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Defence Lawyers for Doctors 

Facing an allegation of professional misconduct is never easy.  For medical professionals, allegations that they are not fit to practise are particularly serious, often leading to investigation by the GMC and the involvement of the Medical Practitioners Tribunal Service.  Investigation can be a complex and lengthy process which requires high quality legal advice from the initial investigation through to the final tribunal decision being made.  As a barrister with extensive experience in professional representation, I am able to guide you through this process and answer your questions.

What does the initial GMC investigation involve?

Whenever a complaint is made against a doctor, inquiries will be carried out and the General Medical Council (GMC) will decide whether to refer the doctor in question to a tribunal.  Factors to be considered when deciding whether to refer will include how serious the allegation is and whether it is likely that the case could be proven at tribunal.

The investigation by the GMC will gather evidence, which may include obtaining witness statements, obtaining expert reports and assessing the doctor’s performance.  The doctor in question will have an opportunity to comment.  Legal advice at this stage is very important in order to safeguard the doctor’s interests.

Once the investigation is complete, the case will be considered by two case examiners.  They will decide:

  • whether no further action is required;
  • whether a warning should be issued;
  • whether the doctor should agree certain specific undertakings; or
  • whether the case should be referred to the Medical Practitioners Tribunal Service for a tribunal hearing.

The Medical Practitioners Tribunal Service is the body which deals with the tribunals which determine whether a doctor is fit to practise.  The Medical Act 1983 sets out the powers and responsibilities of the MPTS in relation to tribunals.  The GMC Fitness to Practise Rules also lay out how the tribunals operate.  The rules around the tribunals can appear complicated but, with the help of expert advice, the system can be navigated and a strategic approach taken to defending the allegations.

What is an Interim Orders Tribunal?

In certain cases, a doctor will firstly be required to appear before an Interim Orders Tribunal (IOT).  This can happen at any point in the investigation process.  An IOT can suspend or impose conditions on registration while investigations are ongoing and before a final determination is made as to fitness to practise. 

Cases are usually referred to an IOT where the GMC believes this is necessary to protect certain members of the public, to protect the general public interest, or to protect the interests of the doctor. 

An IOT can suspend registration or impose registration conditions for a maximum of 18 months. 

There must be review of the order every 6 months at least.  It is important to remember that these orders are intended to be interim, pending a final decision being taken about fitness to practise.

An example of a case which may be referred to an IOT would be one where there is a risk to the public due to clinical issues.  For example, if a doctor shows a lack of medical knowledge or there is a failure to show the proper standard of care, it may be appropriate to refer the matter to an IOT. 

Equally, non-clinical issues may also lead to a referral – for example, investigations by the police into the doctor’s behaviour which suggest that the doctor is a threat to the public.

What is a Medical Practitioners Tribunal?

A medical practitioners tribunal (MPT) is the body which fully investigates allegations that doctors are not fit to practise. 

The MPT is made up of medical professionals and laymen who investigate allegations.  A tribunal will usually be made up of three members – a chairman, one medical professional and one layman.  In addition to the tribunal members, a legal assessor advises on points of law, procedural rules and the powers of the tribunal.

In terms of representation, both the doctor and GMC will usually be legally represented.  The GMC and the doctor in question can both call and cross examine witnesses.  The tribunal will also ask the witnesses questions.  This evidence gathering and examination process is the opportunity for the doctor to clearly articulate their case.  It is therefore extremely important to have high quality representation at this point.

Once all the evidence has been led, the tribunal will decide whether the alleged facts took place and whether the doctor’s fitness to practise is impaired and his or her registration should be affected.  The standard of proof is the civil standard of proof, i.e. the balance of probabilities, rather than the higher criminal standard of ‘beyond reasonable doubt.’

Fitness to practise can be impaired in many circumstances.  For example, a failure to keep medical knowledge up to date could render a doctor unfit to practise.  Similarly, if a doctor abuses their position as a doctor or is too ill to work safely, this too could lead to a finding that the doctor is unfit to practise.

Even if it is found that the doctor’s fitness to practise was not impaired, it is possible for the tribunal to issue a warning.  In the event that the doctor’s fitness to practise has been impaired, there are numerous possible decisions available to the tribunal.

It may be that no action at all is taken or undertakings are given by the doctor.  In other cases, sanctions may be more severe and include placing conditions on the doctor’s registration; suspending the doctor’s registration; or removing the doctor from the Medical Register, meaning that they can no longer practise.  Significantly, the tribunal cannot impose financial penalties or order a doctor to provide treatment.

The tribunal, however, does not necessarily have the final say on the matter.  Doctors have a right to appeal against a decision to restrict or remove their registration to the High Court in England and Wales and the Court of Session in Scotland.  Any appeal is likely to be complicated and will require extensive knowledge of the law, which an experienced barrister will be able to provide.

Importance of Strategic Advice - Defence Lawyers for Doctors 

Evidently, the GMC disciplinary system is complex. When your livelihood and professional reputation is at stake, it is important to have access to strategic advice from the outset. Due to my significant experience in the area of professional tribunal cases, together with the often accompanying criminal elements to these matters, I am in a strong position to provide top level representation and first class advice to you if you are facing potential disciplinary action or a professional tribunal. Get in touch with me directly to find out more. 

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