On 11 June 2012, the Medical Practitioners Tribunal Service (MPTS) became the new adjudication body for doctors' fitness-to-practise proceedings. Whilst still being part of the GMC, it operates independently and is accountable to parliament.
Why the need for change?
In 2010, the government decided that the costs of setting up the Office of the Health Professionals Adjudicator were disproportionate to the benefits it would bring and asked the GMC for its proposals for ensuring independent adjudication of its fitness-to-practise proceedings. Following public consultation, the MPTS was created with the aim of providing a clear distinction between the GMC’s prosecution and adjudication functions. The creation of the MPTS is a key part of the GMC’s planned reforms and the largest change to its process since its creation in 1858.
One of the objectives for creating the MPTS is to strengthen professional and public confidence in the fitness-to-practise process. The GMC wants its process to be seen as fair and transparent and for unnecessary delays in dealing with cases to be avoided. The GMC is understood to be keen to introduce time and cost efficiencies for all parties involved in the process and it sees the introduction of the MPTS as one of the necessary requirements for the delivery of these objectives. The GMC hopes that its new approach will make its procedures more effective by reducing the length of hearings which is understood to have been increasing steadily over recent years.
How does MPTS work?
It continues to occupy the same address in Manchester. It has taken over the adjudication of all fitness-to-practise cases relating to doctors registered with the GMC.
The work of the MPTS is overseen by its committee, which is formed of the chair and two further members, one medical and one lay person, both of whom are drawn from a pool of experienced panellists.
The MPTS chairman is judge David Pearl who was appointed through an independent process. Judge Pearl has held several senior judicial roles prior to this, including the president of the Care Standards Tribunal and commissioner of the Judicial Appointments Commission. In this role as chairman, he will be responsible for appointing, training, appraising and mentoring adjudication panel members. He will report directly to parliament on an annual basis.
An MPTS panel is able, in the most serious of cases, to remove or suspend a doctor from the medical register or, for less serious cases, to put restrictions on a doctor’s practice. It also has the ability to take early action where it is deemed necessary for the safety of patients by either suspending doctor’s ability to practise pending the outcome of a full investigation or putting immediate conditions on their registration.
At a fitness-to-practise hearing before the MPTS, panel members will hear evidence from both the GMC and the doctor’s legal representatives. They will then make an impartial decision about whether, as a result of its findings a doctor’s fitness to practise is impaired and, if so, what restriction, if any, should be imposed upon a doctor’s ability to practice in the discharge of its public protection function.
Reaction to change
When the proposal to create the MPTS went to public consultation, it received strong support with only 6% of those responding believing that its introduction would make no practical difference.
The responses to the consultation also showed that almost three quarters of those consulted supported the MPTS being governed by a statutory committee as it was felt that this would increase confidence in the appearance of separation between the GMC’s fitness-to-practise prosecution and adjudication functions.
The responses also showed that people felt that it was more important that the committee governing the MPTS should contain both medical and lay representation. It was felt that a drawback of the previous adjudication model was that it was difficult for the GMC to provide leadership for adjudication panellists, given its involvement in the prosecution of fitness-to-practise cases. Administrative staff in the MPTS and investigating officers in the GMC’s fitness-to-practise directorate who investigate and prosecute cases will now be managed separately.
The majority of respondents to the consultation thought that a close working relationship between the GMC and the MPTS was necessary to ensure the smooth running of adjudication. However, 28% of people objected to the proposals for establishing close working relationships because they felt it could affect the independence of the MPTS.
Will it work?
It is too early to make any kind of informed observation on this and only time will tell whether the MPTS can and will deliver on its objectives. Accountability to parliament should provide some reassurance, going forward, that the creation of the MPTS is not merely a question of label and name change but will bring with it real benefits in terms of public perception in separation of powers and improved process, reduce costs and bring greater efficiency to the function of adjudication.
By Kevin Duce, an associate, Jane Williams, a senior solicitor, and Laura O'Donnell, a trainee solicitor, at national law firm Mills and Reeve.