Although private medical treatment is often perceived as being better than NHS management, a decision by the Medical Practitioners Tribunal Service (MPTS) last year highlighted the potential pitfalls patients can face when private doctors perform procedures their NHS employers have stopped them from performing. Moving forwards we ask: Should the GMC require doctors to record all limitations to their practice?

The decision resulted in the erasure from the GMC Register, the list of doctors who are legally entitled to practice, of Mr T, a general surgeon based in Essex. This meant that Mr T was no longer able to work as a surgeon, with the decision being ‘necessary, proportionate and in the public interest’.

Mr T had been working at an NHS Trust in Essex and in early 2016 underwent additional training in an attempt to improve his skills in colonoscopies. As a result of ongoing issues with his skills, the NHS trust prevented him from performing colonoscopies at the trust. At the same time, Mr T had been performing private work with Spire who, importantly, he failed to inform of this restriction in his practice.

In 2018, despite ongoing restrictions, he performed two colonoscopies privately. It was later discovered that these had been performed to a very poor standard (he had failed to recognise lesions and polyps which could have been cancerous). His patients were also unaware of the limitations of his practice and it was decided he had also failed to obtain proper consent. Spire referred Mr T to the GMC for investigation when the concerns about his treatment were discovered.

The MPTS reached the only logical conclusion it could: Mr T’s conduct was such that he should not be able to continue to work as a doctor. Whilst this case is unusual, it does demonstrate that private medical treatment does not always mean a better standard of care. If Mr T had advised Spire of the restrictions he would not have been able to perform the procedures at their hospital, instead patients were left at risk of life-threatening conditions being missed. This case also raises broader questions, such as whether local restrictions on practice should be registered with the GMC.

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