More than a quarter of overseas GPs lack legal representation at fitness-to-practise hearings, and are more likely to face ‘harsher sanctions’ as a result, an indemnity organisation has revealed.
GMC data obtained via a Freedom of Information (FOI) request by the Medical Protection Society (MPS) showed that 28% of UK GPs who graduated overseas were not represented when facing a Medical Practitioners Tribunal Service (MPTS) hearing between 2018 and 2021.
This compares with 21% for those GPs who qualified in the UK.
The figures also showed the ‘dramatic difference’ representation makes to tribunal outcomes, the MPS said.
Among 98 overseas GPs who faced an MPTS hearing, those ‘without legal representation were more likely to receive a harsher sanction’, it added.
The findings included:
- Of those who were unrepresented, 93% were either suspended or erased from the medical register with only 4% receiving a ‘no impairment’ judgement.
- However, only around half (52%) of those who were represented were suspended or erased from the register while 28% received a ‘no impairment’ judgement.
- One in ten (11%) of those with representation were given a more lenient ‘warning’ – indicating their behaviour or performance is below the standards expected and should not be repeated – but no GPs without legal representation had this outcome.
MPS says inductions for doctors who graduated overseas must ‘dramatically improve’ so they are aware that the state indemnity schemes only cover NHS clinical negligence claims and not GMC fitness to practise hearings.
It urged the GMC to encourage more overseas doctors to join a medical defence organisation (MDO) when they arrive in the UK ‘so they do not risk facing a fitness-to-practise hearing alone’.
MPS president Professor Dame Jane Dacre said: ‘We have been talking with doctors who qualified overseas to gauge their understanding of the healthcare system and indemnity arrangements when they arrived in the UK.
‘Only 52% said they joined an MDO when they arrived and started work. The GMC figures serve as a powerful reminder of how important it is for these doctors to ensure they have support with GMC investigations as soon as they start work.’
She added that ‘many coming to work in the NHS may assume that the state indemnity schemes provide blanket protection’, with NHS guidelines ‘bewildering for any doctor’ and ‘even more difficult’ for those who trained overseas.
However, state schemes cover only NHS clinical negligence claims and ‘support with GMC investigations, complaints, inquests and disciplinary proceedings is also vital’, she said.
Professor Dacre added: ‘GMC investigations often take several months – and sometimes years – to conclude and the hearings can last weeks. For some, fitness to practise proceedings have career ending implications.
‘I cannot imagine facing this process alone, without someone fighting my corner. Sadly though, 28% of GPs who graduated overseas do and the majority go on to face tougher sanctions at their hearing when compared to those with legal representation.’
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