Letters: GMC chairman responds to Chris Lancelot

Dear Dr Lancelot,

I welcome your letter (GP, 24 April). I know that one of my earliest challenges is to re-frame our dialogue with doctors.

You caricature the GMC's regulatory role as a 'poisoned chalice' and, as with all caricatures, I recognise elements of the parody. But I also know that there are many misconceptions among doctors about our role and what we actually do. It is time we understood one another better.

You highlight aspects of our fitness-to-practise procedures. It is understandable that you feel sensitive about this. The vast majority of doctors are good doctors who do an excellent job.

Yet, as a profession we also know that some of our colleagues cause concern. If such concerns are raised with the GMC, we are legally obliged to consider whether a complaint requires action. The balance that we constantly strive to achieve in carrying out this statutory role is to protect patients and be fair to doctors.

Figures from our fitness-to-practise procedures suggest we generally have the balance right. There are 230,000 doctors on the medical register. We receive about 5,000 complaints each year from members of the public, hospitals, the police or other bodies. A third of these are immediately closed as they would never call a doctor's fitness to practise into question. A third are referred to local NHS procedures.

You make an interesting case for what you call 'truth and reconciliation meetings'; perhaps these local procedures would be the most appropriate context to handle the kind of mediation you are proposing?

We deal only with the most serious issues of conduct and performance - doctors who, for example, have repeatedly conducted inappropriate intimate examinations; have been convicted of serious criminal offences and who have worked well beyond the level of their competence and endangered their patients.

You refer to the language of the letters which we send to doctors about complaints. I also think it is time we took a fresh look and we will. When we send a letter to a doctor to close a complaint, it has to do certain things.

For example, it refers to the statutory test on which our procedures are based. We include this for the avoidance of any doubt on the part of those representing the doctor.

It is legal language which can make us seem remote. But the letter does also acknowledge that complaints are stressful and thanks the doctor for providing us with the information which we have asked for in order to reach a decision.

Could we do this better? Quite possibly. I will keep a close eye on the results of our current review. I am not complacent. As chairman, I believe the time has arrived to rebalance our engagement with the profession.

We shall continue to protect the public from the small number of doctors who let the profession down and we will continue to do so robustly; but we must not lose the medical profession in the process. We must find a way to engage effectively.

Equally, I believe that doctors cannot and will not be immune from changes in society and its expectations. My aim is to achieve a regulatory system which is of the highest quality, ensuring that we continue to have excellent doctors.

Let's do it in partnership.

Professor Peter Rubin, GMC chairman

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