The new Labour government is embarking in the first reform of the professional regulation of the General Medical Council for 40 years. This welcome development comes after the GMC extended its scope to cover physician and anaesthesia associates at the end of last year. In theory it will allow the GMC more flexibility to change its rules and allow less adversity among fitness to practice cases involving doctors thus avoiding referrals to the overloaded and often unfair employment tribunals. It also abolishes an arbitrary rule that prevents it looking at cases that are more than five years old.

From my observations of recent complaints against doctors who raise patient safety cases and conversations with doctors who are concerned about referrals to the GMC the whole process needs a radical overhaul. It is also an overhaul that requires some political intervention.

How the GMC handles individual complaints against doctors is by no means transparent. Nor is the GMC directly accountable for their failings and omissions and its workings can be manipulated by individual health trusts. I am about to give you two different examples,

Many doctors think the complaints system is flawed because of a practice of referring the case to the so called ” responsible officer ” to handle it. The responsible officer is often the person who has brought the complaint in the first place – the chief medical officer of the trust. Now the chief medical officer is not what the public might think – the ultimate person protecting medical standards on behalf of patients. He is part of the trust’s management team whose main purpose is to protect the reputation of the trust which may not be in the interest of patients. So surely this is a conflict of interest?

NHS Managers labelled one doctor ” too passionate about patient safety”

There was also an extraordinary experience of a whistle-blower who was a warned by local managers against being too “passionate about patient safety.”

And does the GMC do a thorough job when it investigates.? Doctors are sceptical. In one example it appears the complaints about serious safety issues, were closed at the first step and  not even seen by GMC clinician. The bald reply from the GMC confirmed that to be the case; neither the team had nor did they seek any advice or expert opinion.

The GMC’s current practices enable its staff without clinical knowledge to close clinical concerns in such manner or only with hospital managers’ response, even when the concerns about the said managers are known to the GMC. In one example it appears the complaint was not even seen by fellow clinicians.

Given the whole point, according to many of the doctors who have raised patient issues, is the worry that either patients have already been harmed or more are left  at risk of being harmed by such poor medical practice,  these do not appear to be safe concern closure processes for a regulatory body.

There is another side and here I can quote an actual case – as it came up in an employment tribunal – the removal of cardiologist Dr Usha Prasad from the then Epsom and St Helier NHS Trust ( now merged with St George’s Hospital in Tooting, south London.)

Here the GMC faced with 41 complaints from the trust who wanted her removed did do a thorough investigation and checked with very senior cardiologists and exonerated her -including revalidating her working for the next five years.

But the trust’s chief medical officer, Dr James Marsh , refused to accept this, making the fatuous statement that the trust’s medical standards were ” higher than the GMC’s “. This is also ironic as the doctors from that organisation are being revalidated by, no one else but the GMC.

Where a doctor is revaluated the rules should be changed so in those circumstances the GMC’s decision is binding and final and this requires a politician to intervene to make sure this happens. An individual chief medical officer should not have the power to wreck a doctor’s career if their complaint to the GMC is utterly rejected. and not formally appealed against.

I would be very interested to see if other doctors have had similar experiences in both these areas and doctors can contact me on my website  ie either concerns were dismissed without due consideration or the GMC decision was ignored by the managers.  All contact will be treated in confidence unless the doctor wishes to go public.

This is a once in a lifetime reform and we need to get it right for both the benefit of the doctors and the safety of patients who entrust their lives to the NHS.

Karen Smyth, the minister of state for health, has a huge list of responsibilities from this area to cancer care and hospital car parking. The list is here. She needs to focus on this and ask pertinent questions.