You have emphasised your model of adjudication as being one that ensures total independence from the investigatory process. What are the advantages of an adjudication process that is independent from the regulator?
Everyone has the confidence – the medical profession, patients (and we are all patients), the medical defence organisations, etc – that decisions taken are totally independent of the GMC, in a separate function, with all training and selection of panel members down to the MPTS.
We have a quality assurance group, which I chair, and which looks at the vast proportion of our decisions to quality assure them and pick up any learning issues. I ensure these go back into training requirements. Rather than us questioning panel decisions, our focus is on assessing whether the reasons given for the decision are clear enough in the written determination.
Investigation and adjudication should be entirely separate, rather like the criminal courts – the Crown Prosecution Service makes a decision on whether to prosecute and the courts decide whether they are guilty or not
Previously, the GMC had a similar review group – but this meant the GMC was the prosecutor and then reviewed its own decisions, and that was clearly wrong. Investigation and adjudication should be entirely separate, rather like the criminal courts – the Crown Prosecution Service makes a decision on whether to prosecute and the courts decide whether they are guilty or not. The GMC gets the complaint, investigates, and makes a decision whether they are going to refer the matter for adjudication; we take over and make a decision based on whether the facts are as proved, whether there is impairment, whether there should be a sanction – and that’s all up to us; the GMC plays no part at all.
What are your views on other models of adjudication?
Our model certainly fits into this kind of disciplinary process – I believe you need a panel, rather than one person making the decisions, and that the panel should be a mixture of medical and lay members. I do know, for example, that pharmacists have a different model of adjudication – the chairs of their panels are legally qualified and therefore they do not use legal assessors. As a model I think ours is the right one, especially when we make the changes that I feel are necessary.
Have there been any criticisms of this model?
When I have spoken at conferences I have been asked: “How can you call yourself independent when the GMC control your budget, and your salaries are paid by the GMC?” The model that has been worked on and agreed is that we are part of the wider GMC family; in the context of the regulation of the profession, that is the right model. It is the best model for disputes, in my view, between the registrant and the regulator.