Soapbox: More likely than not
From April this year, the GMC will start applying the civil standard of proof for its fitness to practise (FTP) hearings. It will change from beyond reasonable doubt (criminal standard) to the balance of probabilities (civil). But what will this mean in practice?
If the GMC is to be believed, those facing the most serious allegations will be treated the same as they are now; however:
- Applying the criminal standard, a FTP panel has to be certain that a doctor is guilty of unprofessional conduct
- Applying the civil standard, the panel will only need to think it more likely than not that this is the case.
The GMC says that it will apply the civil standard of proof flexibly, tailoring it to “the facts of any given case”. Presumably, this means that, if the allegations are not particularly serious, the quality of the evidence does not have to be very strong for the panel to find them proved. So far, the guidelines are not clear regarding standard of proof and sanctions. This is because the process takes place in three stages:
- The allegations have to be proved (the standard of proof is applied).
- The panel then makes a judgment on whether the doctor’s fitness to practise is impaired.
- They decide what sanctions are appropriate.
How this will actually work is even less clear. When the civil standard is applied, it can only be justified if the regulator places a heavy emphasis on remediation rather than punitive sanction. MPS has argued strongly against these changes because a finding of impaired fitness to practise can have a profound effect on a doctor’s reputation and livelihood. We will continue to lobby vigorously against this proposal and try to ensure that the standard of proof is applied fairly and proportionately.