Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
I have considerable experience of working with the GMC gained over two decades of investgation work.
Dr Kapur is correct in saying that the GMC has partial accountability to the PSA(1) , however I twice asked this organisation to review a GMC decision not to investigate what seemed to me to be serious matters and their response on both occasions was that a "decision not to investigate is not defined as a decision for the purposes of our remit" meaning they have no power to scrutinise such decisions.
Given that the GMC's failings encompass both a failure to investigate serious concerns such as in the case of Ian Paterson and its inexplicably harsh verdicts in other cases such as the case of Manjula Arora, I agree that it needs to be accountable and all its decision making needs to be open to scrutiny.
I think however, the problem runs deeper than this and accountability alone will not improve the situation. Having run an investigation team for two decades, I do not consider the GMC investigation processes and powers to be fit for purpose. In 2015 I passed evidence to the Health and Social Care Committee about the GMC's point blank refusal to look at payments from private hospitals to doctors which appeared designed to influence clinical practice (2) and which directly breached the principles in Good Medical Practice. During the hearing ( Q101) it transpired that the GMC do not have the power to use investigators to perform proactive investigation work something that in my experience is essential to properly examine an issue.
We certainly need a regulatory framework which is transparent and accountable in its decision making, but also one which has the necessary powers processes and capability to deal with the problems that it faces,
Re: How the GMC can do better
Dear Editor
I have considerable experience of working with the GMC gained over two decades of investgation work.
Dr Kapur is correct in saying that the GMC has partial accountability to the PSA(1) , however I twice asked this organisation to review a GMC decision not to investigate what seemed to me to be serious matters and their response on both occasions was that a "decision not to investigate is not defined as a decision for the purposes of our remit" meaning they have no power to scrutinise such decisions.
Given that the GMC's failings encompass both a failure to investigate serious concerns such as in the case of Ian Paterson and its inexplicably harsh verdicts in other cases such as the case of Manjula Arora, I agree that it needs to be accountable and all its decision making needs to be open to scrutiny.
I think however, the problem runs deeper than this and accountability alone will not improve the situation. Having run an investigation team for two decades, I do not consider the GMC investigation processes and powers to be fit for purpose. In 2015 I passed evidence to the Health and Social Care Committee about the GMC's point blank refusal to look at payments from private hospitals to doctors which appeared designed to influence clinical practice (2) and which directly breached the principles in Good Medical Practice. During the hearing ( Q101) it transpired that the GMC do not have the power to use investigators to perform proactive investigation work something that in my experience is essential to properly examine an issue.
We certainly need a regulatory framework which is transparent and accountable in its decision making, but also one which has the necessary powers processes and capability to deal with the problems that it faces,
References
(1) https://www.bmj.com/content/379/bmj.o2892/
(2) http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidence... question 98 onwards
Competing interests: No competing interests