Fitness to Practice

Post-Shipman fitness-to-practise overhaul falls victim to cuts

11 Aug 10

The Government is set to scrap plans for a massive shake-up of GP fitness-to-practise hearings, in a move it claims will save the NHS more than 60 million by avoiding an unnecessary new layer of bureaucracy.

In the latest in a string of Labour initiatives to face the axe, proposals for an independent tribunal called the Office of the Health Professions Adjudicator (OHPA) appear to be doomed, after Treasury forecasts claimed the costs risked spiralling.

A consultation published this week sets out three options for the future, with the Government's preferred option enabling the GMC to keep control of fitness-to-practise hearings, but on the condition that it slashes the bureaucracy and red tape involved in a bid to keep a tight lid on costs.

The OHPA, which had been due to take over fitness-to-practise hearings from April next year, was spawned by the Shipman Inquiry, which highlighted concerns about whether the GMC could operate adjudication independently from its investigatory role.

The consultation claims the original estimated costs over two years of setting up the OHPA had sky-rocketed from between 3m and 4m to up to 16m - and suggests the long-term savings from scrapping it could top 60 million.

It says the GMC has already tackled major sources of concern such as slashing the length of hearings and, most significantly, switching to a civil standard of proof, which it said made it more akin to modern tribunals in place for other professions.

‘The Government’s initial assessment of these proposals (subject to this consultation) is that they present an opportunity for the GMC to modernise and improve existing processes and provide for independence of adjudication on a much clearer basis than is the case now,' it adds.

‘This may also provide the opportunity to realise substantially the same benefits as regards adjudication for doctors as would be the case should OHPA become operational, without the additional cost to the public purse.'

The consultation also claims that the new-look GMC hearings have proved to be robust, with less than 0.5% of decisions successfully challenged in 2008/9.

It adds: ‘The Government has asked the GMC whether, and if so how, independent adjudication could be strengthened without the need to proceed to implement OHPA, but instead through modernisation of existing legislation. The GMC has made it clear that it fully supports the principle of independent adjudication and it is willing to develop such a model.’

Recently Stephen Shaw, chief executive of the OHPA, told Pulse the new body planned a major crackdown on GPs seen as deliberately time-wasting in fitness-to-practise hearings, claiming huge delays in cases are caused because of doctors' legal teams drawing out proceedings.

He claimed the OHPA would dramatically reduce the time spent at hearings and slash GMC bureaucracy.

Responding to the publication of the consultation this week, GMC chief executive Niall Dickson said: 'We welcome the Government's proposal as a sensible way forward.'

'The GMC is committed to the concept of independent adjudication and to building on the reforms that we have already implemented.'

The previous administration's post-Shipman regulation agenda has become a prime target for NHS cost-cutting in recent weeks. The GMC recently announced plans to streamline its revalidation process after Pulse revealed the Government was determined to slash the costs.