Sir Anthony Hooper, who was invited to conduct an independent review of how the GMC engage with individuals who regard themselves as whistleblowers, presented his report to the GMC on 19 March 2015.
Whistleblowing is the raising of a concern, either within the workplace or externally, about a danger, risk, malpractice or wrongdoing which affects others.
Sir Anthony was asked “to conduct a review of how the General Medical Council handles cases involving individuals who regard themselves as whistleblowers and who have appropriately raised concerns in the public interest. These are individuals:
- whose fitness to practise is being investigated or determined under the General Medical Council (Fitness to Practise) Rules 2004; or
- who have reported such a concern to the GMC.
Sir Anthony communicated with a number of doctors about their experience as whistleblowers, spoke to employers and received the help of many staff members of the GMC.
This review was conducted against the background of Sir Robert Francis QC’s review and recommendations contained in the Report on the Freedom to Speak Up – February 2015, the introduction of the duty of candour and the GMC’s own guidance, Good Medical Practice (2013) about the duty to raise concerns.
Sir Anthony’s concern is that employers may use the process of making an allegation to the GMC about a doctor’s fitness to practise as an act of retaliation against a doctor because he or she has raised concerns or, simply, as an inappropriate alternative to dealing with the matter in-house. If that happens, the GMC unwittingly becomes the instrument of the employer in its campaign against the doctor.
In Sir Anthony’s opinion the GMC can take a number of steps to enhance its ability to recognise when referral is being used by organisations as a reprisal against a doctor who has raised concerns, or as an inappropriate alternative to dealing with the matter in-house and made eight recommendations.
- Organisations making the referral should be encouraged to answer a written question the effect of which is to ascertain whether the doctor being referred has raised concerns about patient safety or the integrity of the system
- They should be encouraged to have the document containing the allegation signed by a registered doctor and to contain a statement by the doctor to the effect that: “I believe that the facts stated in this document are true”
- If the written document containing the allegation is not signed by a registered doctor and/or does not contain a statement to the effect that “I believe that the facts stated in this document are true”, organisations should be encouraged to explain why this has not been done.
- If a doctor being referred to the GMC has raised concerns about patient safety or the integrity of the system with the organisation making the referral, then the necessary steps should be taken to obtain from the organisation material which is relevant to an understanding of the context in which the referral is made
- Investigators assessing the credibility of an allegation made by an organisation against a doctor who has raised a concern should take into account, in assessing the merits of the allegation, any failure on the part of an organisation to investigate the concern raised and/or have proper procedures in place to encourage and handle the raising of concerns
- In those cases where an allegation is made by an organisation against a doctor who has raised concerns, the Registrar should, where it is appropriate to do so, exercise his powers to conduct an examination into that allegation, including asking the doctor for his or her comments on the allegation and the circumstances in which the allegation came to be made
- Those who investigate allegations made against doctors who have raised concerns must be fully trained to understand “whistleblowing”, particularly in the context of the GMC and the NHS
- The GMC, together with healthcare regulators, professional organisations, unions and defence bodies, set up a simple, confidential and voluntary online system, run by an organisation independent of the regulators which would enable healthcare professionals to record electronically the fact that they have raised a concern with their employers.
BLM would be happy to provide further advice on the recommendations and their implementation as part of the GMC’s investigation process.