GMC calling PAs 'medical professionals' puts safety at risk, court hears

The GMC acted unlawfully, irrationally and potentially put patient safety at risk through its approach to regulating associate professionals, a court has heard.

The medical regulator’s ‘deliberate’ and ‘conscious’ decision to apply the umbrella term of ‘medical professional’ to doctors and physician and anaesthesia associates saw it go against its own statutory functions and objectives, lawyers for the BMA have argued in the High Court.

During a two-day hearing held this week on 12 and 13 February, the court heard how the GMC’s decision to refer to all three groups as medical professionals in its 2024 GMP (Good Medical Practice) guidance, has served to blur the distinction between the roles of doctors and non-doctors.

Acting for the BMA at the High Court this week, Jenni Richards KC argued the GMC’s decision to refer to doctors and associates as ‘medical professionals’ within its GMP guidance and elsewhere was inconsistent with its statutory framework, failed to have regard to safety and public confidence and was ultimately irrational.

She said: ‘It is not the case that there is no role [for associate professionals], that is not the BMA’s position, but there is a distinction between these roles and, in the absence of a scope of practice, the public should not be potentially misled into thinking that associate professions can do everything a doctor can.

‘Our case is that the GMC has chosen to articulate this guidance in a way that conflates rather than differentiates the fundamentally different roles of doctors and associates.

‘The [GMP] guidance tells the public and associate professionals that they are members of the medical profession, that they are entitled to describe themselves as being in medical practice … that gives rise for the potential for patient confusion and concern.’

The GMC became the regulator of the associate professions (physician and anaesthesia associates) following the implementation of the Anaesthesia Associates and Physician Associates Order last December.

Ahead of this, however, the regulator already labelled doctors and associates as medical professionals when it published the latest version of its GMP guidance on 22 August 2023.

The BMA announced its intention to seek a judicial review of the GMC’s decision in June last year.

Representing the GMC, Ivan Hare KC rejected the claim the regulator’s decision to apply the term ‘medical professional’ to doctors and associates was inconsistent or contrary to either the law or to its own statutory objectives.

He said that, while it was not the purpose of the GMP guidance to differentiate between the roles of doctors and associates, the GMC did not accept that its decision had resulted in confusion among patients or that it had undermined their safety.

He said: ‘There is simply no evidence for the assertion that the GMC’s choice of the term “medical professional” in the GMP has impacted patient safety or, indeed, that it has caused any confusion for patients.’

Following the conclusion to the two-day hearing on 13 February the judge presiding over the review Mrs Justice Lambert said she had been given ‘much to consider’ ahead of delivering her judgment.

Speaking at the outset of this week’s hearing, BMA council chair Phil Banfield said the BMA had had no choice but to challenge what it saw as a ‘failure’ by the GMC to distinguish between doctors and associates.

He said: ‘The description of physician and anaesthesia associates as "medical professionals" is not a semantic disagreement we have with the GMC. It goes to the core of its failure as a regulator.

‘Its job is to reassure the public that there is a clear difference between who is and who is not a doctor. Now that it is a regulator both of doctors and non-doctors, that job has become even more crucial, and its failure to distinguish between them even less forgivable.

‘Put simply, associates are not medical professionals. Doctors are. The NHS is a complex enough system as it is and if the GMC’s regulatory approach is to further confuse patients by blurring the lines between the two, it only undermines public confidence in the healthcare they receive.

‘It should not need a court to make the GMC to do the right thing, listen to the medical profession, and put patients first. It should not have required us to bring this case, and it is galling to see taxpayers’ money being spent on defending the GMC’s confusing position, which we hold to be flawed and unsafe. Doctors will continue to advocate for and on behalf of our patients’ safety.  

‘There is currently an ongoing Government review into the safety of the PA and AA roles while evidence of patient harms mounts. The GMC should be taking stock of the situation and concluding that instead of defending the indefensible it should concentrate on giving patients the reassurance that they are being treated by a doctor, with all the training and skill that go with that title.’

Mrs Justice Lambert is expected to deliver her judgment on the case later this year.