Letters, calls & emails: Civil standard of proof will be flexibly applied

Dear Editor

I'd like to clarify a point made in your recent article, 'Civil proof standard to start in 2008', which stated that cases before fitness-to-practise panels 'will be judged on a civil or criminal standard' (GP, 1 June).

In fact, the proposal is to switch all our hearings to the civil standard of proof, flexibly applied.

Removing a doctor from the register is very serious; and the rigour of the criminal standard of proof, or a standard close to it, is appropriate.

But, where the consequences are less profound, the standard of proof can be applied more flexibly.

This approach is consistent with our statutory purpose - to protect, promote and maintain the health and safety of the public - while remaining fair to doctors.

We have been guided by an important judgment in the Court of Appeal in 2006 (R v Mental Health Review Tribunal) where Lord Justice Richards explained that the civil standard of proof is inherently flexible. It takes into account the seriousness of the allegations and the seriousness of the consequences of finding them proved.

This means that, although there is a distinction in principle between the civil and criminal standards of proof, in practice the strength of the evidence required in a case where doctors could be erased from the medical register and lose their livelihood should lead to an outcome which would be the same, or very similar.

The proposed change should be seen in a wider context. Of the nine healthcare professional regulators, six already use the civil standard.

Also, the GMC is about to introduce further changes to our fitness-to-practise procedures - in particular 'consensual disposal'.

This will allow us, in particular categories of case, to agree undertakings with a doctor so there is no need for a hearing by a fitness-to-practise panel.

Professor Sir Graeme Catto, president, GMC.

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