Council 20-21 May 2003
4b
To note President's Advisory Committee: Work since November 2002 Issue 1. The President’s Advisory Committee’s work since its report to Council in November 2002. Recommendation 2.
To note this report (paragraphs 4 -24).
Further information 3.
Sarah Bedwell Christine Payne
020 7915 3618 020 7344 4751
[email protected] [email protected]
Background 4. This paper summarises the PAC's work since November 2002. Council previously agreed that it would recommend to the reconstitued Council that it would not be necessary for a PAC to continue after 1 July 2003. The last scheduled meeting was held on 27 March 2003. Discussion Council for the Regulation of Healthcare Professionals 5. The President was appointed to represent the GMC on the Council for the Regulation of Healthcare Professionals (CRHP), which was to be chaired by Jane Wesson. Other appointments included ex-GMC lay member, Sue Leggate. The President reported that he had attended CRHP’s first meeting, and that work had begun on a baseline assessment of where regulators are on such issues as education and fitness to practise, and the power to appeal against fitness to practise decisions. Implementation of the Reforms 6. The PAC received regular updates on the progress of legislation, and provided advice to the President on a number of aspects, including the proposal that the GMC should have a statutory duty to co-operate with other organisations, and the procedure for reviewing interim orders. The section 60 Order was formally approved by the Privy Council on 17 December 2002 and work then began on the programme of secondary legislation. European Commission: Draft Directive on the Mutual Recognition of Professional Qualifications 7. The GMC had continued to be active in its lobbying programme, and a number of MEPs and professional and consumer bodies had expressed support for the GMC’s concerns. The President reported that he had provided briefing to parliamentarians at a meeting on 31 October 2002, and this had been followed by a meeting in January 2003 between the Alliance of UK Health Regulators on Europe (AURE) and John Hutton MP, Health Minister, and Baroness Finlay, cross bench peer, to discuss our concerns. Revalidation and Appraisal 8. The Committee agreed that the Registration Committee should be responsible for overseeing the implementation and operational policy issues associated with the licence to practice and revalidation. Reports from external consultants on the feasibility of revalidation proposals against the background of the introduction of annual appraisal for NHS doctors were considered. The President hosted a Symposium on 18 February 2003, to discuss the key issues around revalidation - the links between appraisal, revalidation, clinical audit, and medical education - with representatives of doctors, patients and employers; and to explore the possibilities for maintaining confidence in their quality and reliability. The debate continued at the
2
Internal Conference in February 2003, and the President held meetings with representatives of the BMA and RCGP. The first package of information was issued to doctors and other interested parties in April 2003. Accommodation and Relocation 9. The PAC received a number of progress reports from the Accommodation Strategy Working Group (ASWG), following the strategy agreed by Council in November 2002. This included the appointment of property advisers Jones Lang Lascalles, the identification of possible properties, and preliminary visits by ASWG members. 10. The Chief Executive reported that consultation with staff had begun and that an employee assistance programme had been put in place. The Committee noted that detailed work had been undertaken on the planned relocation of work, and endorsed the conclusions reached about which functions should remain in London and which should be relocated to Manchester. Electoral Scheme 11. Following Council’s decision in November 2002, the Committee was asked to advise the President on approval of the Electoral Scheme, after the relevant legislation had been approved by Parliament and the Privy Council in December 2002. The Electoral Scheme was issued in January 2003. Postgraduate Medical education and Training Board (PMETB) 12. The PAC noted progess on the establishment of PMETB, and that the enabling legislation was expected to be passed before the summer 2003 recess. The GMC was represented on the working group, and we submitted our response to the consultation document 'Medical, Health Care and Associated Professions', following discussions with the Education and Registration Committees. Shipman Inquiry 13. It was agreed that the Chief Executive would give the GMC’s evidence at the Inquiry, and his statement was submitted in December 2002. Since then, the Inquiry had requested large amounts of further information and additional resources had been employed to deal with the extra work. The Office had been advised that the Inquiry would focus next on the GMC’s role and processes from the 1970s to the present day. Work is underway on planning the communications strategy. NHS University (NHSU) 14. Progress on proposals for the NHSU was noted following the publication of the Government’s consultation document “Learning for Everyone”, and the GMC had met Professor Fryer, Chief Executive of the NHSU, in February 2003.
3
Assessment 15. Following a meeting in mid-2002 (attended by the Chief Executive), CMO (England) asked the major players in assessment of doctors to write describing their assessment role and possible challenges and problems in the way of developing better practice. The President responded on behalf of the GMC, and the Office attended a follow up meeting in February 2003. Patients Protection Bill 16. It was noted that this private members Bill sought to prevent doctors from withholding or withdrawing nutrition and hydration from patients, if the intention of doing so was to hasten or cause death. The Bill had been debated in the House of Lords on 17 March 2003, and the Office had sent briefing to peers about the GMC’s guidance, “Withholding and Withdrawing Life-Prolonging Treatments: Good Practice in Decision-making”. Victoria Climbie Inquiry – interprofessional learning 17. The GMC had been represented at a conference arranged by the Department of Health (DoH) to consider recommendations for improving arrangements for interprofessional learning about children and families. Conclusions reached by the project, led by the General Social Care Council, would be fed into the GMC’s work on undergraduate and postgraduate medical education. Modernising Medical Careers 18. Work in progress on this initiative, launched in England in February 2003, was noted, and the Office would maintain close contact with DoH about future developments. Confidentiality 19. The Patient Information Advisory Group (PAIG) reported its concerns about a number of proposals which affect the GMC’s guidance on confidentiality. These include giving the Commission for Healthcare Audit and Inspection (CHAI) much wider powers of access to medical records than the Commission for Health Improvement (CHI) currently has; new powers of access to medical records being sought by Primary Care Trusts to facilitate the assessment of quality indicators required under the new GP contract; and a suggested amendment to The Health Service (Control of Patient Information) Regulations 2002 allowing the use of databases containing identifiable patient data to be used for management, planning and assessment purposes. 20. The PAC agreed that the Standards Committee should discuss this at the earliest opportunity, to ensure that the GMC can fully consider its position and response.
4
Independent External Review 21. Council considered the report of the independent external review on 26 February 2003. Subsequently the President, having consulted the members of the PAC, provided copies of chapters 4 and 5 of the report to two journalists covering the Dr Colman’s application for a judicial review of PCC decisions about her empanelment in order that their reports might be both fair and accurate. Legal Proceedings 22. The PAC agreed that the President and Chief Executive should take decisions about the handling of the claim brought by Dr Colman, seeking advice from the PAC where necessary. Key events and decisions on the handling of the case are set out below: a. Dr Colman served the claim on the GMC by letter dated 30 October 2002. b. On 20 December 2002 the GMC issued an application to strike out the proceedings. c. The hearing to consider the strike out application was listed for 12 and 13 May 2003. d. On 12 March 2003 the Charity Commission decided that, in their view, the claim constituted or included charity proceedings and refused authority for the taking of the proceedings. e. Given the new circumstances, on 16 April 2003 the GMC issued an application to stay the proceedings as Dr Colman did not have Charity Commission consent. That step was taken in the light of the duty owed by all Trustees to act in the best interests of the charity. The aim, in the new circumstances, was to substitute a low cost procedure (the application to stay) for a higher cost procedure (the application for strike out). f. In response, Dr Colman wrote on 23 April 2003 to the Master in charge of the case. In that letter, Dr Colman suggested that there should be mutual agreement to a stay of two months, to determine whether the proceedings were charity proceedings, with an agreed timetable for service of documents thereafter. If that were not possible, Dr Colman proposed that the hearing on 30 April 2003 and the hearing on 12 and 13 May 2003 be re-listed to later dates, that is adjourned. The GMC did not agree to Dr Colman’s suggestion. g. On 25 April 2003, Dr Colman issued her own application for an Order that the proceedings be stayed for two months, after which time the GMC should serve a Defence. h. The hearing to consider the applications to stay went ahead on 30 April 2003. The Court ordered that:
5
i.
The proceedings are stayed.
ii.
Either party may apply to have the stay removed after 1 July 2003.
iii.
The costs of the application for the stay are to be dealt with later.
23. As the proceedings are stayed, the hearing listed to consider the GMC’s application for strike out will not go ahead. There will be no further action on the case unless and until either party applies to have the stay lifted. 24. On 4 March 2003 the permission hearing for Dr Colman’s request for a judicial review of decisions about her PCC empanelment was adjourned until July 2003. Since then the Charity Commission have informed the office that they consider that Dr Colman’s application for judicial review may require their authority. Recommendation: To note this report. Resource implications 25.
There are no resource implications directly from this paper.
Charitable Status 26. The Committee’s work has been compatible with our charitable status and with charity law. Equality 27.
There are no equality considerations directly from this paper.
6
