“You have raised a concern about the charity acting outside of its objects and the response provided to you by the charity. We have carefully reviewed all the information you sent us. We do not consider that it shows wrongdoing by the trustees…we will not be contacting the charity.”

And with no further explanation the Charity Commission rejected our complaint to them about the GMC.

We are unsatisfied with this decision, and we have appealed.

Let’s go through the background. The GMC, which dates back to 1858,  is a body set up to protect the public by ensuring proper standards in the practice of medicine. Its role has always been ensuring  the public knows who is and is not a registered doctor (strictly speaking a Registered Medical Practitioner).

This is an important role for them, especially nowadays with the widespread blurring of definitions and job titles in healthcare. The public, who expect to be protected and alerted about non-doctors, have a reasonable expectation that the GMC will preserve and maintain their ability to make that distinction. 

But instead, the GMC put themselves forward to regulate non-doctors – Anaesthesia Associates  – and have already spent considerable sums of public money on the project. Over £5m has gone on IT systems and there have been significant salary and opportunity costs.

The precise clinical role of Anaesthesia Associates (and Physician Associates) and their levels of direct supervision and accountability, remain poorly defined and very unclear. One would have expected that clarifying that role would be the very first step towards protecting the public, especially since these non-doctors are the subject of increasing concern amongst both patients and medical bodies. 

It is unusual for government bodies to be granted charitable status. The GMC first applied to become a charity in 1928 but their request was denied. They reapplied in 1999 their grounds can be read here

We submit that in embarking on this non-doctor work the GMC is in direct conflict with these Charitable Objects. They have themselves partially conceded this point by announcing they will change them in the future. 

The Trustees could and should have recognised this new work was outside their Charitable Objects. They should have sought early advice on the complexities of changing them as a statutory body. But they did not. 

For an organisation that prides itself on adhering to the letter of the law, and maintaining the highest possible standards of probity in order to reassure the public, we think this is a sloppy and casual approach by the trustees. For them to show a complete lack of remorse, and failing to issue an apology, shows a degree of audacity.

We have appealed to the Charity Commission to re-examine their decision. The text of our appeal follows below. We will keep you updated when we hear back from them.

Our Appeal

In April 2001 the GMC was granted charitable status. In reaching this decision, the Commission concluded (see Paras 8.3.2-3 and of their 2001 report) that the main function of the GMC was the regulation of doctors, that the ‘practice of medicine’ was inexorably linked to the register of medical practitioners. As a consequence of the GMC regulating doctors the general public would then have the assurance that their doctors were educated to a standard appropriate for practicing medicine. 

Despite this unambiguous remit the GMC are currently spending money, well in excess of £5m, on regulating non-doctors – PAs and AAs (Physician and Anaesthesia Associates). In doing this they are taking on an entirely different and separate function. Such a change would require the commissioners to at least consider whether their 2001 decision to grant charity status is still appropriate. 

We consider that by taking on this new role without addressing their charitable objectives first then the Trustees have acted in breach of trust, as per the “Harries vs Church Commissioners” guiding principle. We see this breach as deliberate, and we note the GMC have shown no remorse nor apology. We conclude it may be either misconduct or mismanagement, and that this therefore warrants a S15 enquiry, in particular to determine whether or not this activity with non-doctors should continue before the charitable objects have been amended.

We feel the Charity Commision was in error to conclude that there was no wrongdoing by the Trustees. This disregard of their charitable objects, and the cynical and belated suggestion that their objects can be changed retrospectively, is manifestly wrong and it brings both themselves and charities generally into disrepute.