The British Medical Association (BMA) has begun legal action against the government over its decision to retain and expand the General Medical Council’s (GMC's) right to appeal fitness to practise tribunal decisions, accusing ministers of misrepresenting the review they cited as justification for reversing years of policy.

A coalition of 13 leading medical organisations led by the Medical Protection Society (MPS) has also urged the government to reconsider.

In a letter before action, the BMA said the government's consultation on GMC reform was "materially misleading" and therefore unlawful. The BMA claimed the consultation misrepresented the findings of the Mann Review — the report it cited as the basis for retaining and expanding GMC appeal powers — and that the review itself was not published until more than 2 months after the consultation opened, leaving respondents unable to scrutinise its recommendations.

The GMC’s powers, dating from 2015, were due to be revoked this year following years of pressure from medical organisations and a commitment by the GMC itself. An independent review in 2018 by Sir Norman Williams and a GMC-commissioned review by Dr Leslie Hamilton in 2019 both recommended that appeal powers be removed from the GMC in favour of a single, independent route held by the Professional Standards Authority (PSA). 

The latter found that the Hadiza Bawa-Garba case had damaged doctors’ trust in the GMC and created a “toxic fear” of reprisals. Bawa-Garba, a specialist registrar, was convicted of gross negligence manslaughter following the death of a child under her care, subsequently struck off after the GMC appealed the tribunal's decision, and then reinstated on appeal in 2018.

Misrepresentation Alleged 

Both the government of the day and the GMC backed the recommendations, which had widespread support amongst the medical profession. “The lack of action to implement this change over successive years has been a source of significant frustration,” the joint letter said. 

Yet under the terms of the Draft General Medical Council Order 2026, the GMC would retain its powers of appeal over decisions of its own Medical Practitioners’ Tribunal Service. This duplicates the PSA’s established statutory role in overseeing decisions across all healthcare regulators. The Order further sets out additional powers for both the GMC and PSA to appeal interim decisions.

The BMA said the government claimed that a consultation on GMC reform launched in March indicated that these proposals were a recommendation of the forthcoming Mann Review into antisemitism and racism in the NHS. However, that review was not published until earlier this month. It did not specifically recommend retaining the GMC’s right to appeal, only that the government should consult on this.

Removal Backed by Every Government Since 2018 

BMA council deputy chair Dr Emma Runswick said: “The removal of the GMC’s right to appeal was recommended by the Williams Review in 2018 and backed by every government since. Now this U-turn, which is based on an entirely false premise, will only further erode the trust and confidence that the medical profession has in its regulator and will do nothing to protect patient safety.”

She added that having now seen the full Mann Review, “we can only conclude that the government deliberately intended to mislead people in its consultation on the changes.” Union officials said that they would seek a judicial review against the Health and Social Care Secretary over the proposed extension of the GMC’s powers.

The MPS coalition letter to Minister of State for Health Karin Smyth urged her to reconsider the government’s position. The letter warned that for the GMC to retain powers of appeal risked “seriously undermining the profession’s and the public’s trust in the independence of the tribunal process, and [in] the regulator itself.” 

Unnecessary Duplication 

Dr Pallavi Bradshaw, medical director at MPS, said in a press release that the GMC’s right to appeal decisions made by its own tribunal service was “an anomaly” within UK healthcare regulation. The current set-up “creates unnecessary duplication and uncertainty, without adding a material benefit for patients and the public.”

The joint letter was signed by the MPS along with the Medical Defence Union, the Medical and Dental Defence Union of Scotland, the BMA, the Doctors Association UK, the Hospital Consultants and Specialists Association, the Association of Anaesthetists, the Royal College of Paediatrics and Child Health, the Faculty of Forensic & Legal Medicine, the Medical Women’s Federation, the British Association of Physicians of Indian Origin, the British Islamic Medical Association, and the Royal Medical Benevolent Fund.

The protests come against a background of the GMC in recent years being variously charged with racism, labelled “a failing, dysfunctional organisation” and “not fit for purpose,” and creating a culture of fear and blame. A BMA survey in June 2025 found that most doctors polled expressed lack of confidence in the GMC’s ability to protect the public, and 80% backed creating a replacement body.

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.