In 2015 the General Medical Council (“the GMC”), the regulator for all medical doctors working in the UK, announced the development of new ethical guidance for those doctors who carry out cosmetic procedures.
Following the PIP scandal of 2012 when 40,000 female patients were told they had non-medical grade material breast implants, Sir Bruce Keogh prepared a review of the cosmetic industry in the UK entitled Review of the Regulation of Cosmetic Interventions. This report was dated April 2013 and identified concerns about regulation in this area and a lack of safeguards for patients, particularly for those patients who elect to undergo non-surgical cosmetic procedures such as dermal fillers. This report famously stated that “a person having a non-surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen or a toothbrush”.
As a result of this report, the GMC decided to launch a task and finish group followed by a public consultation on the draft new guidance in 2015.
The GMC, anticipate that the new guidance will come into force in June 2016 but it has today published the draft guidance. They state that the new guidance builds on the principles already established in their core guidance for doctors, Good Medical Practice.
The new GMC guidance includes the following:
- A requirement that doctors advertise and market their services responsibly and that any advertising must be clear, factual, and not use promotional tactics, such as “two-for-one” offers to encourage patients to make ill-considered decisions;
- Doctors will no longer be allowed to offer cosmetic procedures as prizes;
- Doctors must not allow others to misrepresent their services;
- Doctors must give patients time for reflection ensuring that they have the time and information about the risks of surgery in order that they can make a voluntary and informed decision about whether or not to go ahead with a procedure. Patients should not feel rushed or pressured into the decision;
- Doctors must also seek patient consent for the procedure themselves and will be responsible for discussing the procedure with the patient, providing them with the information and support they need and obtaining consent from them where previously this may have been carried out by a member of staff at the clinic. This responsibility cannot be delegated;
- Doctors carrying out the procedure will also have to provide continuity of care, ensuring that patients know who they need to contact and how their care will be managed if they experience any complications and that the patient has full details of any medicines or implants;
- Doctors must support patient safety by making full and accurate records of consultations, using systems to identify and act on any patient safety concerns and contributing to programmes to monitor quality and outcomes, including registers for devices such as breast implants.
In addition to this, the Royal College of Surgeons has published a new set of standards for cosmetic surgeons and is calling on the government to introduce new legislation to ensure that those doctors carrying out these procedures are qualified to do so.
For some, the new GMC guidance is welcome but does it go far enough to protect both doctors and patients?
As GMC solicitors, defending doctors when they face allegations of impairment of fitness to practise, we have seen all types of cases related to cosmetic surgery, from those doctors accused of not being qualified to carry out the procedures to those who have performed cosmetic procedures on patients which has allegedly then resulted in a complaint about the results and/or complications suffered as a result of the procedure. Suffice to say that, historically, this has been a very grey area in terms of the law.
The GMC appear to have recognised this and have sought to make their expectations of doctors clearer with the publication of their new guidance in an effort to stamp out ‘poor practice’.
However, billions of pounds is spent by the general public every year on cosmetic surgery, with over one million pounds being spent on botox alone. This is a booming industry but patient groups are now questioning whether self regulation in the form of new GMC ethical guidance is sufficient as they insist that the new guidance is just that, ethical guidance, and that the changes set out in the new GMC guidance should be implemented in law.
The advice being given to doctors practising in this area is that they should be honest with themselves and with patients as to their own competencies; the suggestion being that many doctors performing cosmetic procedures are not qualified to do so.
The advice being given to patients considering a cosmetic procedure is that they carry out due diligence when choosing their doctor, that they ask questions of their doctor’s competencies and that they are not embarrassed to do so.
As doctors who are either employed by such a clinic or who own and run such clinics, you need to ensure that the new GMC guidance is followed as failure to do so could result in a Medical Practitioner’s Tribunal Service (“MPTS”) Fitness to Practise Panel hearing where allegations of impairment of fitness to practise are considered, which, if found proved, could result in erasure from the medical register.
It would appear that the GMC has taken some time in the preparation of their new guidance. But what does this mean for doctors who have already been practising in this area? In recent times, six doctors have been erased from the medical register in relation to allegations concerning the carrying out of cosmetic procedures and many others have faced fitness to practise investigations, some of which resulted in a lesser sanction than erasure from the medical register.
No doubt there are very many doctors whose fitness to practise is yet to be investigated for procedures carried out prior to the publication of the new GMC guidance and more doctors will be investigated once the new guidance comes into force in June 2016. For those doctors facing a GMC fitness to practise investigation, the specialist GMC lawyers at Burton Copeland can assist.
We can also assist doctors in terms of providing advice on the new guidance issued by the GMC and assistance on how to avoid a fitness to practise investigation if you are a doctor who has been carrying out cosmetic procedures and who is now uncertain whether or not you meet the requirements of the new GMC guidance.
If you are doctor requiring advice and assistance in this area, please contact Charlotte Ellis of Burton Copeland on 0161 827 9500 for further information.
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