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.
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.
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.
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
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."
57. In oral evidence to the Committee the GMC
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.
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 closureit is
a fine balancing actbut 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.
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
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."
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.
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.
The GMC is seeking the power to publish the circumstances
surrounding its VE decisions.
When asked by the Committee if this would amount to a "guilty
plea", the GMC responded that it would.
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, www.gmc-uk.org Back
"Insurers object to surgeon avoiding hearing", Financial
Times, 1 November 2010 Back
Ev 25 Back
Q 49 Back
Ev 39 Back
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