Regulation: GMC should be given powers to reduce number of GP investigations

Doctors are bearing the brunt of an outdated and inflexible system of professional regulation, which needs to change, says Dr Catherine Wills from the MDU.

Too many GPs have to undergo the stress and anxiety caused by GMC investigations because of an inefficient and unbalanced regulatory system. Between 2012-16, 17% of GPs on the register received a complaint and 5.3% underwent an investigation, but only 0.7% of GPs received a sanction or warning.

In one recent case, an MDU GP member underwent a police and GMC investigation and had to work under conditions. The GMC investigation was eventually closed with the doctor being given advice only, but the doctor faced stress and uncertainty about his future career. The doctor told us: 'While the investigations were ongoing I couldn’t eat or sleep properly, I wondered what would happen to the rest of my life. It felt extremely hopeless.' 

The GMC agrees with us that the proportion of doctors who are formally investigated is far too high when compared with those who receive a warning or other sanctions. While it has taken steps to make its triage and early investigation processes more responsive and quicker, further improvements are needed. The problem is that the regulator isn’t able to easily make the changes needed under the current rules.

But there is an opportunity on the horizon to give the GMC and other healthcare regulators the powers needed to put in place more proportionate, responsive and quicker procedures.

DHSC consultation on regulation

The DHSC consultation 'Promoting professionalism, reforming regulation', which closed last week, provides an opportunity to modernise the system of regulation. The MDU has responded robustly supporting the GMC’s call for it to be freed from outdated law that stops reform and modernisation.

While the regulators can’t influence the number of complaints they receive, they can do a lot to investigate cases more swiftly and fairly. The GMC should have the ability to reduce the number of unnecessary, stressful and costly fitness to practise investigations.

It should also be able to reform and improve its application process for specialists and GPs so that it still protects the public but makes decisions more efficiently, is less burdensome for doctors and allows them to join the NHS workforce far more quickly.

There should be safeguards to ensure regulators use any new powers appropriately and that registrants are treated in a fair and transparent manner, but it is possible to achieve this by incorporating such requirements into the new legal structure.

Another way to make the regulation more efficient and reduce costs to remove the right of the Professional Standards Authority (PSA) to appeal fitness to practise decisions. The PSA is funded by a levy on regulators which means doctors pay for it indirectly through their GMC annual retention fee. As the GMC is already able to appeal MPTS tribunal decisions, which it has done on a number of occasions, there is no need for PSA to retain similar powers. The PSA should lose the power of appeal as there is no evidence it improves public protection and doctors shouldn’t have to fund it indirectly.

It is in all doctors’ interests that the system is changed, and soon, to achieve a fairer balance between public protection and the regulation of doctors. Successive governments have talked about regulatory reform for far too long and GPs and others bear the brunt of outdated and inflexible processes. The MDU believes action is needed now to reduce the time, stress and cost of regulatory procedures.

  • Dr Catherine Wills is deputy head of advisory at the MDU

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