Effective regulation of healthcare professionals underpins a safe and successful health system. In the UK, our model of regulating doctors is crying out for reform. For decades, outdated legislation has created complex and lengthy processes which fail those providing critical patient care. Despite repeated promises by successive Governments to modernise the current system, meaningful reform has been repeatedly kicked into the long grass. Now is the time for real reform – ambitious reform.
The Medical Defence Union (MDU) has long banged the drum on this issue because we witness the human impact of the system's failings day after day. Currently, too many doctors are subject to outdated fitness to practise (FtP) processes – which in many cases run on for years. Recent figures show FtP hearings take almost two years to process on average, with an astounding number of ‘cold cases' (180 at last count) open for more than three years. Behind every number is a doctor left in professional, and often personal, limbo while the process plays out.
Our members tell us that living with this uncertainty has a profound effect. While no strangers to high-pressure scenarios, they describe the FtP process as one of the most stressful experiences in their career, placing a huge toll on their health and wellbeing. While awaiting the outcome of the process, they face many unknowns as to the future of their vocation and financial security. Sanctions placed on doctors under investigation can limit their ability to work, placing an even greater strain on colleagues and healthcare services already under pressure.
It's fair to say no-one would design today's current system for regulating healthcare professionals. As the GMC's chief executive put it in a recent briefing to the House of Commons Health and Social Care Select Committee, the current legislative framework is ‘fragmented, inconsistent, poorly understood, cumbersome, and expensive.' Yet despite this widely held view, time and again over the past decade, Governments have promised new legislation, which has never materialised. The DHSC last consulted extensively on this in 2021. Five years on, we are still waiting for reform.
It's against this backdrop, that the MDU cautiously welcomes renewed Parliamentary focus on updating the governing legislation of the GMC. Detail is still light and we will be carefully scrutinising proposals as we respond to the upcoming consultation, but the direction of travel is promising.
The recent Select Committee hearing was an opportunity for the GMC to outline their plans. They say that they hope updated legislation will deliver more discretion over which FtP cases they take on; allow cases to conclude faster and prevent tribunals being required when both sides agree on an outcome – reducing the adversarial nature of the process.
The MDU particularly welcomes signals the GMC will be losing their right to appeal tribunal decisions in this new legislation. We've made the case for this for years and it's long overdue.
Drawn out processes, delays and proportionality around FtP cases are a major concern for the MDU, but there are a host of other issues that this updated legislation must tackle. Regulating an increasingly global workforce is complex and challenging, requiring effective collaboration with a range of overseas partners. For the GMC to manage this as safely and efficiently as possible, it needs a modernised legislative framework to operate from. It is not a silver bullet, but it has the potential to significantly improve the current situation if done right.
The Government, healthcare professionals and the regulator itself agree our healthcare professional regulatory system needs overhauling. This cannot be put off any longer. Ahead of us is the prospect of a more efficient system for registering medical professionals, investigating concerns and setting the standards for patient care. This is our opportunity to get the regulation of our doctors right.
The profession has been promised reform for years. They are tired of waiting and so are we.
