Mandatory RCGP Membership: Part 2

Exactly a month ago, in July 2025, I wrote about the mandatory cost dumped on every GP trainee in the UK: pay the Royal College of General Practitioners (RCGP) hundreds each year to gain access to a training portfolio platform called FourteenFish.

It isn’t really about “membership”; it’s about paying for the right to log into a database.

Since then, I’ve taken this further: raising a formal complaint with the RCGP, writing to the Secretary of State for Health, and referring the case to the Competition and Markets Authority (CMA) (.pdf, 92kB) for suspected anti-competitive behaviour.

The RCGP’s Stage 1 reply dressed the arrangement up as “transparent”, “competitive”, and “value for money”. None of those claims survived contact with scrutiny. My Stage 2 complaint, now with the RCGP’s executive, sets out exactly why:

• No transparency: the RCGP has yet to publish the 2019 tender documents, criteria, or trainee feedback that supposedly led to FourteenFish being chosen.

• No choice: FourteenFish is the only system permitted; trainees cannot use an alternative even if it meets GMC requirements.

• No value for money: over training for what was once a paper folder; fee rises are unexplained; non-member fees include vague “broader training support” that isn’t itemised.

Why it matters to the public

The NHS is struggling to recruit and retain GPs. At the same time, the RCGP is making it a condition of training that future GPs pay almost £1,000 to a single private provider, now owned by UnitedHealth Group, a US healthcare giant repeatedly fined,¹ sued,² and investigated for fraud,³ anti-competitive behaviour,⁴ and conduct harmful to patients.⁵

This is not “supporting the profession”, it’s a toll gate, and the toll collector is a corporation with a track record that would fail any reasonable ethical test.

The bigger picture

Once, a trainee’s progress could be documented with a ring binder and sign-off sheets. Now, we are told that only one approved platform can do this, and that we must all pay for it, regardless of need or means. Digital convenience should not come with a monopoly surcharge.

If the RCGP believes this platform is indispensable, it should provide it free of charge, funded from its existing £51.5 million annual income or negotiated into its supplier contract. Anything else is profiteering by proxy.

Full correspondence with the RCGP is here.

The Stage 2 complaint is now pending a formal response. Updates will follow.