Complaints and Litigation - Health Committee Contents


Written evidence from the General Medical Council (CAL 20)

INTRODUCTION

1.  The General Medical Council (GMC) is the independent regulator of doctors in the UK. The GMC protects, promotes and maintains the health and safety of the public by ensuring proper standards in the practice of medicine.

2.  We do this in four ways:

  1. (a)  By controlling entry to and maintaining the list of registered and licensed doctors.
  2. (b)  By setting standards for and co-ordinating all stages of medical education and training.
  3. (c)  By determining the principles and values that underpin Good Medical Practice.
  4. (d)  By dealing firmly and fairly with doctors whose fitness to practise is in doubt.

3.  The GMC is pleased to respond to this inquiry into Complaints and Litigation. We note that the inquiry addresses a number of issues that fall outside the GMC's remit. We would however like to clarify the role of the GMC as a regulator of the medical profession and our role in dealing with enquiries about doctor's fitness to practise. We have also submitted evidence detailing the rise in enquiries that we have received and the work that we have undertook to ensure that our procedures are more accessible and easier to understand.

THE ROLE OF THE GMC IN DEALING WITH COMPLAINTS

4.  One of the GMC's four main functions is to deal firmly and fairly with doctors whose fitness to practise is in doubt. The purpose of our fitness to practise procedures is to consider whether action needs to be taken to protect the public interest for the future, by removal or restriction of a doctor's right to practise. The purpose is not in order to punish doctors or to provide redress for complainants. Where appropriate, in cases that do not require GMC action on registration, we redirect the complaint or enquiry to the NHS or other healthcare provider.

5.  Listed below are examples of the types of cases where the GMC may need to act:

  1. (a)  serious or repeated mistakes in carrying out medical procedures or in diagnosis, such as prescribing drugs in a dangerous way;
  2. (b)  failure to examine a patient properly or to respond reasonably to a patient's needs;
  3. (c)  fraud or dishonesty;
  4. (d)  serious breaches of a patient's confidentiality; and
  5. (e)  any serious criminal offence.

INCREASE IN ENQUIRIES REGARDING A DOCTOR'S FITNESS TO PRACTISE

6.  Anyone can make a complaint to the GMC if they have a fitness to practice concern about a doctor. We categorise the sources of these complaints into "members of the public", "people acting in a public capacity" and "other enquiry sources".

7.  In 2009 the GMC received a total of 5,773 enquiries regarding a doctor's fitness to practise.

8.  The majority of enquiries regarding a doctor's fitness to practise come from members of public. This accounted for 3,689 enquiries of the 5,773 received in 2009 (64%).

9.  There has however been a notable increase in the proportion of enquiries referred to us by "persons acting in a public capacity" (an individual acting on behalf of a public organisation, most commonly health bodies or police forces). The number of enquiries received from persons acting in a public capacity has gone from 394 in 2006 to 1,030 in 2009, an increase of 160%.

10.  The GMC has also experienced a marked increase in the number of Stream 1 cases (enquiries which appear to require GMC investigation into potentially serious concerns). The number of cases that the GMC investigated as Stream 1 increased from 1,465 in 2008 to 1,758 in 2009 (an increase of 20%).

11.  The increase in Stream 1 cases in turn has resulted in an increase in the number and length of fitness to practise panel hearings. 270 Fitness to Practise Panel hearings took place in 2009 compared with 204 in 2008 - an increase of 32%. As a result, a total of 68 doctors were erased from the Medical Register at Fitness to Practise Panel in 2009, more than in the previous three years.

12.  The GMC is keen to understand what may be influencing this increase in enquiries, particularly the notable increase that we have experienced in enquiries coming from a "person acting in a public capacity". We have therefore commissioned a programme of research, which will include in-depth interviews and surveys among those responsible for referrals from public bodies. We expect this report to be finished by the end of Quarter 1 in 2011 and the GMC would be very happy to present this information to the Health Select Committee once it is published.

MAKING THE GMC'S PROCEDURES AS ACCESSIBLE AS POSSIBLE

13.  We understand that it can be stressful for patients and members of the public who feel they have cause to complain about a doctor. The process of making a complaint can however be easier and less stressful if the complaints procedure is easy to understand and that patients complain to the right organisation the first time around.

14.  The GMC has therefore developed our services to help patients, the public and organisations that employ doctors to know how and when to make a complaint. We provide a helpline service that ensures that potential complainants can discuss their concerns directly with us. Through our publications and our website we provide extensive information for those who wish to raise concerns about a doctor.

15.  "How to complain about a doctor", a publication aimed at patients, includes information about the areas in which the GMC handles complaints, and when complaints are more appropriately dealt with at a local level and by other organisations. We have published separate versions of this publication for each of the four UK countries to take account of differences in local complaints systems. A Welsh language version is also available, and we have produced a consolidated version in Arabic, Bengali, Chinese, Gujarati, Hindi, Punjabi and Urdu. We have also published an Easy Read version.

16.  In 2008 we launched Patient's Help, an interactive online information resource aimed at educating the public and advice organisations. It shows the public how and where to lodge a complaint about a doctor and includes an interactive map for local advice centres across the UK. Patients' Help provides case studies of typical complaints; an overview of the complaints process and what patients can expect if they make a complaint; and information on where they can go for more advice. Where a concern is outside our remit, the website signposts the reader to other complaints procedures.

17.  We have also aimed to make the process of filling in the complaint easier; complainants now have the option of completing either an online or a hard copy complaint form.

18.  We are in the process of developing regional services to improve our understanding of and relationships with regional healthcare arrangements. We are extending the local liaison model we currently have in Scotland, Wales and Northern Ireland to every region in England. The aim is to enhance relationships with our key interests and will enable us to work more closely with patient groups to explain our role, how and when to complain to us and to better understand local issues.

19.  As part of this work we are developing an employer liaison service to enhance our relationship with the employers of doctors and, in particular, medical directors and responsible officers. We will be recruiting a team of employer liaison advisers, who will be fitness to practise experts, to work closely with medical directors in each region in England and in Scotland, Wales and Northern Ireland to share information about concerns about doctors and to improve the speed and quality of decision making. A key role of employer liaison advisers will be to work with medical directors to improve understanding of our threshold for when a case should be referred to the GMC rather than dealt with locally.

20.  The GMC is committed to ensuring our complaints procedure as accessible as possible. We believe that if people know how and when to make a complaint about a doctor's fitness to practice their complaints will be dealt with more quickly and effectively. Ultimately this will therefore help the GMC towards achieving our aim of protecting the public by ensuring proper standards in the practice of medicine.

December 2010



 
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