General Medical Council internal review

The case

Concerns were raised about Arora Majula, a Manchester-based GP, after she had told her employer’s IT department that she had been ‘promised’ a work laptop by the medical director, but this was later found to merely be an acknowledgement of Dr Arora’s interest in obtaining one. In May 2022 the Medical Practitioners Tribunal Service (MPTS) heard the case. One aspect of the proceedings revolved around whether or not Dr Arora’s conduct was dishonest.

The dishonesty test that the MPTS followed was set out in Ivey v Genting Casinos (UK) Limited [2017] UKSC 67. The MPTS found that Dr Arora had been dishonest in her use of the word ‘promised’ as she had exaggerated her position. This led to them suspending Dr Arora for one month.

This decision drew widespread criticism, particularly from the Doctor’s Association UK, the British Medical Association (BMA) and the British Medical Journal (‘BMJ’). For instance, the BMJ stated that it was unfair to expect perfection from doctors and that the GMC was prone to applying their requirement of ‘scrupulous honesty’ unevenly. Various other commentators wondered how the allegations were not resolved locally and were able to progress as far as they did.

In May 2022, the GMC announced that they had commissioned an independent review of the MPTS’ decision. Later, on appeal by Dr Arora in June 2022, the MPTS decided that the dishonesty test had been incorrectly applied. The appeal was successful and the suspension was lifted. Furthermore, in August 2022 the High Court quashed the tribunal’s facts determination which meant that Dr Arora had no findings on her registration.

The GMC review

The results of the independent review found that the dishonesty allegation should never have been referred to the MPTS and should have been resolved locally, by the employer. The review also highlighted the GMC’s need to proactively seek out bias and also the requirement that doctors should be challenged in a polite and respectful way in tribunal hearings. Additionally, the report made a series of recommendations for the GMC, including embedding a culture of professional curiosity and expanding their existing internal review processes.

The authors of the GMC review also highlighted the need to treat doctors with compassion as fitness to practise investigations can have a significant impact on their mental and physical wellbeing.

The GMC accepted the recommendations without reservation and issued an apology to Dr Arora. They also stated that they are carrying out a ‘regulatory fairness review’, which is aimed at tackling and understanding the effects of bias in decision-making.