Introduction

The previous chapter provided a critical introduction into the development, implementation and evaluation of medical revalidation as a system of governance designed to ensure that practitioners remain up to date and fit to practise in their chosen specialty. In this chapter, we look more closely at the processes in place for when a complaint is made against a doctor and their fitness to practise is called into question.

As already noted, the medical register of approved practitioners is overseen by the GMC under the aegis of the Medical Act 1983. The GMC is, therefore, the statutory body responsible for responding to complaints about the fitness to practise of doctors and has the authority to remove them from the register by instigating disciplinary proceedings via a fitness to practise panel (FPP). In 2014, the Law Commission’s comprehensive review of healthcare professionals (2014a) noted that medical FPPs are a vitally important legal mechanism for ensuring that public trust in medical regulation is maintained when complaints are made about a doctor and, as a result, it has acted to strengthen the investigatory and adjudication process, by legislating to ensure that the panels are independent, autonomous structures of the GMC.

Official figures show that when revalidation was implemented nationally in 2012, there were 252,553 doctors on the medical register, and in 2012 a complaint was registered against 4% (10,347) of doctors and less than 1% (208) were removed from the medical register (GMC 2013). This is a very small proportion of practising doctors in the UK. Nevertheless, as this chapter will outline, year on year over the last decade the number of complaints made to the GMC has increased. Moreover, the rise in the volume of complaints has been accompanied by a growing perception within the medical profession that the GMC itself is far less tolerant of infractions than before.

After the respective Bristol and Shipman cases, there was broad consensus within the medical profession that substantive changes were needed to reform both the organisation and working culture of the GMC, to ensure that underperforming doctors, as well as those engaging in malpractice and/or acts of criminality, could be more easily prevented from continuing to practise.