The fifth report of the Shipman Inquiry voiced concerns about the independence of adjudication by the General Medical Council (GMC) in Fitness to Practise (FTP) cases. Reviews were undertaken and reports published concerning the regulation of doctors and of other health professionals.

A programme of reform followed, with a move towards more independent adjudication on FTP matters planned. The Health and Social Care Act 2008 provided the legal framework for an independent body – the Office of the Health Professions Adjudicator (OHPA). The plan was that the OHPA would provide adjudication for the GMC and General Optical Council with other regulators to follow. The OHPA became a legal entity in January 2010 with hearings due to go live in April 2011.

As part of the current Government spending review further implementation of OHPA is being re-examined. At the time of publication of the fifth Shipman report the GMC had already made changes and further change has taken place since. The Department of Health has just published a consultation document Fitness to Practise Adjudication for Health Professionals: assessing different mechanisms for delivery, which sets out quite how far things have moved on.

The Government now says that the rationale for moving to adjudication on FTP matters through OHPA is less clear cut and say there may be the opportunity to realise substantially the same benefits without the additional cost to the public purse of proceeding with OHPA. Projected costs in the short term have escalated, though it is recognised that OHPA offered some future economies of scale.

The Department of Health is consulting on three options:  

  1. continue with OHPA as planned;  
  2. repeal the legislation establishing the OHPA, and legislate to make adjudication more independent and to modernise existing processes at the GMC; and  
  3. repeal the legislation establishing the OHPA and take no further action.

Option 2 is stated to be the preferred one. The consultation concludes on 11 October.