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A compelling case for urgent GMC reform

Dr Matthew Lee, Medical Defence Union (MDU) chief executive, on the implications of the recent independent review of a GMC case.

MDU chief executive Dr Matthew Lee

'Referral to the GMC is hugely stressful and traumatic for any doctor irrespective of the outcome. They often feel trapped, humiliated and illtreated. Going through such an experience affects not only their physical and mental wellbeing but also their wider families.'

These are not my words, but those of the recently completed independent review by Professor Singh and Martin Forde KC into the GMC’s handling of a recent case.

It is the latest in a growing number of reviews that have investigated GMC fitness to practise procedures in recent years, following recommendations made by the Hamilton and Williams’ reviews. All point to the need for reform of the current system – something the GMC itself wants to see.

Urgent case for reform

Reform could, if carefully implemented, result in a more flexible, proportionate and hopefully compassionate system. A system that supports a struggling and bruised medical workforce rather than damaging it further is in the interests of doctors and patients. Reform is urgently needed and we are calling for the government to implement change without delay.

At the MDU, we see first-hand the enormous impact GMC investigations have on our members. Although, we robustly defend doctors and provide them with access to a peer support network, it is still painful to witness the toll placed on them, their families and colleagues when their professional integrity is dissected and scrutinised.

Among the many recommendations made in the report, all of which the GMC has accepted, are that the GMC should collaborate with other organisations to produce a local resolution first approach so that doctors are only referred for a full fitness to practise investigation when absolutely necessary. The review also recommends the GMC embeds a culture of professional curiosity among staff and considers whether its decision-making procedures are fair and unbiased.

Get represented

This is the latest in a number of high-profile cases in which doctors have been unfairly judged by regulators and the courts. It demonstrates why it’s so important for GPs to have membership of an organisation like the MDU.

Not only that, but all the evidence points to doctors who have legal representation at the GMC having better outcomes than those that don’t. Research carried out on behalf of the regulator and published in the journal BMC Medicine in 2019 found that doctors who lacked legal representation or did not attend their fitness to practise hearing received worse outcomes. The study covered all 1,049 doctors referred for Medical Practitioner Tribunal service (MPTS) hearings and receiving an outcome from June 2012 to May 2017.

The MDU’s own statistics show that in MPTS cases between 2016 and 2020, our solicitors representing members achieved no finding of impairment in 42% of cases compared to the GMC average of 21.5%.

A single clinical incident can lead to several different investigations. Not only by the GMC, but Coroner’s courts, NHS complaints, Ombudsman procedures, performers’ list investigations and even criminal cases. This is known as multiple jeopardy.

The MDU exists to defend members’ interests. No doctor should have to experience this ordeal without the expert legal representation, advice and support we provide.

MDU advice

As a learning organisation, we are studying the latest review to see whether there is even more we can do to support doctors. In the meantime, our advice to doctors facing a medico-legal investigation includes:

  • The earlier you involve your medical defence organisation the better.
  • Speak to your medical defence organisation before you respond to a complaint or adverse incident but write a statement to share with them while it’s fresh in your mind.
  • Medico-legal investigations are stressful. Get support from colleagues, your occupational health department or your GP, while respecting patient confidentiality.
  • When the dust settles, take time to reflect on what you have learnt and what you would do differently. This helps demonstrate insight and professionalism.


Run by doctors for doctors, the MDU has over 135 years' experience of successfully defending our members' professional reputations. Find out more about MDU membership at themdu.com

This article is funded by the MDU for GP Connect

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