Create a new regulator of doctors to replace the General Medical Council (GMC)

The General Medical Council (GMC) needs to be replaced by a new, fully accountable body, with transparent, constructive and competent practices and policies. It’s time to establish a different organisation, that can truly, yet efficiently, represent the needs of patients and doctors.

We believe the General Medical Council (GMC) is not fit for purpose. For example, concerns have been expressed about racial bias, and we conclude from accumulating evidence that, for various reasons, it has now forever lost the profession’s trust and respect. The regulation of the medical profession needs to be conducted by a distinctly different system, which is more consistent and practical, so retaining the confidence of the profession and patients.

The General Medical Council (GMC) is the regulator of all medical doctors practising in the UK. It sets and enforces the standards to which all doctors must adhere. The GMC is independent of Government, directly accountable to Parliament and is responsible for operational matters concerning the discharge of its statutory duties. The Government considers the GMC fit for purpose to discharge these duties.

The Department for Health and Social Care is reforming the GMC’s legislative framework to give the GMC more flexible powers to ensure that their processes are fair, efficient and effective. The Government considers that these reforms will empower the GMC to better protect the public and support its registrants.

Regulatory Reform

The Government is aware that the current UK model of regulation for healthcare professionals is rigid, complex and needs to change to better support healthcare professionals whilst maintaining public protection. This is why in 2021 we consulted on detailed policy proposals to deliver a flexible and modern system of regulation for health and care professionals across the UK in ‘Regulating healthcare professionals, protecting the public’.

Under our reform proposals, unnecessary and overly detailed legislation that stifles improvement and flexibility will be removed. This will allow regulators to better support and regulate the professions for which they are responsible. Regulators, including the GMC, will be given consistent and flexible powers to deliver fitness to practise (FtP) processes that are faster, fairer and less adversarial, which will benefit all parties involved in FtP proceedings and, most importantly, will ensure swift public protection where needed.

We recently consulted on draft legislation that will introduce anaesthesia associates and physician associates into regulation by the GMC under a modernised regulatory framework. This legislation will provide the template to introduce these much-needed changes for all healthcare regulators.

Reforming the GMC’s wider regulatory framework for doctors remains a key priority. We have already started to work with the GMC to scope out the changes needed to enable us to roll out these reforms to medical practitioners over the next couple of years.

Mitigating the risk of bias

The Government works closely with the GMC and is reassured it has processes in place to mitigate the risk of bias and support the fairness and transparency of its investigation process and its FtP decisions. This includes, but is not limited to:    

• equality and diversity training for all staff members, Equality, Diversity and Inclusion (ED&I) champions at a senior level across the organisation and the provision of ED&I training to decision makers;

• robust decision-making guidance that has undergone an equality impact assessment to identify and mitigate any unintended impact on doctors with protected characteristics;

• a comprehensive internal audit process for FtP decisions and independent audits of FtP processes based on random samples of decisions.

The GMC has also established a programme known as Fairer Employer Referrals (FER) following the publication in 2019 of Fair to refer?, a review aimed at understanding more about why some groups of doctors are disproportionately referred by employers to the GMC (https://www.gmc-uk.org/-/media/documents/fair-to-refer-report_pdf-79011677.pdf). The GMC has committed to eliminating disproportionality in FtP referrals from employers based on ethnicity and place of primary medical qualification by 2026. The GMC has:

• had fairness conversations with all employers to emphasise their duty to provide supportive and inclusive working environments and to explore how they are implementing the findings of the Fair to Refer? research;

• made changes to the GMC referral form used by Responsible Officers to include additional questions about how employers have considered systemic issues, the support they have provided locally, and the impartial checks that have been made to ensure the referral is fair and inclusive;

• developed new training for staff on the specific risks of bias in employer referrals;

• implemented a mechanism to provide feedback to employers about the outcome of concerns referred to the GMC at the end of an investigation;

• developed a mechanism to provide feedback to employers about concerns that do not meet their threshold for FtP investigation;

• supported the work by others to standardise local investigation processes and how these might address disproportionality at the early stages of a concern being raised.

The GMC’s annual report on its Equality, Diversity and Inclusion measures and targets, shows evidence of the progress it has made in addressing disproportionate referrals.

We recognise there are concerns about the disproportionate representation of Black, Asian and minority ethnic doctors in formal procedures and the impact this may have on doctors’ lives. We will continue to work with the GMC to ensure it provides robust assurance about its processes.

Department of Health and Social Care