Meeting of the RCPCH with the General Medical Council

Representatives of the RCPCH met with senior leadership at the GMC on 27 February 2018 to discuss issues arising from the recent GMC appeal regarding Dr Hadiza Bawa-Garba.

Representatives of the RCPCH were Professor Neena Modi, President; Professor Judith Ellis, CEO; Dr Mike Linney, Registrar; Mr Graham Sleight, Head of Governance. Representatives of the GMC were Professor Terence Stephenson, Chair; Mr Charlie Massey, CEO; Mr Anthony Omo, Director of Fitness to Practise; Dr Colin Melville, Director of Education and Standards; Ms Stephanie McNamara, Assistant Director of Communications.

RCPCH asked the GMC to explain clearly why they had come to the decision to launch an appeal against the Medical Practitioners’ Tribunal (MPP) verdict in respect of Dr Bawa-Garba. The GMC acknowledged that appeals against MPT decisions (“Section 40 appeals”) are discretionary (PDF), but also stated that they had concluded they had no choice other than to pursue the appeal in light of legal advice they had received that the MPT had erred in law in attempting to re-hear elements of Dr Bawa-Garba’s criminal trial. RCPCH pointed out that the simultaneous use of the terms “discretionary” and “no choice” in GMC communications have added to the confusion, uncertainty, anger and distress felt by healthcare practitioners.

RCPCH raised the issue of doctors’ reflections. In his letter to Dr Sarah Wollaston MP, of 9 February (PDF), Charlie Massey stated, “The GMC never asks doctors to provide their reflective statements”. The RCPCH asked whether this extended to third parties such as Royal Colleges who may hold such statements on their systems such as ePortfolio. The GMC response was that third parties, holding such reflective statements written by doctors, might be required or choose to disclose to show that the doctor has insight into what has happened and to provide specific examples of remediation.

RCPCH wishes to emphasise that reflection is an important component of good medical practice. RCPCH has no record of having ever disclosed doctors’ reflections to the GMC. However, in the light of confirmation that Royal Colleges might be required to disclose doctors’ reflections to the GMC, potentially without a doctor’s consent, RCPCH will urgently be reviewing their guidance on reflective practice, as well as seeking legal advice on any relevant enquiries that may be received from the GMC. In the meantime, RCPCH recommends that trainees follow current guidance.  RCPCH notes that the GMC is also undertaking its own review regarding reflective practice.

The GMC outlined several pieces of work that it is undertaking in response to the concerns raised in the last few months. The review of Gross Negligence Manslaughter, chaired by Dame Clare Marx, will be announcing terms of reference shortly, and RCPCH has offered to provide a representative to this group. RCPCH and GMC reiterate that doctors are not above the law, but also agree that existing law may be found not to be fit for purpose and that the Marx review may lead to a conclusion that the law and how it is interpreted through the legal process requires review.  

RCPCH expressed willingness to contributing to other GMC work around related issues, including doctors’ mental health and wellbeing, and ensuring fair treatment of Black and Minority Ethnic doctors in GMC processes.

Ultimately though this may be a prolonged process. RCPCH wishes to see a return in the confidence of the profession and the public in the regulation of healthcare practitioners, and that the safety of patients is built upon honesty and a culture of learning from mistakes

RCPCH will continue to keep members informed of developments, through this website, social media, and meetings with members. Comments from members on these issues are welcome at