11. Memorandum submitted by
the General Medical Council
THE ROLE
OF THE
GENERAL MEDICAL
COUNCIL (GMC)
1. The GMC welcomes the opportunity to assist
the Home Affairs Select Committee in its inquiry into Immigration
Control. This submission provides information on the following:
(a) Our statutory role as the regulator for medical
practitioners registered in the United Kingdom.
(b) Our statutory role in registering all international
medical graduates wishing to practise medicine in the UK.
(c) Information on our statutory role in education
and training for medical students.
(d) An outline of our Fitness to Practise procedures,
which govern the way in which we deal with doctors whose fitness
to practise is in doubt (these procedures would cover any instance
where a doctor had been convicted of a criminal offence).
2. The GMC's role in the regulation of doctors
is defined in our statutory and charitable purposes: to protect,
promote and maintain the health and safety of the public by ensuring
proper standards in the practice of medicine. The law gives us
four main functions under the Medical Act 1983 (hereafter
referred to as "the Act"):
(a) Keeping up-to-date registers of qualified
doctors.
(b) Fostering good medical practice.
(c) Promoting high standards of medical education.
(d) Dealing firmly and fairly with doctors whose
fitness to practise is in doubt.
REGISTRATION OF
INTERNATIONAL MEDICAL
GRADUATES (IMGS)
3. All IMGs (non UK, non EEA doctors), applying
for registration with the GMC must demonstrate their medical knowledge
and skills. They can do this in a number of different ways. The
most common method (presented by about 70% of IMG applicants)
is a pass obtained in the Professional Linguistic and Assessment
Board (PLAB) test.
4. Before being granted registration IMGs
must provide evidence of good standing (this consists of a character
declaration and a certificate of good standing from the appropriate
medical regulatory authorities).
5. IMGs satisfying the GMC's application
requirements, are granted limited registration which will allow
them to practise medicine under supervision within the NHS (see
below).
6. Doctors wishing to take the PLAB test
can attain all relevant information through our website. The purpose
of the PLAB test is to ensure that international medical graduates
have the knowledge and skill necessary to practise medicine in
the UK as required under Section 22 of the Act.
(a) The PLAB test is in two parts: Part 1 (which
is a paper-based test of knowledge) can be taken in the UK but
is also available at 17 centres in 13 countries worldwide, which
are facilitated by the British Council. These countries are: Australia,
Bulgaria, Egypt, India, Iran, New Zealand, Nigeria, Pakistan,
Russia, South Africa, Sri Lanka, the West Indies and the United
Arab Emirates.
(b) If candidates pass Part 1 they must come
to take Part 2 of the test (which is a practical test of clinical
and communication skills) at the Clinical Assessment Centre in
our London offices.
7. The Sunday Times", "Doctors
in "cash for visas" scam' (11 September 2005), to
which the Committee refers, claims that it is a requirement to
have some form of sponsorship letter in order to take the PLAB
test. This is not the case.
(a) The number of candidates taking the PLAB
test is outlined in the table below:
PLAB Test: Numbers of candidates taking
the test and pass rates for 2000-05
|
| Part 1: No of candidates | Part 1: Pass Rate
| Part 2: No of candidates
| Part 2: Pass Rate |
|
| 2005 | | |
|
| 9,117 | 62%
| 8,569 | 77%
|
| 2004 | | |
|
| 12,588 | 64%
| 8,214 | 78%
|
| 2003 | | |
|
| 12,513 | 62%
| 6,580 | 79%
|
| 2002 | | |
|
| 8,306 | 61%
| 3,741 | 79%
|
| 2001 | | |
|
| 4,682 | 60%
| 2,031 | 88%
|
| 2000 | | |
|
| 3,440 | 43%
| 1,349 | 83%
|
|
8. Some doctors, who have advanced some way in their
chosen speciality, can be sponsored by a UK Medical Royal College,
a Faculty or a small number of postgraduate institutions (which
have been approved for the purpose by the GMC).
9. In 2006 the law will change and IMGs will be granted
full registration, as limited registration will be abolished.
They will not be required to have an offer of employment before
being granted full registration. This change is intended to remove
discrimination against IMGs by having a single form of registration
for all doctors registered with the GMC. All new registrants will
still be required to carry out a period of supervised employment.
EDUCATION AND
TRAINING
10. The GMC's role does not extend to regulating or quality
assurance of any courses designed to assist candidates wishing
to take the PLAB test.
11. We do, however, have a statutory power, under Section
4 of the Act to inspect the medical schools and other bodies entitled
to issue UK primary medical qualifications.
12. International students can apply for undergraduate
medical courses that lead to provisional registration. The Department
of Health has agreed that each medical school in England will
be able to recruit 7.5% of their total intake from overseas. As
a result the 2005-06 intake target for England has been increased
from 272 to 456.
IDENTITY CHECKS
13. The GMC checks the identity documentation (normally
a passport) for all doctors before they are granted limited registration.
ABUSE OR
DISHONESTY OF
DOCTORS IN
ASSISTING ILLEGAL
ENTRY TO
THE UNITED
KINGDOM
14. The GMC issues guidance to all registered doctors
on professional values and best practice. The core document is
Good Medical Practice, a copy of which is made available
to all doctors registering with the GMC. The guidance describes
the principles of good medical practice and the standards of competence,
care and conduct expected of doctors in all aspects of their work.
Serious or persistent failures to meet those standards may result
in referral to a Fitness to Practise Panel which has powers to
restrict or remove a doctor's registration.
15. The GMC has broad categories for the types of cases
considered at Fitness to Practise Panels. In 2005 there were some
30 cases involving dishonesty. These included cases where doctors
had perverted the course of justice, been involved in prescription
fraud, financial fraud, made false claims to qualifications and/or
experience or date of birth, provided misleading references and
took part in research fraud. Police forces have a requirement
to notify the GMC of any criminal conviction involving a registered
medical practitioner.
16. Providing false references to visa applicants is
a criminal offence and the GMC would expect police forces to notify
us of any medical practitioner convicted as such. We do not, however,
have a specific category for this type of offence.
17. In seeking evidence from the GMC, the Committee has
referred to an article in The Sunday Times, "Doctors
in `cash for visas' scam" (11 September 2005). Where there
is evidence of dishonesty, and it is brought to our attention,
we have a clear duty to investigate and we are looking into specifics
of the issues raised by this particular article.
Hugh Simpson
Head of Public Affairs
10 February 2006
| 
