Supplementary memorandum by the General Medical Council (ACI 167)
INTRODUCTION
1. Further to the oral evidence given by Professor Hilary Thomas and Miss Isabel Nisbet on 1 July 1999, we have been invited to submit a memorandum to the Health Committee containing further information on a number of the matters raised.
DISCUSSION
Referrals to the GMC by HM Coroner
2. The Committee asked whether there would be any verdicts at an inquest which would automatically result in a referral to the GMC (page 12 of the transcript).
3. We would expect to be notified of any case where the coroner was concerned, as a result of information disclosed during the inquest, about the fitness to practise of any doctor involved in the deceased person's care. However, there are no specific verdicts which we would expect would invariably trigger a referral, and we have not issued specific guidance to coroners.
Referrals to the GMC from medical defence organisations
4. The Committee asked if the GMC ever receives referrals from medical defence organisations (page 26 of the transcript).
5. As Miss Nisbet told the Committee, doctors regularly bring concerns about colleagues to our attention following advice from their defence organisation that it was their professional responsibility to do so. However, we have not identified any cases which were referred directly to us by a defence organisation.
Liaison between the GMC and medical registration bodies overseas
6. The Committee asked about arrangements for the GMC to notify other regulatory authorities about fitness to practise decisions involving doctors registered with the GMC, and vice versa (pages 17 to 19 of the transcript).
7. The list of those whom we notify in this way of decisions by the GMC is attached as Annex A. Notification is by way of a monthly circular.
8. In turn, we have reciprocal arrangements with many, but not all, of the regulatory authorities listed at Annex A. Some of the authorities who currently do not provide us with information have told us that they are prevented from doing so by their country's data protection legislation.
9. The GMC requires applicants for registration from the European Economic Area to produce evidence of good standing from their member state of origin.
Profile of fitness to practise caseload
10. The Committee asked for a breakdown of cases between the fitness to practise procedures (page 36 of the transcript).
11. In 1998, we received 3,066 complaints involving 2,863 doctors (a number of doctors were the subject of more than one complaint). Many of these complaints have not yet reached a final outcome, and for that reason it may be more meaningful for the Committee to have details of action taken under our fitness to practise procedures in 1998 (bearing in mind that some of the complaints involved would have been received in 1997 or earlier).
12. In 1998, we took action, following initial screening, against the following numbers of doctors under our fitness to practise procedures:
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Conduct
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Health
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Performance
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262
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171
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11
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13. On past experience we would expect that about 15 per cent of complaints made to us in any year will lead to action under our fitness to practise procedures. In the remaining 85 per cent of cases where no action can be taken, we provide complainants with appropriate information which may be of help to them in pursuing the matter elsewhere, for example, through the NHS complaints procedures or the Health Service Commissioner. These cases would be classified as "conduct" because, as Miss Nisbet explained, that is the default category.
Annex A
OVERSEAS REGISTRATION BODIES WHO ARE ADVISED OF DECISIONS AFFECTING DOCTORS' REGISTRATION
Medical Practitioners Board of Victoria
Medical Board of South Australia
New South Wales Medical Board
The Medical Board of Western Australia
The Medical Council of Tasmania
The Medical Board of the Australian Capital Territory
Australian Medical Council
Medical Board of the Northern Territory
The Medical Board of New Zealand
College of Physicians and Surgeons of Ontario
The College of Physicians and Surgeons of British Columbia
The Newfoundland Medical Board
The College of Physicians and Surgeons of Quebec
The College of Physicians and Surgeons of Saskatchewan
The South African Medical and Dental Council
The Medical Council of Hong Kong
The Registrar of Medical Practitioners of the State of Malaysia
Singapore Medical Council
The Federation of State Medical Boards of the United States
Bahamas Medical Council
Belize Medical Council
Ministry of Education, Health, Youth Affairs and Sports, Dominica
The Medical Registrar, Grenada
Medical Board of Guyana
Medical Council of Jamaica
The Medical Boards, St Kitts & Nevis
Medical Council, St Lucia
Ministry of Health and Community Development, St Vincent
Medical Board of Trinidad and Tobago
Le Conseil Superieur de L-Ordre des Medicins, Belgium
National Board of Health, Denmark
Patients Complaints Board, Denmark
Le Conseil National de l'Ordre des Medicins, France
Arbeitsgemeinschaft de Westdeutschen Arztekammer, Germany
Hellenic Medical Association, Greece
Federazione Nazionale, Italy
Ministere de la Sante, Luxembourg
Ministerie van Volksgezondheid, Netherlands
St Bernards Hospital, Gibraltar
Medical Council of Tanzania
Consejo General de Colegios Medicos, Spain
Royal Dutch Society for the Advancement of Medicine
Osterrei chische Arztekammer, Austria
National Board of Medicolegal Affairs, Finland
Socialstyrelsen, Sweden
Ministry of Health and Social Security, Iceland
Directorate of Health of Norway
Ordem Dos Medicos, Seccao Regional do Sul, Portugal
Ordem Dos Medicos, Conselho Regional do Centro, Portugal
Ordem Dos Medicos, Conselho Regional do Norte, Portugal
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