When serious concerns are raised with the GMC, deciding whether a doctor’s registration should be restricted or suspended is crucial to protecting patients. David Pearl, former Deputy High Court Judge and Chair of the Medical Practitioners Tribunal Service, looks back on progress to reform fitness to practise adjudication in the UK.
Fitness to practise hearings are an important part of protecting patients. If there are doubts about a doctor’s fitness to practise, it is in everyone’s interest that the matter is resolved in a way that is fair, transparent and swift.
Patients want to know that a doctor will be prevented from practising medicine if their competence or behaviour falls below the standards that we set for doctors.
Doctors too want to feel reassured that if the GMC brings a case against them, it will be heard by an independent panel and a decision made as soon as possible.
For those reasons, it is my responsibility to create a modern, efficient adjudication service that meets those needs. And that means making significant changes to how we work.
I started chairing the MPTS last year and felt I had judicial experience to bring to the role as a previous president of the Care Standards Tribunal. I have been impressed by the commitment of the MPTS staff and panellists who have embraced our reforms.
More efficient hearings
The MPTS has heard over 350 fitness to practise cases in our first year. Sometimes these can take several weeks to include with time lost to legal arguments and delays.
With my past experience of tribunals, I strongly believe that effective case management is the key to preventing these delays.
Before a hearing starts, discussions about what evidence is admissible should have concluded. Papers and witness statements should be provided in advance for the panel to read.
To help with this, in May 2013 changes were made to the rules governing our hearings. This means we no longer read out allegations at the start of a hearing. We have also made hearings easier for witnesses who found giving evidence a daunting experience by using video or telephone links, while those who need to give evidence in person are given much more notice.
There is more we can do.
Other tribunals have the power to impose costs if either party delays proceedings unreasonably. I believe MPTS panels should have this power and that the threat of costs will concentrate minds on all sides. Later this year, the Department of Health will consult on this and other legislative changes.
There is still much work we can do to make our decisions more accessible and easier to understand, in the way we present them and the language we use.
My ambition is that the MPTS should provide an efficient and effective service, as speedily as possible, with decisions that are understood to be fair to both doctors and patients.