The General Medical Council (GMC) is consulting with regard to a fundamental change to the method of disposal of some Fitness to Practise (FTP) cases. The consultation document can be found here.

Following abolition of the Office for the Health Professions Adjudicator, which would have adjudicated in GMC FTP cases, the GMC intends to continue to modernise its hearings procedures.  

Most GMC FTP cases go to a full public hearing. Numbers of complaints and the cost and time involved have increased. The process is regarded by some as overly punitive to doctors, and is stressful for both doctors and witnesses.

The GMC emphasises that the purpose of FTP proceedings is public protection, maintenance of confidence in the medical profession and fairness. Its purpose is not, and never has been, redress, punishment or the allocation of blame.

In an FTP case where the doctor is willing to accept the proposed sanction, and there is no substantial dispute about the facts, is a hearing necessary? The GMC says that, where a doctor is willing to accept its proposed sanction, the case for a public hearing is hard to make. Consideration has been given to whether, in such a case, a hearing should be insisted on, on public policy grounds. The GMC has not identified any category of cases where such a public interest exists.  

The GMC acknowledges that public regulatory hearings contribute to the confidence of the public in professions, a long recognised consideration. As Lord Woolf said in the case of R v Legal Aid Board ex parte Kaim Todner:  

“… the reason it is so important not to forget why proceedings are required to be subjected to the full glare of a public hearing. It is necessary because the public nature of proceedings deters inappropriate behaviour on the part of the court. It also maintains the public's confidence in the administration of justice. It enables the public to know that justice is being administered impartially. It can result in evidence becoming available which would not become available if the proceedings were conducted behind closed doors or with one or more of the parties' or witnesses' identity concealed. It makes uninformed and inaccurate comment about the proceedings less likely.”  

It is clear from the consultation document that the GMC has this issue well in mind in pursuing this consultation and contributions are sought addressing aspects of the proposals which may meet these concerns.

Two other significant developments are also under consideration. Where a registrant has been convicted in a criminal court of certain serious offences such as murder or rape, it is proposed that there should be a presumption that the doctor should be erased. It is also proposed that there should be automatic suspension of a doctor who fails to cooperate with an FTP investigation.