If a doctor is referred to the General Medical Council (GMC) for disciplinary measures and they decide to investigate the case, the Medical Practitioners Tribunal Service (MPTS) will set a hearing to discover if fitness to practise is impaired and if sanctions are needed.
In the third of our of series of blogs on legal services for professionals, we will help you to understand what constitutes an offence, the process of sanctioning, and provide clarity on the support available for you as a doctor.
WHO ARE THE MEDICAL PRACTITIONERS TRIBUNAL SERVICE?
After a complaint is received about a doctor and enquiries have been carried out, the GMC decides whether to refer the doctor to a medical practitioners tribunal hearing with the MPTS – the adjudication function for UK doctors.
They oversee two types of tribunal hearings:
- Interim orders tribunals can make an order suspending or imposing conditions upon your registration as a doctor while a GMC investigation is in progress
- Medical practitioner tribunals hear evidence and decide whether your fitness to practise is impaired
WHAT SORT OF OFFENCES ARE CONSIDERED FOR TRIBUNAL HEARINGS?
Examples of offences that can lead to disciplinary proceedings:
- Neglect or disregard to patients for their care and treatment. For example, failing to visit or provide treatment, or improper delegation of medical duties.
- Abuse of professional privileges or skills, for example; prescribing of drugs outside the course of bonafide treatment or providing false or misleading documents.
- Abuse of professional confidences, such as: disclosing confidential information about a patient or entering into an emotional or sexual relationship with a patient that causes distress to the patient or their family.
- Misuse or abuse of alcohol or drugs
- Dishonesty – including forgery, fraud and theft.
- Indecency and violence; including assault.
- Advertising. The publication of anything that promotes the professional services of a doctor – either directly or through a third party. Whether or not it amounts to serious professional misconduct will depend on the circumstances such as whether the published material conformed to currently accepted standards, whether it sought to suggest superior skills than other doctors, whether it was published to attract patients, and the motive of the doctor concerned in arranging for or agreeing to publication.
- Depreciation of other doctors, including; the depreciation of the professional skill, knowledge, qualifications or services of another doctor, or canvassing to obtain patients either directly or through a third party.
- Improper arrangements to extend your practice, such as the transfer of patients to your National Health Service list without the knowledge and consent of the patients or in a manner contrary to the National Health Service regulations.
WHAT ARE THE SANCTIONS THAT CAN BE IMPOSED?
Should a tribunal find your fitness to practise is not impaired, it cannot impose a sanction. However, it is able to issue a warning.
Should a tribunal find your fitness to practise is impaired, it can take four courses of action:
1) Take no action;
This is very rare and accepts that the undertakings agreed between you and the GMC are a suitable alternative to a sanction.
2) Impose conditions on your registration for up to three years;
In many cases, the purpose of conditions is to help you to deal with health issues and/or remedy any deficiencies in your practice, while protecting the public. Conditions might include requirements to work under supervision. They can be renewed for a further three-year period each time they are reviewed.
3) Suspend your registration for up to 12 months;
Suspension is considered appropriate for serious misconduct, but that which falls short of being incompatible with continued registration (for which erasure is more likely). Suspension may be appropriate, for example, where there has been acknowledgement of fault and where the tribunal is satisfied that the behaviour or incident is unlikely to be repeated.
4) Erase your name from the medical register
This sanction will be imposed if it is the only means of protecting the public, and can not be applied in cases relating solely to your health or knowledge of the English language.
Erasure may be deemed appropriate even if you do not present a risk to patient safety, but it is considered necessary to maintain public confidence in the profession.
Erasure may be considered in the following instances:
- A deliberate or reckless disregard for patient safety or good medical practice
- Serious harm to others (patients or otherwise) – either deliberate or through incompetence
- Violation of patient rights
- Offences of a sexual nature
*Note: this is not exhaustive, other offences can lead to erasure.
IS IT POSSIBLE TO AVOID PUBLICITY OF A HEARING?
MPTS hearings are, in general, held in public.
However, hearings may sometimes be held in private to protect confidential information or if the panel is considering making an interim order.
Members of the press and the public are able to attend professional conduct panel hearings and a small number of observer places are available for this purpose. They may be asked to leave a hearing if there are confidential matters to discuss.
The outcomes of public hearings are available to the press and public on the conclusion of the tribunal, and made available online.
WILL MY UNION OR INSURANCE COVER LEGAL FEES?
If you find yourself in need of legal support, you should check the terms of your relevant policy.
You may have a household policy which covers legal fees or you may have legal expenses insurance.
You should be aware that some insurers will state in their terms that you must use one of their prescribed solicitors, however, the true position is that you do not have to go with their choice. The Insurance Companies (Legal Expenses Insurance) Regulations 1990 allow you to choose which solicitor will be appointed in respect of any proceedings conducted on your behalf.
Some unions may offer preliminary help and legal advice and provide you with financial assistance towards your legal fees.
It is worth noting that legal rights have time limits, so it is worth checking with your union and insurers as soon as possible.
HOW WE HELP
If you are subject to a disciplinary hearing from the MPTS, they will have explained their reason for doing so in a letter. We will review your case and advise you on your chances of success. We will explain the processes and advise you on the best way of proceeding, and set about gathering evidence to support your case.
At your hearing we will represent you and argue that you are fit to practise and show how this is supported by the evidence obtained.