a failure rate of around 50%.

This made the UK a much less attractive destination for international specialists and also blocked the progression of many specialty and associate specialist doctors already in the country who wanted to step into consultant roles, he said. The reforms would make routes to the register more straightforward and streamlined, give the GMC greater discretion, and speed up the process for senior doctors to join the workforce.

His comments came as the Humberside Group of Local Medical Committees published a report highlighting black and ethnic minority GPs’ experiences of discrimination in areas including training, working patterns, and complaints.3

The Medical Defence Union, which defends doctors caught up in GMC procedures, welcomed the move towards a less adversarial system of regulation. But its professional services director, Matthew Lee, told the conference that proposed changes to the way doctors with health problems are dealt with could penalise the most vulnerable doctors. The reforms would remove health as a ground for a fitness to practice investigation and deal with health under the umbrella of “lack of competence.” Misconduct would be the only other ground for action.

“We understand and support the government’s motives for proposing that health concerns should usually be dealt with outside the fitness to practise process,” said Lee. “It is suggested this will lead to a fairer and more proportionate system, limiting fitness to practise investigations only to concerns that meet the appropriate threshold.

“There will be some cases, however, where progression to a more formal process is deemed necessary and removing the health route under which such concerns are currently dealt with will be a retrograde step. It risks undoing the many advances that have been made by the GMC in establishing sensitive and separate procedures for dealing with doctors in poor health.”

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