Annual accountability hearing with the General Medical Council - Health Committee Contents

4 Voluntary erasure

55.  Voluntary Erasure (VE) is the process through which doctors can apply to have their names voluntarily deleted from the medical register. Doctors can apply for VE at any stage during a fitness to practise hearing, and applications are referred to a panel of one doctor and one lay examiner for consideration.[59] The GMC's own guidance states that:

Decision-makers should not generally consider any application for voluntary erasure until the investigation has concluded and all of the evidence has been gathered in relation to the allegations. Decision-makers should be satisfied that it is right in all the circumstances to agree to voluntary erasure (and not to proceed with the inquiry proper) before any application is granted. 'All the circumstances' can be divided into three categories: the public interest, the private interest of the complainant and the private interest of the doctor.[60]

In most of the 2898 cases in which it was sought in the past year, VE was uncontroversial. We have heard of several cases where it has been controversial and may have damaged the public perception of the GMC.

56.  The case of Owen Gilmore has been widely reported in the press.[61] Mr Gilmore was working in private practice where he was alleged to have administered inappropriate treatments and of removing breast tissue for which there was no clinical indication. He was also accused of financial misconduct. It has been alleged that the GMC took three years to schedule an investigation and when VE was applied for in November 2010 it then gave the relevant insurer 24 hours notice of Mr Gilmore's application for VE, which was then granted. In its public response to this case the GMC stated:

Our primary role is to ensure that those doctors on the medical register are fit to practise: however, in dealing with concerns our process must be fair to the doctor concerned."[62]

57.  In oral evidence to the Committee the GMC told us:

In Dr Gilmore's case, the Case Examiners decided to accept an application for voluntary erasure based on his ill-health shortly before the hearing was due to open. The cases illustrate the often very complex legal hurdles that can arise in a process of prosecution of detailed factual charges and lengthy evidence before a quasi-judicial tribunal. Acceptance by the GMC of a doctor's application for erasure can achieve a quicker guaranteed outcome efficiently without the need to overcome such hurdles, and without the risk that the eventual outcome is less than erasure.[63]

58.  The GMC has been clear that VE is not a form of redress, but rather is another means of ensuring public protection:

We say that the purpose is to protect the public, not to provide some form of redress for patients. That is not to underplay the importance, as you say, of closure—it is a fine balancing act—but we think that where the doctor agrees to take an outcome which would fundamentally protect future patients, we should take that as long as there is a public audit trail of what the concerns were.[64]

59.  However, the Committee also notes the submission from the Patients Association which relates to a GMC panel decision to decline the voluntary erasure of a doctor involved in the Baby P case:

After rejecting the request for voluntary erasure by Dr Al-Zayyat, the doctor in the Baby P case, the FTP panel chair Ralph Bergmann said: "The panel considers that to accede to the application for voluntary erasure would avoid a public, and necessary, examination of the facts."[65]

60.  Although the Committee accepts that voluntary erasure from the medical register can be used to prevent further malpractice by that registrant, an interim order can also be used to prevent a registrant from practising to protect the public whilst a case is under investigation.

61.  Several cases have been brought to the attention of the Committee of doctors applying to remove themselves from the register during an ongoing investigation into their practice by the GMC (so called voluntary erasure). The Committee has no objection to the principle of voluntary erasure as it can be a useful tool to protect the public. However, in some cases, interested parties have been given little or no time to raise an objection to applications for voluntary erasure, and the GMC was not able to offer a clear explanation of this.

62.  Applications for voluntary erasure must not be granted by the GMC unless interested parties have been given adequate notice of an application and have been offered an opportunity to voice an opinion on the matter.

63.   The GMC is proposing that VE can be adapted. The GMC currently informs other regulators of its VE decisions, without a full explanation of the circumstances.[66] It also informs other regulators:

[…] where we know that the doctor is leaving the country. If the doctor were going to another country, we would tell the regulator that the doctor has taken voluntary erasure in the very specific circumstances we have decided to agree to that when there were still concerns about his practice.[67]

The GMC is seeking the power to publish the circumstances surrounding its VE decisions.[68] When asked by the Committee if this would amount to a "guilty plea", the GMC responded that it would.[69]

64.  The Committee fully supports the publication of the facts of any case of voluntary erasure where there is a fitness to practise allegation about the doctor concerned. The GMC needs to ensure that turning voluntary erasure into an admission of guilt does not have a perverse impact in reducing the numbers seeking it and therefore erode public protection.

59   "Voluntary Erasure guidance", GMC website, 2011, Back

60   Ibid.  Back

61   "Insurers object to surgeon avoiding hearing", Financial Times, 1 November 2010 Back

62   Ibid. Back

63   Ev 25 Back

64   Q 49 Back

65   Ev 39 Back

66   Q 50 Back

67   Q 52 Back

68   Q 50 Back

69   Q 51  Back

previous page contents next page

© Parliamentary copyright 2011
Prepared 26 July 2011