As the Medical Practitioners Tribunal Service (MPTS) publishes its first annual report to Parliament, Dame Caroline Swift reflects on her first six months as Chair.
How I came to be at the MPTS
When I saw the advertisement for the recruitment of a new Chair of the MPTS it was a position that instantly appealed.
For more than 25 years I practised as a barrister in Manchester, specialising in cases involving people who suffered from a wide range of injuries and diseases. The work required an understanding of many complex medical issues which fascinated me.
For four years, I was Leading Counsel to the Shipman Inquiry, where I was responsible for gathering and presenting all the evidence required by Dame Janet Smith, the Chair of the Inquiry, to enable her to carry out her role.
At the time of the Inquiry, the General Medical Council (GMC) was responsible for investigating complaints against doctors and also for making decisions on the outcome of fitness to practise hearings.
The lack of separation between the GMC’s investigation function and its adjudication function was criticised in one of the Inquiry’s six reports. Dame Janet recommended that the adjudication function should be undertaken by an independent decision making body. Eight years later, the MPTS was set up, largely as a result of her recommendation.
So, when the role of MPTS Chair was advertised, with the prospect of playing a part in its further development, it was irresistible to me. I had after all been present at the inception of the MPTS, if not its birth.
I was appointed Chair of the MPTS in January this year. Working in an office of nearly 100 people is quite a different environment to my previous work as a High Court Judge, which involved spending all my days in Court, sitting with a jury in serious criminal trials or presiding over complex civil cases.
However, I have been able to use my previous skills and experience when carrying out my new role. And I have been welcomed warmly by a team of highly professional staff who have a positive “can do” attitude.
About the MPTS
The MPTS was created five years ago, in June 2012, and became the first tribunal service of its kind in health regulation.
Although funded by the GMC, we’re a body making independent decisions, not an independent body. It is responsible for appointing, training and quality assuring the almost 300 medical, lay and legally qualified tribunal members who sit on its tribunals.
MPTS staff have no involvement at all in the investigatory process and are located in a separate building from those GMC staff who conduct investigations. Their sole task is to arrange tribunal hearings, support our tribunal members and assist hearings to operate efficiently.
Two years ago under the leadership of my predecessor, David Pearl, the MPTS secured parliamentary approval to introduce a number of changes to improve the way we run the MPTS.
These changes included the MPTS being made a statutory committee of the GMC, with the responsibility of delivering an annual report to parliament. Our first annual report has now been published and it gives a good insight into the work of the MPTS.
The changes have increased the degree of separation between the MPTS and the GMC. The GMC can now appeal decisions made by our tribunals, whereas previously only a doctor or the Professional Standards Authority could challenge tribunal decisions.
Annually, we hold an average of more than 220 Medical practitioners tribunal hearings. Last year, we also held 339 Interim orders tribunal hearings, at which the tribunal can impose an interim order restricting a doctor’s medical registration while the GMC conducts its investigation.
My primary aim is to ensure that MPTS hearings are conducted efficiently, effectively and fairly and to eliminate as far as possible the lengthy delays which sometimes occur, whilst maintaining the high quality of decision making.
Adjournments and delays to hearings can be most distressing for doctors, who are understandably keen for concerns over their fitness to practise to be resolved. They can also be distressing for patients who are waiting to learn the outcome of their complaints.
We are seeking to address the problem of delay in a number of ways. We are now providing bundles to tribunal members in advance so that tribunal hearings are not delayed and can start on time.
We have an Adjournments Working Group which meets regularly to review those cases in which adjournments have occurred and to discuss how this can be avoided in the future. We are also working in collaboration with the GMC and doctors’ representatives to find other ways to avoid delay.
In addition, we have recently appointed more than 70 experienced solicitors and barristers to take on the role of Legally Qualified Chairs of the tribunals which make decisions on doctors’ fitness to practise. They will be responsible for advising the other members of the tribunal on questions of law during hearings and for ensuring that hearings run effectively.
During my time as a barrister and as a Judge, I have seen the severe stress which fitness to practise investigations and hearings can have on professionals so I am acutely aware of the anxiety that doctors must feel when attending a Medical practitioners tribunal.
For that reason, work to improve the tribunal experience for doctors, particularly self-represented doctors, is a key priority for me. We have a volunteer-led Doctor Contact Service, which involves trained members of staff offering pastoral support to doctors on the day they attend for their tribunal hearing and signposting them to the information they need. This service has received positive feedback and we will continue to build on this valuable resource.
At the MPTS we strive to treat those who use our tribunal service with fairness and respect. We do this by supporting doctors and providing special measures such as allowing screens to shield vulnerable witnesses from view when giving evidence. Furthermore, we regularly train tribunal members to make sure their decisions are of the high standard expected by doctors and the public.
Most of our hearings are held in public and we welcome those who want to attend to observe a hearing. Further information about our premises and tribunal processes can be found on our website.
MPTS staff and I are always keen to hear suggestions on how we can improve. Any queries or suggestions for improvement can be sent to MPTSchair@mpts-uk.org.