GMC public confidence duty risks 'trial by media' for doctors

Doctors could face 'trial by media' because of a lack of clarity around the GMC's duty to maintain public confidence in the medical profession, the BMA has warned.

Responding to the GMC-commissioned review into gross negligence manslaughter, led by heart surgeon Dr Leslie Hamilton, the BMA warned that the regulator’s statutory duty to ‘promote and maintain public confidence in the medical profession’ could have an unfair impact on doctors facing investigation.

The BMA warning comes just days after judges overturned the controversial decision to strike off junior doctor Dr Hadiza Bawa-Garba. She had been removed from the medical register in January after the GMC appealed against a one-year suspension imposed by a medical tribunal - a sanction the regulator argued was insufficient to maintain public confidence in the profession.

The BMA has called for more clarity on how the regulator can balance public confidence alongside the maintenance of proper professional standards and conduct for doctors.

Its response to the review says: ‘We have previously expressed concern that the public confidence criterion could lead to "trial by media" and called for guidance that properly relates "public confidence" to the GMC’s overarching objective of public protection.’

Public confidence

The subjectivity of public confidence considerations is a particular concern, the BMA says, because it could lead to the same act being treated differently in different cases and more severe sentences for doctors.

This could ‘have consequences which are contrary to the public interest, such as encouraging defensive practice [and] discouraging remediation, candour and openness as the best means of promoting patient safety’, the BMA response argues. People could also be deterred from choosing careers in medicine.

The BMA said: ‘We would like to see research into the question of what members of the public would really expect in cases involving clinical error… We would also suggest that any use of the public confidence criterion should be with reference to the perceptions of a citizen who is well-informed about the issues raised by the case.’

Findings from the Hamilton review are expected to be available from the end of 2018.

The GMC is preparing its own response to the review, and did not wish to comment on individual submissions from other organisations.

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