Medical Act 1983 (Amendment)

Part of the debate – in the House of Commons at 5:03 pm on 3rd March 1987.

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Photo of Mr Nigel Spearing Mr Nigel Spearing , Newham South 5:03 pm, 3rd March 1987

I beg to move, That leave be given to bring in a Bill to amend section 36 of the Medical Act 1983 to enable the Professional Conduct Committee of the General Medical Council to exercise greater discretion in respect of conduct which they judge cannot be regarded as acceptable professional conduct.

The Bill arises from the tragic and harrowing experiences of two lady constituents of mine in Canning Town and Silvertown, respectively. The Bill has been printed and distributed in two previous Sessions, and it was opposed by the General Medical Council and the then Minister for reasons that they have given.

The Bill has been prepared after extensive consultation with medical institutions and bodies, including the General Medical Council. Last year, the council of the British Medical Association passed a resolution that it would not oppose the Bill. I am glad to see in their places the two hon. Members who are sponsoring the Bill with me, my hon. Friend the Member for East Kilbride (Dr. Miller) and the hon. Member for Cambridgeshire, South-West (Sir A. Grant). He and other hon. Members have examples of other tragic cases that highlight the need for amendment of the law. The hon. Gentleman explained his tragic case to the House on 25 March 1986. I am also glad to see the Under-Secretary of State for Health and Social Security, the hon. Member for Derbyshire, South, (Mrs. Currie), on the Treasury Bench.

This is not kite flying or a testing of the temperature of the ten minutes rule procedure. In 1982, young Alfie Turner of Canning Town revealed, through his untimely death, an otherwise unknown and unsuspected gap in the legislation. I believe that this private Member's Bill, which consists of only two clauses and eight lines, is an excellent way of putting right the law in this case and that it is a proper use of this procedure.

It is not a matter of doctor bashing. The overwhelming majority of the members of the medical profession are dedicated and skilful, and I pay tribute to them. Indeed, at the age of 13 I owed my life to the work of a general practitioner who operated on me in a cottage hospital. But for that, I might not be here. Because of the very nature of its work, the profession needs protection, as do the public, from that tiny proportion of doctors whose conduct has proved to be unacceptable. The task of dealing with this problem falls to the General Medical Council, which was set up as a self-regulating professional body under section 36 of the Medical Act 1983.

Through its professional conduct committee, the GMC is able, by statute, to administer the mildest of sanctions at its legal disposal — that of conditional registration. There is an elaborate series of standing orders and rules that assist and are auxiliary to the legislation, but the General Medical Council can apply those sanctions, particularly the mildest of them — conditional registration—only if a doctor is found to be guilty of serious professional misconduct.

Even if professional misconduct is proved, or even if, according to its own rules, that conduct cannot be regarded as professional, the General Medical Council has no sanction. In the case of the late Alfie Turner of Canning Town, the facts alleged were proved. The doctor had failed to treat, to call an ambulance and to be courteous to the family of a seriously ill boy who was later found to be in a coma. Unfortunately, he died five days later. I am not suggesting that he would not have died had there been treatment immediately. Nevertheless, they were found as facts. The General Medical Council found that those facts were unacceptable, but did not amount to serious professional misconduct. Therefore, no action could take place.

A second, and rather horrific, case occurred in Silvertown some time later and, as a result, the doctor was found guilty of serious professional misconduct and appropriate steps were taken. But for that—two and a half years after the first case — the doctor would still have been practising.

Most hon. Members and others might be surprised that the hurdle of serious professional misconduct must be surmounted before constructive and remedial steps can be taken. The law at present does not permit appropriate action that could protect the public and the profession. The purpose of my Bill is to give discretionary power to the GMC so that it can impose conditions on a doctor where its professional conduct committee judges that the doctor's conduct is unacceptable. I use that term because it is already used by the GMC in respect of its own internal processes, and was accepted in the case of Alfie Turner. Although it found the doctor's conduct unacceptable, it did nothing about it. But for the bravery of a lady and her husband in Silvertown, in particularly distressing circumstances, in bringing the second case, that doctor could be practising today.

I hope that the House will find that position unacceptable. Why then does the GMC oppose my proposals? It gave its reasons in correspondence to a former Minister. First, it considers that its powers are adequate. As I and others have demonstrated, the events show the opposite.

Secondly, the GMC fears the substitution of the greater charge for the lesser. But do we have only dangerous driving? It not driving without due care and attention a useful and proper measure? In any case, surely Parliament and the public are more concerned with proper preventive and remedial measures than any technical difference between serious and other professional misconduct?

Thirdly, the GMC says that it is impracticable or inappropriate to attach conditions to a doctor's registration. The GMC already has that power and it uses it, as it has done for so many years. In my proposal, the use of it would be optional and at its discretion.

Recently, in notes sent to Members of Parliament, the GMC states that it is not conceivable that it could equitably examine all cases of alleged unacceptable conduct in relation to 100,000 doctors. The professional conduct committee could not do that. There is already an understandably elaborate preliminary process.

My Bill, as published, would mean that only doctors whose conduct was judged unacceptable by the professional conduct committee could be placed on conditional registration. In the same notes that were sent to hon. Members, the GMC states: The Council's primary task is, and always has been, of informing and protecting the public. If that is so, it must not only be done, but be seen to be done. The Merrison report of 1976, Cmnd. 6018, on which much of the current legislation was based, in paragraph 10, says: We have suggested that the regulation of the profession can be looked upon as a contract made between the public and the profession. It is important to understand in this context that the GMC is merely the instrument for the proper supervision of this contract and that it derives its authority, and indeed its being, from legislation. The legislature—that is, Parliament—acts in this context for the public, and it is for Parliament to decide the nature of the contract and the way it is to be executed.

On that, I rest my case in the hope that the Bill can proceed without opposition or objection.