Independent non-prescribing medical doctors do not need a licence: the GMC’s own published guidance shows that

I found this ‘licence case study‘ on the GMC website, just a few days before my MPTS tribunal. The GMC had not mentioned it to me.

Screenshot_2019-03-15 I'm retired and thinking of giving up my licence What should I do

I submitted it as a ‘legal argument’ of the GMC, after the GMC’s barrister had made his oral submission on 18th March. The transcript (to be published in full) will show that he simply kept repeating ‘unlicensed practice’ with no regard for my own legal arguments made to the GMC weeks earlier.

The GMC’s barrister tried to oppose the case study being considered by the tribunal panel, even though he acknowledged it came from the GMC’s own website. This may seem incredible to readers of this piece, but I believe the transcript will support my account.

However, because the tribunal chair interrupted my submission, I lost my place in my notes and did not actually discuss this case study. However, the panel deliberated for over three hours and had ample time to consider it. I did fully discuss the Medical Act 1983, below.

The ‘case study’ refers to ‘nutritionism’ and ‘homeopathy’, which must often bring mental health diagnoses such as depression, anxiety, bipolar disorder and schizophrenia into consideration. The GMC guidance makes clear that this independent non-prescribing doctor can practice without a licence, but remain on the register. He is free to give opinions and advice.

Under the Medicines Act 1968, only licensed doctors can prescribe prescription-only medication.

The Medical Act 1983 makes clear that doctors working outside of the NHS and similar state organisations, who do not sign death certificates or do Mental Health Act work, do not have to be licensed:

Screenshot_2019-04-01 Legislation

[…]

Screenshot_2019-04-01 Medical-Act-1983_pdf-73285575 pdf

Screenshot_2019-04-01 Medical-Act-1983_pdf-73285575 pdf(1)

An earlier part of the Act makes clear that ‘regulations’ can only be made for licensed doctors. Therefore, although the GMC must monitor registered-but-unlicensed practice, it

Screenshot_2019-04-01 Medical-Act-1983_pdf-73285575 pdf(2)

cannot introduce rules.

This may seem strange, but as I said in the tribunal of 20th March: ‘…in interpreting statute law there must be a primary regard for the will of Parliament, and there are no significant ambiguities or unintended consequences of the 1983 Act concerning licensing. It is well-known that Margaret Thatcher’s conservative government had a deep suspicion of professional monopolies, and in restricting licensing to the activities specified in Sections 47 and 48 of the 1983 Act, Parliament clearly intended to provide a degree of freedom to independent (especially non-NHS) medical practitioners.’

So, if the GMC wants to regulate (and not just monitor) registered-but-unlicensed practice it must go back to parliament and get the law changed. It cannot pretend, as it appears (selectively) to be doing now, that it requires all doctors who see patients to be licensed.

In my case, the longer the GMC refuses to acknowledge the legal position, the more likely it is that its obtaining my suspension reflects its bias, and perhaps even a collusion with the senior psychiatrists I have criticised, rather than mere clumsiness and incompetence.

Under UK law, I am free to give ‘opinions and advice’. Moreover, the GMC has not disputed that my ‘opinions and advice’ on psychiatric and medical issues are well within accepted practice, or what in law is sometimes called a ‘responsible body of opinion’.

To give one example relevant to its own ‘case study’ above, I am a supporter of MMR vaccination.

I suggest that in apparently having no interest in monitoring the homeopath Dr Littleman, perhaps for decades, the GMC is failing in its duty to protect ‘patients and the public’. There is a good chance he could develop anti-vaccination views. Maybe he already has.

So far, the GMC has appeared more interested in protecting the ‘reputation’ of ‘certain psychiatrists’ than in carrying out its legally-prescribed duty in part 1 of the Medical Act 1983: ‘(a) to protect, promote and maintain the health, safety and well-being of the public.’

And ‘reputation’ does not appear in any UK law relevant to this issue, that I know of.

 

(Added 4th April. Concerns about medical homeopaths are hardly a secret:

Screenshot_2019-04-04 ben goldacre on Twitter

)

 

About Dr Neil MacFarlane MRCPsych

Independent Psychiatrist providing culturally informed mental health opinion, advice, and a few new facts. Based near London, UK. Main qualifications: BA MBBS MA MRCPsych.

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