The Medical Practitioners Tribunal Service has been making decisions in doctor’s fitness to practices hearings since it was established in 2012. MPTS Chair His Honour David Pearl looks ahead to changes that he believes will reduce the stress on doctors and witnesses.

When a doctor is called before a fitness to practise hearing, it is important that doctors, patients and the public have confidence that the panel will be making a fair, independent decision.

It is also important that we recognise that giving evidence to a hearing can be stressful, for doctors and for witnesses. We need to ensure that decisions are reached in good time, without unnecessary delays.

I have been the chair of the Medical Practitioners Tribunal Service (MPTS) for three years and we hear in the region of 230 fitness to practise cases a year. That is in the context of around 260,000 doctors on the UK medical register.


The General Medical Council (GMC), which brings cases before the MPTS, receives around 9,000 enquiries each year about doctors’ fitness to practise, the majority of which are resolved without the need for a public hearing.

When the GMC feels it is necessary to bring a case against a doctor, it is in the interests of everybody concerned that the MPTS hears the case and reaches a decision. Too often, panels are diverted in to matters which could and should have been dealt with in advance.

The answer to this problem is effective pre-hearing case management.

Effective case management

Failure to comply with case management decisions can cause substantial delays to hearings. It increases stress and inconvenience for all those involved and wastes money – all of which comes from the medical profession.

More effective enforcement of decisions is intended to shorten hearings and resolve cases more quickly.

I am pleased that Parliament agreed in March 2015 to make changes to the Medical Act that will give the MPTS stronger case management powers. Subject to the outcome of a consultation on the rules governing our hearings, we intend to implement these powers by the end of 2015.

The changes will allow the MPTS to appoint legally qualified case managers, whose decisions will be binding unless there has been a change in circumstances. If either party fails to comply with a rule or case management decision, panels will have powers to exclude evidence and draw adverse inferences. In addition, where there is both a failure to comply with a rule or case management decision, and either party or their representative acts unreasonably, the panel will be able to award costs.

It is my view that these changes will concentrate minds and ensure case management is effective, ultimately shortening hearings and reducing stress for all involved. In my experience similar powers are common in other tribunals, but are rarely used.

Proportionate and fair decisions

We have a pool of around 300 medical and lay panellists who protect patients by making independent decisions on the evidence put before them.

To ensure our panels are reflective of the medical profession and society as a whole, we actively encourage applicants from a BME background, women and those with a disability.

We recruit to the highest standard, helping to ensure consistent and well-reasoned decisions.

The MPTS has a diverse pool of panellist from a range of backgrounds. We look for people with demonstrable integrity and objectivity, along with the ability to reach considered, unbiased decisions affecting other people.

When our panels decide it is necessary to impose a sanction on a doctor’s registration, it is important that their decisions reflect what the public would expect when a doctor puts the safety of patients, or public confidence in doctors, at risk.

A new Sanctions Guidance document will be introduced in August 2015. I chaired the project board which oversaw the consultation on, and revisions to, this guidance. We received an overwhelming response to the consultation which ensures that the guidance reflects the views of doctors, patients and the public. I am confident that the new guidance will support panels in making decisions that are proportionate and fair.

Very few doctors are brought before fitness to practise panels, but when they are it is right that they can take the appropriate action to protect patients.