The General Medical Council investigates allegations of impairment of fitness to practise by reason of misconduct, deficient professional performance, knowledge of English, conviction or health.
But what do they mean by the term ‘health’? Concerns about a doctor’s health can relate to either a physical illness or a mental illness. In our experience, the vast majority of cases relate to allegations concerning mental illness, sometimes to do with alcohol-related illnesses, often to do with depression.
What does the GMC do in these cases?
The GMC, when it receives allegations relating to a doctor’s mental health, will conduct an investigation in order to find out whether or not the illness or condition could amount to an impairment of the doctor’s fitness to practise.
What happens next?
When the investigation commences, witness statements can be taken by the GMC from those who may have witnessed the doctor’s behaviour or who may have concerns about the doctor’s health. In addition, the doctor may be asked to allow access to his/her medical records.
Most importantly, the GMC usually order health assessments to be undertaken on the doctor in question.
If a doctor is asked to undergo a health assessment by the GMC during the course of their investigation, what does this mean?
It means that the GMC will select two doctors, usually in the area local to the doctor being investigated, who will then examine the doctor on the basis of instructions received from the GMC. In many cases, and particularly in cases where mental health is the GMC’s concern, these assessors will be psychiatrists.
If the doctor is willing to attend the appointments and for the examinations to go ahead, the GMC will organise and pay for the assessments to be undertaken.
The GMC will ask the medical assessors to write a report once they have seen the doctor and this report will cover whether or not, in their opinion, the doctor is fit to practise either fully or with restrictions and any further recommendations about how the case should be managed.
If the doctor is unwilling to undergo these assessments, the GMC can refer the case to the Medical Practitioners Tribunal Service in order for them to decide whether the doctor’s fitness to practise is impaired on the basis of the refusal to undergo health assessments.
The Case Examiners
Once all of the evidence has been collated, the doctor will be sent what is known as a Rule 7 letter which will detail the specific allegations and will allow the doctor 28 days in which to respond.
Once this response has been received, the GMC Case Examiners, one medical and one lay, will consider the case (including the health assessments) and the doctor’s response if he/she has chosen to prepare one, and will decide what action, if any, needs to be taken.
Case Examiners have the following options available to them in a case relating purely to a doctor’s health:
- conclude the case with no further action;
- refer to the MPTS for a medical practitioners tribunal hearing; or
- agree undertakings with the doctor.
Issuing a warning in not an option available to the Case Examiners in case relating purely to allegations of ill health.
If there is a ‘realistic prospect’ of establishing that a doctor’s fitness to practise is impaired to a degree justifying action on his/her registration, then the matter will be referred to a Medical Practitioners Tribunal Service (“MPTS”) Fitness to Practise Panel hearing where a decision will be made as to whether or not the allegations are found proved and if so, whether the proven allegations amount to impairment of fitness to practise. If this is found to be the case, the Panel will consider what sanction to impose on the doctor’s registration.
At the MPTS hearing, the Panel will hear evidence from both the GMC and from the doctor. This may include witness evidence and will most certainly include evidence from the two GMC health assessors.
It is always open for the doctor to obtain his/her own assessment during the course of the GMC investigation and to use this in evidence at any MPTS hearing.
Based on the evidence heard, including more often than not, evidence from the doctor himself/herself, the Panel will make their decisions as outlined above. If a sanction is deemed to be necessary then the Panels have the following options open to them in health cases:
- conditions placed on the doctor’s registration for a maximum period of three years;
- suspension of the doctor’s registration for a maximum period of 12 months.
Please note that erasure from the Medical Register is not an option for Panels where the case relates to allegations concerning the doctor’s health alone.
We hope that this brief summary of GMC health cases has been helpful. If you are a doctor facing a GMC investigation or an MPTS Fitness to Practise Panel hearing on the basis of your ill health, please do get in touch with the professional regulatory discipline specialist team at Burton Copeland on 0161 827 9500 as we can help you.