This consultation sets out the GMC's proposals to increase confidence in the independence of decisions made by fitness to practise panels at hearings and to modernise the adjudication procedure. They set out a possible new governance structure to further separate adjudication from our other fitness to practise work as well as steps to streamline and speed up the hearing procedure and introduce greater efficiency.
Summary -
- The GMC is consulting on proposals for repositioning and modernising adjudication within the GMC following the Government’s decision not to proceed with the establishment of the Office of the Health Professionals Adjudicator (OHPA).
- Reform of adjudication remains a key aim of the GMC and until recently involved preparation to transfer its adjudication function to OHPA in April 2011; a recommendation of the previous Government’s 2007 White Paper, Trust, Assurance and Safety – the Regulation of Health Professionals in the 21st Century.
- Following consultation which ended in October 2010, the Government has confirmed that it intends to repeal legislative provisions relating to OHPA and, in separate legislation, take forward steps to enhance the independence of adjudication and modernise existing processes at the GMC.
- The Health and Social Care Act 2008 contains the provisions to establish OHPA. The Government has included provisions repealing this legislation in the current Health and Social Care Bill, which is expected to become law by the end of 2011.
- Meanwhile, the GMC believes it is time for it to consult on proposals for repositioning and modernising adjudication within the GMC. This will help the GMC to develop the proposals we set out in its response to the Government’s consultation last year (see Annex A).
- The consultation document is in two sections: the first considers proposals to reposition adjudication within the GMC and how this might be achieved; the second explores proposals for modernising our adjudication work.
COMMENTS ON
GENERAL MEDICAL COUNCIL
REFORM OF THE FITNESS TO PRACTISE
PROCEDURES AT THE GMC:
THE FUTURE OF ADJUDICATION AND THE ESTABLISHMENT
OF THE MEDICAL PRACTITIONERS TRIBUNAL SERVICE
The Royal College of Physicians of Edinburgh (the College) is pleased to respond to the General Medical Council’s consultation on the Future of Fitness to Practise Adjudication and the establishment of the Medical Practitioners Tribunal Service.
The College has the following answers and comments on specific consultation questions:
Question 1. Do you agree with our proposal to create a new tribunal service for fitness to practise adjudication?
Yes. The service proposed is reasonable and proportionate.
Question 2. Do you agree that the tribunal service governance should be vested in a new statutory committee? If not, please give reasons and any alternative suggestions.
Yes, with the proviso that all proceedings of the Committee are entirely transparent to ensure separation of the GMC’s investigation and adjudication work.
Question 3. Do you agree with the specific responsibilities of the tribunal service as set out in paragraph 55? If not, please give reasons and any alternative suggestions.
Yes.
Question 4. Do you have any views on what the new tribunal service should be called?
No.
Question 5. Do you agree with the proposed membership of the MPTS governance committee? If not, please give reasons and any alternative suggestions.
Yes. However, it is important that there is an appropriate mix of medical and lay members on this Committee. It is important to include the input of lay members to increase public confidence in the Committee.
Question 6. Do you agree with our ambitions to appoint the Chair and the other members of the MPTS through an open, transparent and independent recruitment process? If not, please give reasons and any alternative suggestions.
Yes.
Question 7. What skills, qualifications and experience do you think should be required for: (a) the Chair of the MPTS? (b) the other members of the MPTS governance committee?
- The Chair should be legally qualified and have a wide range of experience in this area.
- There should be an appropriate mix of medical members and lay members who can demonstrate experience using judgment. For example, a lay member might have been a Justice of the Peace or Magistrate.
Question 8. Do you agree that the proposed reporting arrangements for the MPTS are appropriate, if agreed by all necessary authorities? If not, please give reasons and any alternative suggestions.
Yes, however, clear guidance needs to be developed which outlines the action that, for example, Parliament or the proposed joint forum could take if they were not satisfied with the report provided by MPTS.
Question 9. Do you agree with our proposals for establishing close liaison between the GMC and the MPTS? If not, please give reasons and any alternative suggestions.
Yes, to an extent. There is a definite need for liaison, but there must be a clear demonstration of separation and independence. Minutes of any meetings must be published openly to allow scrutiny of the proceedings. The implementation of paragraph 71 might give extra assurance that arrangements are working effectively and transparently.
Question 10. Do you agree that, in principle, if feasible, the GMC should have a right of appeal against decisions of the MPTS on the same grounds as CHRE has? Please give reasons and any alternative suggestions
No comment.
Question 11. Do you agree that, where possible, Chairs should have a role in pre-hearing case management? If not, please give reasons and any alternative suggestions.
Yes. This would enable a faster case management process.
Question 12. Do you agree that there should be provision for case management hearings to deal with procedural or administrative matters, where Chairs are involved in the pre-hearing stage? If not, please give reasons and any alternative suggestions.
Yes.
Question 13. Do you agree that medical practitioner tribunals should have a power to exclude evidence which is sought to be introduced in breach of directions without good reason in order to encourage reasonable behaviour? If not, please give your reasons and any alternative suggestions.
No comment.
Question 14. Do you believe legally qualified chairs should be used in (a) certain cases? If so, do you have any views on what criteria should be applied in deciding whether to appoint a legally qualified chair? (b) in all cases? Please give reasons for your answer and any alternative suggestions.
There should be a legally qualified Chair in all cases, as it would be difficult to establish the criteria that would distinguish between cases that require a legally qualified Chair and those that do not.
Question 15. Do you agree with our proposals to introduce powers for sanctions imposed by a fitness to practice or interim orders panel to be extended, varied or revoked when both parties are in agreement without the need for a review hearing? If not, please give reasons and any alternative suggestions.
Yes.
Question 16. Do you think the power to extend, vary or revoke sanctions in these circumstances should be exercised by (a) the Registrar, or (b) the Chair of the panel which imposed the sanctions acting alone? If not, please give reasons and any alternative suggestions.
The Chair of the panel should make these decisions.
Question 17. Do you agree that, taking all factors into account, we should explore moving to a single hearing centre in Manchester? If not, please give reasons and set out alternative proposals indicating their (cost and other) advantages and disadvantages.
Yes, there appears to be a sound business case to move to a single centre in Manchester.
Question 18. Do you have any views on the suggestions made above to make the current hearing process more efficient?
No comment.
Question 19. Do you have any other suggestions for making the hearing process more efficient that we might explore?
The proposed changes are already extensive, and time is needed to develop new working practices around these before further changes are explored.
Question 20. Do you think that any of the proposals will further one or more of the following aims:
a. eliminating discrimination, harassment, victimization and any other conduct that is prohibited by or under the Equality Act 2010?
b. advancing equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it?
c. fostering good relations between persons who share a relevant protected characteristic and persons who do not share it?
If yes, could the proposals be changed so that they are more effective in furthering those aims?
If not, please explain what effect you think the proposals would have and whether you think the proposals could be changed so that they do further those aims?
No comment.
Question 21. Do you think these proposals will impact on the confidence in our procedures of any particular groups of people? If so, which groups and why?
No comment.