Doctors will lose the power to police themselves under proposals published by the government yesterday.
CAROLYN CHURCHILL and HELEN PUTTICK
DOCTORS will lose the power to police themselves under proposals published by the government yesterday.
A white paper on the regulation of health professionals outlined measures to strip the General Medical Council (GMC) of its ability to adjudicate in fitness to practise cases.
The GMC will still be able to investigate concerns about doctors, but the final decision is likely to be passed to an independent adjudicator.
Other measures include regular "MOTs" to revalidate medical professionals every five years and ensure they are up to date with current practice. This would be a massive undertaking with some 600 doctors across the UK expected to come forward for revalidation each week.
It appears, however, that Scotland ultimately will be responsible for setting up its own systems to relicense doctors.
Finlay Scott, chief executive of the GMC, said: "The way in which some elements of the white paper are implemented will vary quite a lot from one country of the UK to another."
The overhaul of the system is the most comprehensive in 30 years and comes in the wake of the case of Harold Shipman, the GP who murdered up to 250 patients.
It includes plans for regulators to move towards a 50:50 split between lay and professional members, and all fitness to practise hearings to be decided using a civil rather than criminal standard of proof.
Supporters said the changes would enhance patients' confidence, but other experts warned that ending "professionally-led regulation" could have a negative impact on doctors and patients.
James Johnson, chairman of the British Medical Association (BMA) said: "Doctors need to have confidence that the regulatory system will lead to support and retraining if necessary and not be merely punitive.
"The white paper proposals could lead to a climate of defensive medicine in which doctors are forever looking over their shoulders instead of concentrating on working in the best interest of patients."
But Sir Graeme Catto, president of the GMC, said that the body did not share the BMA's view that the changes would lead to a loss of professionally-led regulation. He said the loss of powers of adjudication was an "incremental" change, adding that independent panels had already been introduced.
At present the GMC does not hold hearings investigating individual doctors in Scotland and staff who face allegations have to appear before panels in London or Manchester.
Mr Scott said the white paper did not suggest holding tribunals north of the border.
The work of the GMC will be taken forward in different areas of the UK, including Scotland, by so-called "GMC Affiliates" - bodies which will help local employers deal with concerns about staff and ensure the revalidation system is robust. This system will be piloted in England, before being considered by the executive.
Mr Scott said: "It is the risk of bureaucracy that has been behind some of the reservations expressed by Dr Harry Burns as chief medical officer for Scotland, who has said we have got to be very carefulthat we are not excessively bureaucratic thereby diverting doctors from what they are there to do."
An executive spokesman said: "Patient safety is paramount in all decisions about the regulation of the healthcare professions."
