19 healthcare leaders urge Government to strip GMC of power to appeal fitness to practise decisions

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12 Jun 2023

A group of 19 healthcare organisations have united to urge the Government to deliver on its 2018 commitment to strip the General Medical Council (GMC) of its power to appeal Medical Practitioners Tribunal Service (MPTS) decisions before the end of this parliament, as an FOI request reveals the GMC has challenged 24 decisions since 2018.

It is now five years since the Government accepted in full the recommendations of the Williams review into gross negligence manslaughter in healthcare, following the case of Dr Bawa-Garba. This included the central recommendation that the GMC should have its right to appeal fitness to practise decisions removed, through removal of section 40A of the Medical Act 1983, to address the mistrust of the GMC and contribute to cultivating a culture of openness that is central to delivering improved patient safety.

The review said public protection would be maintained, with the Professional Standards Authority (PSA) retaining its near identical right of appeal to MPTS decisions.

In July 2022, the Government said it would progress legislation to remove the GMC’s power to appeal in 2023, alongside legislation that will bring physician associates (PAs) and anaesthesia associates (AA’s) into statutory regulation. However while the government has now consulted on draft legislation to bring these professions into regulation, it is unclear when the Government will progress with the removal of the GMC’s right of appeal. 

The letter to the Health Secretary calling for section 40A of the Medical Act 1983 to be removed before the end of this parliament, was signed by Medical Protection Society, British Medical Association, The Doctors’ Association UK, Royal College of General Practitioners, Royal College of Physicians, Royal College of Emergency Medicine, British Association of Physicians of Indian Origin, Association of Anaesthetists, Hospital Consultants and Specialists Association, Royal College of Anaesthetists, Medical Women’s Federation, Royal College of Surgeons of England, Royal College of Obstetricians and Gynaecologists, Royal College of Physicians of Edinburgh, British International Doctors Association, Royal College of Paediatrics and Child Health, Royal College of Physicians & Surgeons of Glasgow, Royal College of Surgeons of Edinburgh and Royal College of Pathologists.

Professor Dame Jane Dacre, President at the Medical Protection Society who coordinated the letter, commented:

This month marks five years since the Government first committed to removing the GMC’s power to appeal fitness to practise tribunal decisions. During that time the GMC has challenged 24 decisions. The delay is disappointing and frustrating and doctors will have this hanging over their heads until the relevant changes are made to the Medical Act.

The GMC’s power to appeal has generated distrust between the medical profession and the regulator and has contributed to a culture of fear. Fitness to practise proceedings are stressful and lengthy enough for those involved, without the additional worry that the GMC can seek to override the decision made by the MPTS if it does not agree. This is and has long been the PSA’s job.

The added concern now is that when PAs and AAs are brought into statutory regulation, the GMC will not be able to appeal panel decisions relating to their fitness to practise, but they may still be able to challenge decisions on doctors’ cases - parity is key.

19 leading healthcare organisations have signed this letter – the strength of feeling on this issue and the ongoing delays is clear. This important change must not fall behind.


Notes to editors

For further information contact pressoffice@medicalprotection.org 

Additional information:

  • Dr Bawa-Garba was erased from the medical register after the GMC appealed against a tribunal ruling that suspended her for 12 months. She was later reinstated after judges found the original tribunal decision to be appropriate.
  • Professor Sir Norman William’s review into Gross Negligence Manslaughter in healthcare, following the Dr Bawa-Garba case:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/717946/Williams_Report.pdf
  • The Government’s response to the review on 11 June 2018: https://questions-statements.parliament.uk/written-statements/detail/2018-06-11/HCWS751
  • The June 2019 Hamilton Review, agreed with the William’s review recommendation to remove the GMC’s right to appeal MPTS decisions: Independent-review-of-gross-negligence-manslaughter-and-culpable-homicide---final-report_pd-78716610 (1).htm
  • An MPS FOI request to the GMC showed that 24 appeals have been lodged from June 2018-present.
  • The Regulating healthcare professionals, protecting the public consultation (published 25 March 2021) set out a wide range of detailed proposals for legislative changes that would apply to all the regulators, including a recommitment to removing the GMC’s power to appeal. Page 58: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/973017/Regulating_healthcare_professionals__protecting_the_public.pdf
  • In July 2022 the DHSC set out a revised timetable for the implementation of regulatory reform for doctors, and its intention to first introduce AAs and PAs into statutory regulation in 2023. It confirmed its intention to remove the GMC’s right of appeal alongside this, in 2023.
  • In April 2021 a coalition of 13 leading healthcare organisations urged the Government to deliver on its 2018 commitment to strip the General Medical Council of its power to appeal decisions made by the MPTS. The then Health Secretary, Matt Hancock responded to say it was the intention that the draft legislation to introduce PAs and AAS into regulation, will also remove the GMC’s power to appeal decisions made by the MPTS. The PSA will retain its right to appeal a decision of a fitness to practise panel to the High Court on the grounds of insufficient public protection.


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