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Proposed FTP reforms could penalise doctors in poor health, union warns


By James Hacker
13 May 2021

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Proposals to remove health as grounds for a fitness to practise (FTP) investigation could penalise the most vulnerable doctors, the Medical Defence Union (MDU) has said.

The proposals – announced in the Department of Health and Social Care’s (DHSC) consultation on regulating professionals – said that health will be removed as a ground for an FTP investigation, and that it will instead be considered under the ‘lack of competence’ umbrella.

Speaking at a Westminster Health Conference (11 May), Dr Matthew Lee, MDU’s professional services director, said that regulation changes must lead to a ‘more compassionate system’ for those being investigated, given growing evidence about the impact of health on the profession.

‘We understand and support the government’s motives for proposing that health concerns should usually be dealt with outside the fitness to practise process,’ he said.

‘However, there will be some cases where progression to a more formal process is deemed necessary and removing the health route under which such concerns are currently dealt with will be a retrograde step.’

He added that it would risk ‘undoing’ the GMC’s work in establishing sensitive and separate procedures for dealing with doctors in poor health.

‘It is essential that reforms to healthcare regulation leave the GMC well equipped to deal with concerns about doctors’ health and other fitness to practise concerns,’ he said.

Currently, the GMC will question a doctor’s fitness to practise if their health may compromise patient safety or pose a risk to public confidence.

Proposed changes to grounds for action

DHSC’s proposals would see health dropped as a separate ground for launching an FTP investigation, and would instead be ‘considered as part of an assessment of competence’.

The initial stage of the proposed FTP process, regulators would need to determine whether a concern received meets the criteria for referral, before it progresses to case examiners.

DHSC said that cases which fall under the two grounds for action – lack of competence, or misconduct – will be referred onwards.

The proposal defined lack of competence as a registrant being ‘unable to or has failed to provide care to a sufficient standard’, adding that this would include a health condition which ‘affects a registrant’s ability to practise safely’.

It said that it expects the reforms to free up regulators’ time, who would be able to handle health concerns ‘more sensitively’ outside of the FTP process.

Anthony Omo, General Counsel and Director, Fitness to Practise for the GMC, said: ‘We’re not convinced by proposals to remove adverse health from our existing grounds for fitness to practise action and include this in a broader ‘lack of competence’ category. Any reform to our procedures must protect and strengthen our ability to take proactive and proportionate action.’

He also said: ‘Where there’s evidence that health concerns might pose a risk to the public, it’s right that they’re handled sensitively to protect the public and ensure the doctor is supported.’

The DHSC was contacted for comment.

A Department of Health and Social Care spokesperson said: ‘We are currently consulting on proposals to reform the legal framework for the regulation of healthcare professionals in the UK.

‘Our proposals will provide regulators with a flexible set of powers that will enable them to handle concerns about healthcare professionals’ fitness to practise, including those related to health matters, sensitively and in a way that maintains public protection.

‘We invite anyone who has views on our proposals to feed into the consultation, which closes on 16 June.’

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