020 8938 3631
020 8938 3631
Fitness to Practise & Freedom of Speech

Fitness to Practise & Freedom of Speech

Jul 1, 2025

On instructions from the Medical Defense Society, we recently concluded the successful defence of a GP and Medical Defense Society member in fitness to practise proceedings before the General Medical Council (“GMC”).

Background 

Dr A is an experienced GP and partner in a GP practice in England.  She is also an avid user of social media.  Since the outbreak of the Gaza War in 2023, Dr A has frequently posted about this topic.  Her postings range from sharing commentary from journalists such as Owen Jones of the Guardian, to expressing solidarity with US students sanctioned for pro-Palestinian protests, to condemning Israel’s actions and using hashtags including #GazaGenocide #GazaHolocaust and #CeasfireNow.  On a number of occasions, Dr A has described Israel’s actions in Gaza as “slaughter” and “reminiscent of Nazi Germany”.

A complaint was submitted to the GMC alleging that Dr A’s social media posts were in breach of the duties of a doctor registered with the GMC, due to being antisemitic and offensive.  The complaint further alleged that Dr A’s actions were potentially in breach of Sections 5 and 18 of the Public Order Act 1986.  These provisions relate to causing harassment, alarm or distress and stirring up racial hatred.  The complaint asked the GMC to “take urgent action” in respect of Dr A.

In response to this complaint, the GMC opened a fitness to practise investigation into Dr A and notified her of this, following which Dr A immediately contacted Medical Defense Society to seek assistance.

GMC Guidance

The GMC publishes a range of material which is relevant to Dr A’s situation.  For example, the GMC’s core guidance, Good Medical Practice, says:

“You must follow the law, our guidance on professional standards, and other regulations relevant to your work”.

“You must not abuse, discriminate against, bully, or harass anyone based on their personal characteristics, or for any other reason.  By ‘personal characteristics’ we mean someone’s appearance, lifestyle, culture, their social or economic status, or any of the characteristics protected by legislation – age, disability, gender reassignment, race, marriage and civil partnership, pregnancy and maternity, religion or belief, sex and sexual orientation”.

“You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or could reasonably cause them distress”.

The GMC’s supplemental guidance Using Social Media as a Medical Professional also says:

“The standards expected of you as a medical professional do not change because you are communicating through social media, rather than face to face or through other methods of communication”.

“How you behave when using social media matters.  Medical professionals, like everyone else, have rights to freedom of belief, privacy, and expression.  But exercising these rights when using social media as a medical professional has to be balanced with the possible impact on other people’s rights and interests”.

It is important to note, however, that although every doctor has a responsibility to be familiar with Good Medical Practice and to meet the professional standards set by the GMC, Good Medical Practice is not a set of rules and it does not cover every possible scenario which may arise in a doctor’s life.

Meeting with Dr A

Following our instruction, we contacted Dr A within 24 hours and then met with her to provide reassurance and to discuss the GMC complaint and Dr A’s thoughts on it.  We explained to Dr A that the GMC could not determine the allegations of criminal law breaches made against her (which would be a matter for the Police), but would consider her alleged actions by reference to GMC standards and the legal concept of fitness to practise.

Dr A reported feeling extremely upset by the GMC process, which is very common.  In a recent survey of doctors investigated by the GMC, 91% reported that their case triggered stress and anxiety, with 31% experiencing suicidal ideation.

Despite her distress, Dr A also felt strongly that she had not done anything wrong and she believed that the GMC process was being used to inappropriately discourage legitimate criticism.

Having reviewed all of Dr A’s social media posts cited in the GMC complaint, we advised that we felt her actions were defensible and this was not a case where Dr A would be best served by demonstrating remorse, insight and remediation.  We agreed with Dr A that we would draft a response to the GMC complaint for her consideration and that this response would deny any wrongdoing or impairment of her fitness to practise.

Human Rights Act Entitlements

In our view, the GMC’s guidance should include greater reference to doctors’ Human Rights Act entitlements, in particular Article 8 (Right to respect for private and family life) and Article 10 (Right to freedom of expression).

The starting position is that, under the Human Rights Act:

  • Everyone has the right to freedom of expression.  This includes freedom to hold opinions and to receive and impart information and ideas.  A person’s rights under Article 10 specifically include the right to express opinions that offend, shock or disturb others.
  • Everyone has the right to respect for their private and family life, home and correspondence.
  • Postings on social media outside a work context (as was the case here; Dr A’s social media accounts are personal accounts) specifically attract the protections of Article 8 and Article 10.

Regrettably, these rights are barely mentioned within the current versions of GMC guidance.

Response to GMC

The submission to the GMC which we prepared on behalf of Dr A asserted that:

  • Nothing stated by Dr A was in fact antisemitic or capable of amounting to hate speech.
  • Dr A was profoundly shocked and saddened by the extent of the human suffering in Gaza, and believed it was important to raise awareness of this suffering.
  • Dr A holds legitimate concerns about the Israeli government’s actions in Gaza. The Employment Tribunal has held that anti-Zionist beliefs (distinct from antisemitic beliefs) qualify as protected beliefs pursuant to the Equality Act 2010.
  • The GMC had no lawful basis on which to interfere with Dr A’s Human Rights Act entitlements. The test for doing so, as affirmed in the recent High Court case of Adil v General Medical Council [2023] was not made out in Dr A’s case.
  • If Dr A’s case was referred forward to a full fitness to practise hearing, there was no realistic prospect of a finding that her fitness to practise is impaired.

 Outcome

The GMC’s fitness to practise investigation into Dr A was closed with no action, allowing Dr A to put this matter behind her and continue enjoying her use of social media.

Learning Points

It is important for doctors to be familiar with the GMC’s published guidance mentioned above – Good Medical Practice and Using Social Media as a Medical Professional – and to adhere to it.

However, doctors should not be misled into believing that the GMC’s guidance is the only relevant or authoritative source of information regarding their expression of beliefs.

Doctors’ Human Rights Act entitlements are powerful and there are limited grounds on which the GMC can interfere with these entitlements.  Doctors, like all citizens, have the right to campaign or speak up about issues of importance to them.

Being the subject of a GMC investigation is often very upsetting.  In addition to contacting your medical defence organisation without delay, it’s important to access wellbeing support.  Some excellent, free sources of this include Practitioner Health, Frontline19 and The Doctor Support Service.

Links:

Author: Andrea James, Partner – Professional Discipline & Healthcare Regulatory Specialist, Keystone Law

This case study is presented for informational and educational purposes only. The views expressed by the individual involved do not represent the views or positions of the Medical Defense Society. Medical Defense Society remains neutral on all matters of political or personal belief and is committed solely to providing fair, expert medico-legal support to its members.