The General Medical Council has lost its way

Abstract

On March 28, the tragic case of Jack Adcock—a 6-year-old boy with Down's syndrome who died of sepsis in Leicester Royal Infirmary in 2011—and Dr Hadiza Bawa-Garba took another turn. Bawa-Garba, the paediatric trainee convicted of gross negligence manslaughter by a jury in 2015, was given permission to appeal a January High Court ruling to permanently strike her off the medical register. The General Medical Council (GMC), the UK's licensing body for doctors, had successfully appealed its own but independent Medical Practitioners Tribunal Service's decision from last July to suspend the doctor for 12 months but not revoke her licence. The January ruling caused immediate outrage among many in the medical profession and the decision by the GMC to appeal—a legal option granted only in December, 2015—was met with bewilderment and anger. Blaming individuals with such wide reaching consequences in a case that was neither clear-cut medically nor isolated from the wider, egregious systems failures that are sadly now commonplace in an underfunded and understaffed National Health Service (NHS) will have the opposite effect of the GMC's stated purpose “to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine”. Proper standards should include attention to the dismal environment doctors and other health professionals are working in. In its fact sheet related to this case, the GMC says that it sent a clear message in 2016 that there was “a state of unease” in the medical profession. And in response to understaffing and unsafe workloads, it advises doctors that “it is vital you escalate your concerns and document them; but don't walk away”. This is wholly unhelpful advice when staffing gaps, unfilled positions, and unmanageable workloads are the daily reality in the NHS. The GMC's leadership has lost the trust of the profession and public. Empty apologies and further reviews are not enough. To rebuild confidence in the GMC, its Council Chair Terence Stephenson and Chief Executive Charlie Massey must resign. The General Medical Council and the Jack Adcock case: a replyI read the Lancet Editorial about the General Medical Council's (GMC's) handling of the Jack Adcock case with interest (April 14, p 1456).1 Having met with hundreds of doctors over the past few months, it is clear that the Jack Adcock case has been a lightning rod for a range of issues facing the profession. The GMC's part in that case, after coroner and criminal court proceedings, was not taken lightly. As an independent regulator we are frequently called upon to make decisions that are not popular with doctors, and sometimes patients. Full-Text PDF Gross negligence manslaughterAn independent review of gross negligence manslaughter (GNM) and culpable homicide, published on June 6, describes how the conduct of the General Medical Council (GMC) relating to the case of Hadiza Bawa-Garba severely damaged its relationship with the doctors it is supposed to regulate. The review acknowledges several serious concerns about the GMC that emerged from this, and other similar, recent cases. These concerns include an over-representation of black and ethnic minority doctors referred to the GMC and a potential conflict in the responsibilities of the GMC both to ensure doctors are safe to practise and to maintain public confidence in the profession. Full-Text PDF