Questions have been asked about exactly what the Bailiwick’s medical ‘Responsible Officer’ does and how the current post holder spends his time, and earns his wages.
The facts contained in the Responsible Officer’s Annual Report – and potential missing data – has also been highlighted.
After forcing the States to debate the annual report on the Bailiwick’s medical status and the regulation of doctors working locally, Deputy Gavin St Pier said he was prevented from saying all he wanted to.
Multiple points of order were raised during yesterday’s debate as Deputy St Pier and other speakers were pulled back to focus on the report itself – which isn’t confidential, and is readily available for reading online.
Sharing his thoughts with Express, Deputy St Pier described the report as a “brief, formal, technocratic, rather dry and anodyne” document, adding that a number of his observations on the report are about the information that is missing from it, rather than what is in it.
Deputy St Pier pointed out that previous iterations of the report contained “potentially relevant and important detail, such as a table setting out the number of doctors with new concerns about their practice” – but this information is not included in each of the annual reports that have been published in recent years. That makes it difficult to see any patterns, he said.
“I think the States – and the community – are entitled to benefit from this level of data – which it is worth emphasising is about numbers not names,” Deputy St Pier explained. “For example, if there was a rising trend of GMC actions without local actions, there might be legitimate questions as to why? Or, if there were a number of doctors subject to new concerns, ranked as giving a high level of concern about their capability or conduct, this could give rise to valid questions about local recruitment practices?”
The 2025 report confirms that investigations were started into five doctors’ work last year – but that data is not available for 2022 or 2023, Deputy St Pier pointed out.
“… maybe there were none, may be there were a dozen,” he said. “Is five a normal number of investigations? Or is it high or low? How have they been closed – with any action or with no action? It would be reasonable to expect some of both. Each investigation will come at a public cost. If each investigation closes with no action, does that mean the Responsible Officer is triggering too many? If each closes with action, does that mean there are more cases that ought to be investigated but haven’t been? How do we or the GMC know if the Responsible Officer is doing a good job or a bad job as Responsible Officer if there is no data from which to draw any analysis or trends?”
Deputy St Pier has also sought to highlight the “governance black box” that the Responsible Officer works within – with no appeal mechanism available to any health worker who has a concern raised about their practice.
Deputy St Pier cited the example of former Sark doctor Simone Borchardt who took the Responsible Officer to court and won, after he had raised concerns about her work.
The judge ruled that there were serious procedural flaws in the way the investigation was handled and granted permission for a judicial review on three out of four legal grounds, allowing for the quashing of decisions based on the investigation’s findings.
Deputy St Pier told Express that court action is prohibitively expensive for most people, especially when they are facing “career-ending” allegations.
“There will have been some cost implications for Guernsey (from the Dr Borchardt case); but I am more concerned to understand what lessons have been learned from this experience. What will be done differently in the future? In addition, has or will the Health and Social Care Committee give consideration to reviewing the legislative regime to allow a less cumbersome and less expensive appeal mechanism?
“I think fair process, good practice and human rights requires this – not least because a decision by the Responsible Officer could well be career-ending for a doctor.”
The current Responsible Officer is Guernsey’s Medical Director Dr Peter Rabey.
He committed to the Responsible Officer role for a further five years in February this year, before announcing his retirement in March. He remains in post until November working his notice.
Deputy St Pier said he recently learned that while Dr Rabey has been employed by HSC as Guernsey’s Medical Director, he has also been working as an anaesthetist for one day per week.
This puts him in a position where he is working alongside other consultants for whom he has a regulatory responsibility.
Deputy St Pier said he also has concerns about work Dr Rabey does privately for the MSG because it is understood that the MSG does not pay HSC for his time.
Deputy St Pier said he would like these matters addressed when HSC appoints a new Responsible Officer later this year.