AXA PPP healthcare: malpractice cases must be heard in public

Doctors facing charges of serious professional misconduct should continue to undergo public scrutiny rather than participating in a new ‘behind closed doors’ approach proposed by their regulator, according to AXA PPP healthcare.

Currently, doctors under investigation following a complaint face a fitness for practice hearing if safeguards to protect the public cannot be agreed with the doctor in question. This is usually conducted in public. However, the General Medical Council (GMC) is concerned that this results in stress and anxiety for both doctors and witnesses. For example, allegations which may prove false are often widely published in the media. It has proposed in a consultation that closed yesterday that cases should not be referred for a public hearing “if we can deliver fast and effective public protection without the need for one”. For example, if a doctor is willing to be removed from the GMC register they should be able to do so without then proceeding to a public hearing.

Previous examples of doctors opting for voluntary erasure from the register have been heavily criticised. In November Owen Gilmore, a consultant breast surgeon, was permitted to retire without a hearing after being accused of several very serious examples of misconduct, including performing unnecessary operations.

Complaints about doctors have risen by 35% in the past three years, reaching 7,022 in 2010 and the GMC believes that a new approach is required to cut costs and make it clear that their role is to protect the public rather than punish doctors. The consultation suggests that there can be a “mismatch” between the expectations of complainants, who feel a doctor should be punished for past actions and the GMC’s role to protect the public from future misconduct. It argues that complainants can seek redress through the NHS complaints procedure and the courts.

Dr Simon Peck, head of investigations and medical advice at Axa PPP healthcare, who led the investigation into Owen Gilmore’s actions and was “appalled” by the GMC’s decision in this case, said he was concerned about the proposals to allow doctors to escape a public hearing.

"I agree that GMC proceedings are very stressful and minor matters could be dealt with in a fast-track process," he said. "But I would be deeply concerned if serious matters were not examined publicly by some means or other. Malpractice does not invariably occur in isolation, and, whilst all hospitals should have in place statutory systems for clinical and corporate governance, the emergence of such cases is sometimes symptomatic of a wider failure of regulation and governance. We know that on occasions, hospital management have been less than forthcoming about these issues and the public examination of serious failings is one of the essential checks and balances in our system to ensure that patients are protected."

The GMC is now reviewing responses to its consultation.

 

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