23rd April 2024
There has been widespread dismay among doctors that a Medical Practitioners Tribunal has found Dr Sarah Benn’s fitness to practise impaired following her participation in Just Stop Oil protests. (1) The tribunal has suspended her for five months, but the BBC reports that she relinquished her licence to practise in 2022. (1)
Doctors cannot understand how a doctor can be punished for taking action to mitigate the damage to nature and climate, the major threat to global health. There is also dismay that Dr Benn is among the first doctors to appear before a tribunal after protesting and that the finding will set a precedent for other doctors who will be following. UK Health Alliance on Climate Change does not support criminal activity, but it does share the dismay of doctors and calls on the GMC to explore ways in which it can avoid removing the livelihood of doctors protesting that damage is being done to the planet and health.
Dr Benn appeared before the tribunal charged with contempt of court resulting in a prison sentence after “three peaceful protests within a prohibited buffer zone at Kingsbury Oil Terminal in breach of an interim injunction.” (2)
The Medical Practitioners Tribunal Service “run[s] hearings that make independent decisions about whether doctors are fit to practise in the UK.” (3) The Service is “accountable to the GMC’s Council and the UK Parliament,” but operates separately from the GMC.(3)
UKHACC wrote to the chair and chief executive of the GMC seeking reassurance that doctors appearing before tribunals would be able to give a full account of why they took the actions they did. (4) We asked this because of some courts refusing to hear the explanations of charged protestors. In at least one case protestors were found not guilty by a jury after they admitted breaking the law but explained why they had done so. The chair and chief executive of the GMC assured us that doctors would be given an opportunity to explain their actions, (5) and Dr Benn did so eloquently. (1)
The chair and chief executive also told us that the GMC is required in law to refer directly to the Medical Practitioners Tribunal Service a doctor who has received a custodial sentence (whether immediate or suspended) as a result of a criminal conviction. (5) Other doctors who have been convicted after protests have not received custodial sentences, although some have.
The BBC reports that the GMC said the proceedings were not brought as a reaction to Dr Benn’s participation in protests, but the fact that her actions broke the law and resulted in her imprisonment. (1)
UKHACC recognises that both the GMC and the Medical Practitioners Tribunal Service operate under the Medical Act and are constrained in what they can do. A tribunal has three members: a legally-trained chair and one lay member and one medical member, both of whom have received training.
The BBC reports that: “Ms Rolfe, acting as counsel on behalf of the GMC, said that Dr Benn’s conduct had brought the profession into disrepute because she had broken the law by failing to comply with the injunction against protests at the Kingsbury oil terminal on multiple occasions.
She added that Dr Benn’s fitness to practise was impaired as her conduct failed to justify patients’ trust in the profession.
Ms Rolfe submitted that it was not the taking part in protests the GMC had issue with, but the risk to the public’s trust in and respect for doctors by seeing a doctor flouting the law and openly stating her intention to keep breaking the law.” (1)
When making its judgement the tribunal said: “The public must be able to trust that doctors will always act within the law.” (1)
The Sanctions Guidance of the GMC and the Medical Practitioners Tribunal Service (6) makes clear that doctors are expected to meet the standards expressed in Good Medical Practice, (7) including “being trustworthy and acting with integrity and within the law.” Good Medical Practice also states “doctors in particular have a duty to act when they believe patients’ safety is at risk, or that patients’ care or dignity are being compromised.” (7) UKHACC and many, even most, doctors think that patients’ safety is at risk from the impacts of climate change.
A finding of impaired fitness to practise does not necessarily lead to doctors not being able to practise. As Dr Benn herself has pointed out, (8) a finding of impaired fitness to practise does not have to lead to suspension. The Sanctions Guidance allows for “exceptional circumstances: “Exceptional circumstances are unusual, special or uncommon, so such cases are likely to be very rare. The tribunal’s determination must fully and clearly explain: a what the exceptional circumstances are b why the circumstances are exceptional c how the exceptional circumstances justify taking no further action.” (6) This potentially allows an “out” for the GMC if it has the courage to declare the circumstances “exceptional,” as they surely are.
In the case of Dr Benn the suspension is irrelevant as she has relinquished her licence to practise and doesn’t want to undergo remediation, “assuming that ‘remediation’ means a process of, as per my dictionary, ‘’improving or correcting (the) situation’’ and assuming the ‘’situation’’ is my continued involvement in climate activism which may break the law- if that’s what it takes to get action.” (1) But the threat to other doctors of having their livelihood removed is much more extreme than being fined or even imprisoned. The GMC will be imposing a punishment more severe than that of the law.
Many in the GMC must recognise that they are finding themselves on the wrong side of history. As UKHACC has pointed out to the chair and chief executive of the GMC, the Secretary General of the United Nations, the Pope, and the King have all expressed forcefully their anxiety that the world is heading to catastrophe because of damage to nature and the climate and that the responses by world leaders are inadequate. (4) Last week the retiring secretary of the Climate Change Committee criticised the Prime Minister for setting back the UK’s response to climate change, and Scotland abandoned some of its targets for reducing its emissions of greenhouse gases.
Antionio Guterres, the UN Secretary General, has said that: “Climate activists are sometimes depicted as dangerous radicals. But the truly dangerous radicals are the countries that are increasing the production of fossil fuels.” Despite more than 30 years of warning of the escalating danger, there has not been the transformational response that is needed.
It is in these exceptional circumstances that doctors committed to public health have resorted to actions judged criminal. As with other activists like the suffragettes, history will support the minority who took direct action to raise awareness of the consequences of our unsustainable reliance on fossil fuels and be critical of the majority who either passively accepted the status quo or condemned the activists.
UKHACC calls on the GMC to recognise its predicament and seek all possible ways—including if necessary changes to the Medical Act—to avoid removing the livelihood of doctors who are concerned and courageous enough to break what they see as immoral laws.
- Lawson E. Just Stop Oil doctor’s fitness to practise ‘impaired.’ BBC News 19 April 2024. https://www.bbc.co.uk/news/articles/c1vw4k9qn29o
- Medical Practitioners Tribunals Service. Hearings and decisions. Dr Sarah Benn. April 2024. https://www.mpts-uk.org/hearings-and-decisions/medical-practitioners-tribunals/dr-sarah-benn–apr-24
- Medical Practitioners Tribunals Service. https://www.mpts-uk.org/about/our-role
- Smith R. A letter to the GMC on doctors convicted of offences related to protests on climate change and nature loss. UKHACC: 18 December 2023. https://ukhealthalliance.org/news-item/a-letter-to-the-gmc-on-doctors-convicted-of-offences-related-to-protests-on-climate-change-and-nature-loss/
- MacEwen C, Massey C. GMC response to our letter on doctors convicted for offences linked to action on climate and nature 2024. UKHACC: 9 January 2024. https://ukhealthalliance.org/news-item/gmc-response-to-our-letter-on-doctors-convicted-for-offences-linked-to-action-on-climate-and-nature/
- General Medical Council. Medical Practitioners Tribunal Service. Sanctions guidance. February 2024. https://www.mpts-uk.org/-/media/mpts-documents/07_-dc4198-sanctions-guidance-5-february-2024_pdf-104619554.pdf
- GMC. Good Medical Practice [online] 2013. Available from: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice
- Benn S. Statement to Medical Practitioners Tribunal. April 2024. https://www.lar.earth/wp-content/uploads/2024/04/MPTS-Sanctions-Submission.pdf