Two years after the establishment of the Medical Practitioners Tribunal Service (MPTS), much has changed, but there are still significant reforms to be made. MPTS Chair His Honour David Pearl reflects on the progress so far and sets his hopes for the future.

David Pearl - headshot 1

When I took on the role of Chair of the MPTS I was given the remit and responsibility of creating a modern, efficient adjudication service that meets the needs of patients and doctors. And doing that meant making significant changes to the way we worked.

Since 2012 I believe that we have come a long way and have already implemented a great deal of change.

We now digitally record our hearings, instead of using shorthand writers in each case. We’ve removed the need for allegations to be read out at the start of a hearing and have allowed the admission of written witness statements to be accepted as evidence-in-chief. Specialist Health Advisers are no longer appointed as a matter of course. These may be small steps, but they have helped make our processes both quicker and less expensive.

In addition we have also taken steps to further improve the consistency of the decisions made by panels. We now have regular appraisals for newly appointed chairs and annual training for all of our panellists as well as a monthly Quality Assurance Group meeting, which I chair and which reviews many of our decisions.

These steps are just a small selection of the reforms we have implemented over the past two years. The increase in speed and efficiency are important, but these elements are just part of the process. There is still much we can do to ensure hearings are fair and efficient for everybody involved.

We were disappointed to note that the recent Queen’s Speech did not include the Regulation of Health & Social Care Professionals Bill, which would have allowed us to implement changes to improve what we do a lot more easily.

In the meantime we cannot lose the momentum of reform that we have built and need to continue modernising our service, to reduce pressure on doctors, witnesses and complainants.

There is a window of opportunity to do this during this Parliament. By amending the Medical Act by way of a Section 60 order we can bring about some of the necessary changes sooner rather than later.

A change of crucial importance is a case management regime with ‘teeth’, to reduce the amount of time lost in hearings. MPTS panels should have the power to impose costs, just like other tribunals can, if either side behaves unreasonably in the conduct of proceedings. These costs are rarely imposed, but the threat can concentrate minds and prevent delays.

Currently, the GMC has no right of appeal against MPTS panel decision. Only a doctor or the Professional Standards Authority can appeal. This is an anachronism that doesn’t reflect the separation of adjudication from the GMC. Introducing that right of appeal will further cement the MPTS’ operational independence from the GMC.

We must appoint Legal Assessors in all of our hearings. We would like to move to a different model where Legal Assessors are appointed in cases where they are most needed.

Later this year we will be consulting on the Indicative Sanctions Guidance used by our fitness to practise panels help them reach decisions on what types of sanctions should be imposed for different types of issues.

Two years on from setting up the MPTS, the changes are bedding in – but the cycle of change must continue. We are focused on further improving the way we work. With our colleagues at the GMC, we will continue to work with Department of Health to make sure that happens.