GMC admits bias exists and says it must be challenged

The British Medical Association has welcomed a review by the General Medical Council which found that bias within the GMC exists and needs to be systematically changed.

The review looked at the risk of bias in the way the GMC operates after the BMA accused the regulator of racially discriminating against people from ethnic minority groups.

Case study: Omer Karim

One example of this racial discrimination was against surgeon Omer Karim. Mr Karim was referred to the GMC after his hospital trust conducted several investigations into his conduct. Mr Karim then underwent almost four years of GMC investigations and was subjected to an FTP tribunal. This tribunal found that Mr Karim had done nothing wrong.

But the damage was done, Mr Karim lost his private practice and felt forced to leave his trust through a settlement agreement to be able to work elsewhere in the NHS. He was also forced to sell his family home and pull his daughter out of her private school to help with costs.

The GMC then challenged this ruling, arguing that the tribunal wrongly concluded that disproportionate referrals to the GMC by employers constitutes evidence of direct discrimination.

Doctors from minority ethnic backgrounds says the GMC’s refusal to accept the ruling has ‘crystallised’ worries the regulator treats doctors from minority ethnic backgrounds differently.

The GMC will introduce EDI training for its staff

Following this review, the GMC says it will implement various steps to mitigate against bias in decision-making processes, including:

• Consistently auditing the fairness of its work and seeking more external feedback.
• Introducing a single set of decision-making principles to increase consistency across the organisation
• Tailoring equality, diversity and inclusion training for GMC staff across different roles.
• Publishing more detailed data about GMC fitness to practise processes.
• Making sure fairness and EDI training are embedded into the way the GMC operates in future, when the Department of Health and Social Care introduces a new regulatory framework for healthcare professionals.

GMC Chief Executive Charlie Massey says it is important to recognise that all humans are biased in some way and this review has prompted the regulator to look at new ways of identifying and mitigating the chance of it affecting decision-making.

She said: “A degree of bias is inherent in human nature, and so a fundamental principle of our approach is to look for the risk of bias and to assess the controls we have in place to manage it. The recommendations in this report are key to that.”

A much-needed cultural change

Dr Latifa Patel, BMA equality lead, has welcomed this “much-needed cultural change” and says the Association is pleased to see the GMC “moving away from repeatedly comforting itself that there is no evidence of bias in its decision making processes.”

“Only time will tell if the actions set out today to mitigate against bias and provide greater transparency and reassurance will be effective and improve doctors’ confidence in their regulator. The review rightly highlights the need to involve stakeholders such as the BMA in future audits,” she added.

However, Dr Patel warns that there is still a long way to go until doctors have full confidence in the Council. She said: “The BMA has long called for an independent comprehensive review of GMC decision-making to ensure we have a regulation process that is just, fair and proportionate.

“While this review’s findings and actions are a step in the right direction, the recent case of Dr Arora (where there were multiple missed opportunities for GMC staff to raise concerns) shows there is still a long way to go to address the flaws in the GMC’s fitness-to-practise processes.

“We will continue to monitor the GMC’s progress and press for improvements until we have a regulator worthy of the full confidence of UK doctors.”