Dear Editors
“The GMC will always be called upon to make difficult decisions about a doctor’s fitness to practice. My commitment is that we will continue to do so with the same reflection and willingness to learn as the profession we regulate.” (ref 1)
This was not in response to Dr Manjula Arora’s case but Dr Bawa-Garba’s.
In this case, Mr Charlie Massey, the “head of the UK General Medical Council has acknowledged that the legal advice the regulator received during the Hadiza Bawa-Garba case was incorrect”.
To support this, the GMC was willing to supply the full document reflecting this said advice (ref 3).
In June 2022, the GMC stated in response to Dr Arora’s decision to appeal and the attending response by many doctors and medical organisations over her suspension:
“Having considered the tribunal’s decisions and sought the views of external counsel, we believe that the dishonesty test was applied incorrectly by the tribunal.” (ref 4)
The Singh and Forde review found that the GMC itself “incorrectly applied a legal test when considering the allegations against Arora” (ref 5,6) and some suggested that the dishonesty allegation “should not have been taken forward” (ref 5)
In 2018, Mr Massey wrote that the GMC has ” a pivotal role in making health services a place for learning, not blaming” (ref 1,7) in response to the Dr Bawa-Garba’s appeal.
The GMC have previously talked about commitment to improve their approach to case handling, but the Arora case and others (for example ref 8) do not confer confidence in the GMC upon the doctors it regulates.
There appears to be some trend of using “incorrect legal advice” in the GMC’s defense or explanation: in Bawa-Garba case it was the GMC’s legal advice whether to appeal the MPTS determination, whereas the Arora case it was the dishonesty test that was “applied incorrectly” by the MPTS.
SIngh and Forde in their review had to remind the GMC that they are the ones who applied this test incorrectly in their decision to refer her to the MPTS for this aspect of the matter.
Legal advice is precisely just that: advice only, and discretion and decision to follow as advised is ultimately with the GMC. If there is fault in this process, either they need better legal advice or the GMC need better people in discretion and decision making.
Neither Drs Bawa-Garba nor Arora had evidence of previous allegations similar to the ones they were sanctioned for, yet the GMC pursued them vigorously for what appears to be their first transgression.
Considering the GMC may have “form” on blame-shifting to legal advice, who should the GMC be referred to so that they can “learn” under an external authority?
Unfortunately I agree with the authors of this article, and we are lacking a defined oversight process by an authority with prescribed powers over the GMC.
References
1. https://www.rcpch.ac.uk/sites/default/files/2018-04/gmc_comment_piece_-_…
2. https://www.bmj.com/content/365/bmj.l4218
3. https://www.gmc-uk.org/news/news-archive/responding-to-the-case-of-dr-ba…
4. https://www.bmj.com/content/377/bmj.o1583
5. https://www.bmj.com/content/379/bmj.o2619
6. https://www.gmc-uk.org/-/media/documents/the-gmc-s-handling-of-the-case-…
7. https://blogs.bmj.com/bmj/2018/01/30/charlie-massey-we-are-committed-to-…
8. https://www.bmj.com/content/378/bmj.o1628
Walking the talk: who will provide the oversight upon the GMC if it continues in blame-shifting and unfulfilled commitment to improve