Monday, 21 November 2011


I have been castigated after my last post for changing the subject. Apparently we “need to talk about the GMC just now” I make no apology. I have broader interests and would not like to be thought of as having only a single string to my bow.

Regular readers will know full well that I have no time for that collection of scum and villainy that calls itself the GMC. I would argue that we need to talk about the GMC, not just now, but constantly until something is done to bring them under some form of supervision  and control. 

I would also argue that at the moment we do not know if the GMC has done anything, on this occasion, that should concern us. Dr No has now confirmed that two doctors have been reported to the police and under paragraph 58 of the good practice guide that means the GMC must now be involved. What matters is not their involvement but their response. What I would expect of any fair regulator is that if the police feel there is no case to answer then there should automatically be no further action from the GMC.  I have previously published this communication from the GMC.

"In January 1999 the Standards Committee of the GMC met to consider issues involving the behaviour of doctors who comment in the media. It was their view that the GMC should not attempt to curtail doctors' rights to express their personal opinions. Doctors, like anyone else commenting in the media, are subject to the same constraints imposed by media regulatory bodies, and the libel laws. Furthermore, the committee considered that the professionals reputation depends principally on the standards of care and conduct provided by doctors to their patients, and not on personal opinions as put forward in published letters or articles. Whilst you may disagree with the comments Dr Y has made, we cannot take action against a doctor who is expressing a personal opinion".

If the GMC choose to respond contrary to their own policy then that would be cause for concern.  As yet there is no evidence that they have, or will.


  1. "Misconduct" Similar to the military concept of "conduct unbecoming an officer" a catch all used when they have nothing specific to charge you with.

  2. Forgot to respond to this. Opps.


    1.The meaning of SPM is listed in the Shipman Inquiry

    2. Further and more recent case law is listed by Regulatory Law here as applied to negligence The most useful case is Calhaem v GMC Essentially, one off errors are not enough to satisfy the test of misconduct.

    3. The worst part is that the GMC has flipped to civil standard. , Since the switch complaints have sky rocketed. The reasons are
    a. A lower standard to satisfy a capability of misconduct.
    b. No gatekeeper at Rule 4. Sadly, the GMC has always argued that the first person known as the registrar has no discretion to conduct inquiries before a full blown investigation. This means that according to the case R v GMC Ex Parte Pal, all that is required is a "capability" of misconduct. Hence, as argued by Collins J, the only test is whether the conduct goes to the integrity of the doctor.
    c. The most useful case linking a allegation to Fitness to practise is R v GMc Ex Parte Pal. Sadly, the GMC has two cases and can opt for either.
    d. Some years ago, a Committee meeting was held. It was decided against a definition of misconduct.
    e. If we look at Isobel Allen's study One of her criticisms was the lack of standards. To quote
    "One of the main problems identified is that there is no commonly understood working definition of 'serious professional misconduct', through which a doctor may be disciplined or struck off the register. This has undoubtedly led to a lack of clarity among GMC members and staff on the criteria, standards and threshold to be applied in reaching a judgment on cases at the different stages of the complaints procedures.

    The research also found marked differences in outcome between different GMC committees, and concluded that this lack of consistency was difficult to account for in the absence of clear reasons given for decisions. Much greater transparency had been introduced at the screening stage of the GMC procedures, but there were still inconsistencies which could not be explained"
    f. The last point I wanted to make is this, take up of a complaint, a copy of the complaint [ containing untested facts] is sent to all employers. This can never be deleted or removed. It remains on your file/revalidation and appraisal for good.
    g. In Medical Job Application forms, even if you are cleared, you have to declare a cleared application.
    h. I argued that [g] was prejudicial to doctors. Sadly, the judge did not believe that a admission of a cleared investigation could potentially be prejudicial.
    i. R v GMC Ex Parte Pal states that unless a case goes to hearing, it does not have to be declared on application forms. This is untrue. The word "investigation" as determined on application forms starts from the Registrar of the GMC. This principle is enshrined by R v SDA Ex Parte Toth. Two doctors have used R v GMC Ex Parte Pal to justify non disclosure, the GMC still prosecuted them for dishonesty. So, the safe option at present is just to declare. I am though working on changing this and I should have a decision at some point.

    Those fighting the GMC will require its investigation manual. There is a copy with Dr Z or at least a link to it.

    That is the executive summary of the current state at the GMC. There is no balance between doctors rights and complainants rights. Those accused of frivolous dishonesty will find the following useful

    1. GMC v Khan
    2. GMC v Shamsian

    [ I helped on both]

    Contrary to popular defence union belief, the best way to win at the GMC is to develop a robust defence from the outset before the case examiner.
    Both on here

    Good Luck.

    Rita Pal