Regulation

Until just a few years ago the GMC was the only regulatory body we had to worry about and they were in the past criticised, with some justification, for being perhaps too sympathetic to the unfortunate medical practitioners who came to their attention.

Step by step things have changed.

Firstly there are now more bodies that a doctor can fall foul of. NCAS, MHRA, CHRE, NHS counter fraud service and others can all make life difficult for doctors, as explained here, in addition to an increasingly belligerent attitude from Trusts as highlighted here.

Secondly the GMC has over the years become less and less sympathetic to doctors and is seen by many as biased against them. Doctors who feel they have been poorly treated by the GMC have no route of complaint. Complaints about the GMC can only be made to the GMC and the outcome is then predictable. The legal principle of “nemo debet esse iudex in propria causa”, meaning no one should be judge in his own cause is clearly ignored by the GMC. In fact the GMC often behaves as if the law is something that does not apply to them. This is well illustrated in this case. Dr P had brought legal action against the GMC for breaches of Data Protection and Human Rights legislation committed during an investigation. The GMC attempted to have the action struck out. The argument they made to the bemused judge was that they, the GMC had been deliberating for a number of years on how to incorporate the relevant legislation into their procedures, but that they had not yet come to conclusions, and therefore these laws did not apply to the GMC. The extraordinary effrontery, and unspeakable arrogance of this argument was dealt with in no uncertain terms by the judge and an out of court settlement followed soon after. It is a shame that the settlement was accepted by Dr P as the GMC were thus able to avoid the adverse publicity of being savaged in court for their attitude. I do not however wish to criticise Dr P. It takes a special kind of tenacity and resilience to tackle a body as powerful, overbearing and underhand as the GMC and Dr P can not be blamed for bringing things to an end.

The GMC can only be challenged in the high court, and they rely on the financial and emotional disincentives to this action to get away with highly questionable actions. If you google “GMC high court” what is apparent is that the GMC almost always lose on those occasions when they are challenged.

And this is a body that is gradually acquiring more and more powers. It is now two years since the burden of evidence used by the GMC to convict doctors was changed from the criminal standard where guilt has to be proven beyond reasonable doubt, to the civil standard of probability.

And soon we will have revalidation. We are going to have to prove that we are are competent, without any suggestion of misdemeanour or lacking performance. I predict that before long perfectly competent and amenable doctors will be finding themselves in difficulty simply because they have not been able to tick a few boxes.