Ministers have launched a consultation to reform the General Medical Council (GMC), aiming to create a faster, less bureaucratic system to protect patients and NHS staff.

However, proposals to retain and expand the regulator’s right to appeal tribunal decisions have drawn criticism from doctors, who warn they could increase delays and deepen distrust.

Launching the consultation, the Department of Health and Social Care (DHSC) said the current UK model of regulation was “outdated and too bureaucratic.” The Medical Act, which governs the regulation of doctors, dates back to 1983 and has only been updated in a piecemeal way since.

The consultation will implement the first tranche of Lord John Mann’s recommendations on antisemitism and wider racism in the health service. It follows concerns that doctors have used racist and antisemitic language, particularly on social media, without regulators acting quickly enough.

“Racism, including anti-Jewish racism, has no place in the health sector or our NHS, and those who engage in it should face swift and meaningful consequences,” said Lord Mann. “For too long, the system has been too slow and too cumbersome to deliver that.”

Appeal Powers Fuel Distrust Among Doctors

The GMC would retain its existing right to appeal decisions of the Medical Practitioners Tribunal Service (MPTS) to the courts, rather than losing that power as previously planned.

In addition, the Professional Standards Authority (PSA) — the body that oversees all health regulators – would also be given greater powers to scrutinise and challenge decisions. This would increase oversight of the GMC and make it easier for regulators and oversight bodies to act when tribunal decisions were “not strong enough to keep the public safe.”

However, the Doctors’ Association UK (DAUK) warned the proposals go against the Williams review — which recommended that the GMC should have its right to appeal fitness-to-practise decisions by its MPTS removed — and would “dismay doctors.”

“We were promised the GMC would lose its power to appeal its own tribunal’s decisions,” said Dr Matt Kneale, DAUK co-chair. “Instead, this consultation retains that power and creates new ones.”

The proposals were “very concerning,” said Dr Pallavi Bradshaw, medical director at the Medical Protection Society.

“Challenging tribunal decisions is and has long been the role of the PSA. The GMC is the only UK health regulator with a statutory right to appeal its own tribunal’s decisions, which duplicates the PSA’s powers,” she said. 

The MPTS is supposed to be independent, so it was “absurd” that the GMC had its right to appeal not just retained, but expanded, said the British Medical Association (BMA).

The proposed changes would mean doctors could be subject to potential appeals from both bodies following either a substantive or interim sanction — likely leading to more delay, uncertainty, and cost. “This anomaly contributes to the increasing distrust between doctors and the regulator,” she said.

“One key change to improving the profession’s trust in the regulator is to remove its right to appeal decisions made by the independent MPTS,” said BMA council chair, Dr Tom Dolphin.

Missed Opportunity to Fix Regulator

Wider regulatory reforms included overhauling fitness‑to‑practise processes to be “swifter, fairer and less adversarial,” and giving regulators more flexibility over education and training standards so they could respond to workforce needs.

The BMA welcomed this but said that with no duty of care to those the GMC investigates, no independent authority to consider complaints by doctors, and a governance arrangement which doesn’t ensure doctors are at the heart of decision-making, “it rings hollow.” 

The consultation also proposed removing the current 5‑year rule that stops regulators considering historic allegations of sexual abuse after 5 years, allowing very old allegations to be examined where appropriate.

“One positive to take away is that physician associates and anaesthesia associates will be renamed ‘assistants,’ going some way to ending the confusion for patients,” said Dolphin.

The reforms were an important and long-awaited step towards “a more responsive and compassionate approach to healthcare regulation,” said GMC chief executive Charlie Massey.

However, the BMA said the proposed changes were “a far cry” from what was needed to fix a broken regulator and that the proposals were a “missed opportunity.”

“Rather than restoring the medical profession’s confidence in the GMC, or protecting the safety of the public, both will be further eroded,” Dolphin warned.

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.