Edward Davies: Something fishy at the GMC…

Edward DaviesDo you ever feel like somebody is softening you up for some bad news?

When I was 18, I was caught speeding in my dad’s car. I’m not proud of it but there was a 19 year old girl in the passenger seat so I hope you understand. Wondering how to broach the subject of needing to take my father’s car registration to a local police station, when I got home I told my mother I’d been in an accident: my companion and I had escaped with minor injuries but the car was a write-off. When, after 30 seconds of gasping and fussing, I revealed the true story – she was so relieved that she barely blinked at the real news.

The two lessons I learnt from this are as follows:
1) Girls actually aren’t that impressed by speeding fines.
2) If you are going to break some bad news, pre-empt it with something worse.

And so to the GMC.

A few weeks ago I picked up a copy of The Times which ran a huge story on the front page about misbehaving doctors. I expected a massive scandal, a Shipman, a Mid Staffs, a Mike Tindall in a dwarf-throwing bar with a leggy blonde. What I got was a lone case of a doctor, not struck off by a fitness to practise panel (despite a GMC recommendation that he should be) and instruction to turn to pages 2 to 56 for the harrowing accounts of his victims. Which struck me as odd.

Now don’t get me wrong. There is too much malpractice that goes unnoticed and I can’t imagine the horror of being one of those patients at the business end. But is the disputed sentencing of one underperforming doctor really a front page (and several other pages) story for The Times?

Apparently so. And a couple of weeks later another suddenly appeared. The story of Gideon Lauffer: a surgeon who the GMC recommended be struck off but who was eventually suspended for six months. I was reminded of this case again this morning when the Guardian ran a story from a couple of lawyers which looked at how fitness to practise panels work, using Lauffer as its peg. The story began “The GMC’s fitness to practise panels have been under fire recently.” And by golly they’re right.

There seems to be a lot of bad news stories about the sentencing decisions of fitness to practise panels at the moment. And I can’t understand why The Times, Mail, Guardian and others are suddenly so focussed on this when there were 40 cases last year alone where the panel did not take the recommendation of the GMC. It’s complicated and not uncommon.

Which takes me back to my original question – are we being softened up for something?

The GMC’s response to these stories has not been one of shock or outrage but “What can we do? Our hands are tied.”

Here’s one option for what they could do. They could make a case for untying their hands. They could have a consultation in which they suggest an alternative to fitness to practise panels and the possibility of  giving the GMC the right to appeal decisions, something currently done, but not very often, by the Council for Regulatory Healthcare Excellence (CHRE, formally known as CRHP, can’t imagine why that acronym didn’t work out). You could run it for a few months, collate responses, and then, just to make sure you get the result you want without professional dissent, you could put out a few horror stories about the current system and fitness to practise panels so that the world buys your side of the story.

But……. why look-ee here!?! It turns out the GMC did run a consultation earlier this year! And we are waiting for the results! And it did suggest “the establishment of the Medical Practitioners Tribunal Service (MPTS) to oversee the adjudication function” and “a right of appeal for the GMC against tribunal decisions!”

Now there’s a coincidence!

I have no evidence for my assertions and have not spoken to the GMC at all. I just wonder if we’re being softened up for the GMC to gain new powers. Or maybe they’ve got a speeding fine to explain.

Edward Davies is editor, BMJ Careers