In an independent response to each of the CMO’s 44 recommendations in ‘Good Doctors Safer Patients’, Bolton GP Dr Krishna Korlipara, who has served on the GMC council for over 20 years, warned against treating ‘the vast majority of doctors like potential criminals’, ‘demoralising the medical profession’ and also ‘undermining the good doctor-patient relationship’.
He said that the principles that the CMO’s report are based on are good, but his conclusions from them are ‘flawed in many respects’.
‘His most controversial recommendation relates to the burden of proof lowered from a criminal standard of proof beyond reasonable doubt to a balance of probabilities,’ said Dr Korlipara.
‘This principle is enshrined in law both in the UK as well as throughout the EU. A threat to a doctor’s career is like the loss of liberty to an ordinary citizen.
‘No doctor should lose their registration or licence to practise based on allegations not proved beyond reasonable doubt. Doctors are entitled to the same principles of fairness afforded other citizens of society.’
He said the recommendation for ‘GMC affiliates’ in each PCT ‘carries with it a real risk of inconsistent decision-making within the same locality, as well as across the different regions’.
He added that if local doctors are selected to be the affiliates, there is a likelihood of conflict of interest with many locally known doctors.
He also heavily criticised plans for recertification and revalidation, saying that they will simply duplicate appraisals and test knowledge, but not actual performance.
However, his report is not universally opposed to the CMO’s recommendations and offers support on a number of issues.
Dr Korlipara agreed the GMC should become accountable to parliament and that an expert group is established to ‘examine the use of financial incentives to promote safer practice’.
He also agreed that adjudication in fitness-to-practise cases should be undertaken by a completely independent tribunal.
Although the GMC has no control on the panel’s decisions, currently there is a mechanism in place for the panel chairmen to be interviewed by the president.