The High Court has dismissed a judicial review claim brought by the British Medical Association against the use of physician associates and anaesthesia associates.
In a disappointment to doctors and anaesthetists, the High Court has dismissed a judicial review claim brought by the British Medical Association (BMA) against the use of physician associates (PAs) and anaesthesia associates (AAs).
The BMA brought the case against the General Medical Council (GMC) in February concerned about the blurring of lines between skilled doctors and assistant roles, and what this means for patient safety.
In her ruling, Justice Lambert said: “All of the evidence indicates to me that, in producing shared standards, the GMC acted to further patient safety. It undertook a lengthy process of consultation and pre-consultation before the final decision to issue merged guidance was made by the General Council in April 2023. … All these steps were designed to inform the GMC as to the form of regulation which would best protect the public.”
She continued: “The outcome of the process pointed, in the GMC’s view, in one direction: that associates should be held to the same high professional standards as doctors and that a single set of guidance for use by doctors and associates was in the interests of both patients and professionals.”
Logical and lawful
The decision was welcomed by the GMC.
“We are pleased the court has recognised that our decision to produce our guidance in the form of a single set of core standards for all three professions we regulate [doctors, PAs and AAs] was a logical and lawful decision to reach, and one which followed an exhaustive and detailed process of consultation, research and inquiry which engaged all major stakeholders, including the BMA,” said Charlie Massey, chief executive and registrar of the GMC.
“This comprehensive judgment also finds that there is nothing irrational or inherently confusing about the use of the term “medical professionals” as a collective term in this context,” he continued.
The judge concluded that PAs and AAs following the same professional standards as doctors was logical, and that in doing so the GMC had acted at all stages to further patient safety.
A disappointing ruling
Doctor and anaesthetist associations were less jubilant. Phil Banfield, chair of BMA council, called it a “disappointing” ruling.
“Physician associates do not study medicine and are trained to a very different standard to doctors. By labelling both doctors and PAs as ‘medical professionals’ the public is being misled to think they are similarly or equally qualified. They are not,” he said, accusing the court of having “ignored common sense”.
“The potential for patient harm in equating the two roles has been shown in the testimony of doctors recently published by the BMA, which includes hundreds of examples of patients put at risk or harmed. This has been recognised by an increasing number of coroners urging the GMC to clearly differentiate between doctors and physician associates following avoidable patient deaths. The danger is even acknowledged by the health secretary who agrees that the concerns of patients and doctors have been ignored for too long, concerns which must be properly addressed by the Leng Review due to report later this Spring,” he continued.
Professional interest group Anaesthetists United also said it was disappointed.
“We now have to live with the paradox of a non-medically qualified medical professional trained in the medical model,” it said in a statement.
