New research published in The Bulletin of the Royal College of Surgeons of England has found that the Medical Practitioners Tribunal Service (MPTS) is falling short in addressing sexual misconduct by doctors. In nearly one in four cases, the sanctions imposed by MPTS tribunals were more lenient than those proposed by the General Medical Council (GMC), the UK’s independent regulator for doctors.
The study analysed 222 new MPTS tribunal cases heard between August 2023 and August 2024. Of these cases, 55 involved sexual misconduct, with offences including harassment, rape, and child abuse. Key findings relating to cases involving sexual misconduct include:
- Nearly one in four sanctions (23.9%) imposed in cases involving sexual misconduct were more lenient than recommendations from the GMC, and in no case did the MPTS impose a tougher sanction than proposed.
- All perpetrators were male doctors, with more than 80% holding positions of authority (consultant, GP, post-certificate of completion of training, registrar/senior resident).
- 65% of proven cases led to erasure from the GMC register, while 35% resulted only in a short suspension.
- Several cases involved multiple targets, showing repeated and systemic abuse.
MPTS operates independently but is funded by and accountable to the GMC. Its core function is to safeguard the public by ensuring that doctors uphold the professional standards required to practise medicine.
The Royal College of Surgeons of England (RCS England) argues that the findings of this research, alongside the experiences of those who have come forward, demonstrate that the current system of medical regulation is failing targets of misconduct. Instead of delivering justice, the system often compounds trauma, leaves perpetrators in positions of authority, and has an ultimate impact on patient care.
The research has been published at the same time as a new British Medical Journal (BMJ) paper that also looks at the current process for managing sexual misconduct perpetrated by doctors in the UK. The paper also includes case studies, detailing real, lived experience of the process.
In recent months, the MPTS has begun a process to update its tribunal and sanctions guidance, with particular focus on sexual misconduct cases. The Working Party on Sexual Misconduct in Surgery (WPSMS) and RCS England have provided feedback to the MPTS on their guidance, emphasising the need for vulnerable witnesses to be explicitly recognised, for the required level/standard of proof and power dynamics to be addressed, and for trauma informed processes to be applied throughout. This has been positively received by the MPTS.
Mei Nortley, consultant vascular surgeon, and lead author of the research said: “We hope this study aids the MPTS to reflect on whether it delivers its aims of protecting the public, ensuring doctors meet professional standards and promoting public confidence in the medical profession. Allowing rapists, sexual predators and those who use manipulation and coercion to return as practising doctors brings this into question.”
Commenting on the findings, Professor Vivien Lees, Vice President of RCS England said: “This important research, published in The Bulletin of the Royal College of Surgeons of England, highlights deeply concerning inconsistencies in sanctions for sexual misconduct cases before MPTS tribunals. These failures risk leaving perpetrators in power and eroding trust in the profession.
“We welcome the MPTS’s move to update its guidance, but guidance alone is not enough. Tribunal panels must be trained and apply it consistently to ensure fair, robust decisions.
“RCS England will hold the MPTS to account to ensure these vital changes are fully delivered.”
Ms Tamzin Cuming and Professor Carrie Newlands on behalf of the Working Party on Sexual Misconduct in Surgery (WPSMS), said: “The current system fails staff, fails patients, and fails to guarantee an environment that delivers safe care. Sexual misconduct is incompatible with the values and behaviours required of a clinician, and when proven, it must mean erasure from the register – and, we suggest, inclusion on the sex offenders register.
“Despite some progress, regulation of healthcare professionals is still unfit for its primary purpose: protecting the public. This latest research shows the need for systemic change.
“The WPSMS calls for a trusted, centralised, anonymous reporting system, and a radical overhaul of how employers and regulators deal with sexual misconduct.
“Without reform, powerful perpetrators will continue with impunity. Targets will remain silenced, knowing that reporting to a system designed to protect perpetrators, not patients, risks their careers. Right now, the system gives little more than a slap on the wrist for abuse, when only erasure and accountability can ensure safety.”
The authors of the research propose key recommendations as to how the tribunal process could be improved, including:
Removing the requirement to ‘prove’ sexual motivation, introducing research informed specialist investigative practice for rape and sexual offences, mirroring processes outlined by the police force initiative Operation Soteria. Current MPTS sanctions guidance requires sexual motivation to be proven as well as the factual allegations of sexual misconduct.
Adopting of the 3Cs model (clumsy, creepy and criminal) for categorising severity of sexual misconduct. This framework helps distinguish between poor judgement and predatory behaviour, ensuring proportionate and protective sanctions are met.
Giving less weight to ‘mitigating factors’ such as expressions of ‘remorse’, demonstration of ‘insight’, and ‘character references.
Recognising specific risks and dynamics unique to healthcare settings. Proposed aggravating factors include:
- Abuse of hierarchical or supervisory roles
- Repeated behaviours or multiple victims
- Misconduct occurring during or around patient care
- Evidence of grooming or coercion, such as targeted negative reports
- Concurrent forms of misconduct
The findings of the paper published in The Bulletin come in the wake of the publications Breaking the Silence (published by the WPSMS) and Turning the Tide (published by RCS England and WPSMS), two groundbreaking papers that exposed the scale of sexual misconduct within the surgical workforce.
Both reports set out critical recommendations for change. Turning the Tide specifically called on the MPTS to update its decision-making methodology and sanctions bandings for sexual misconduct cases by October 2025. It also said the tribunal service should conduct a review of the appropriateness, influence and evidentiary weight of character references and testimonials in the decision-making process for sexual misconduct cases, among other recommendations.
For further reading visit:
- The Bulletin of the Royal College of Surgeons of England: ‘Protecting or enabling? A review of medical practitioner tribunals involving sexual misconduct’
- Sexual misconduct: UK medical practitioners tribunal service is not fit to practise | The BMJ
- Turning the tide: progress and actions to support targets of sexual misconduct in surgery
- Sexual misconduct in surgery
