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Last Updated: Wednesday, 21 February 2007, 14:07 GMT
Reaction: Medical regulation reform
Medical equipment
Doctors will face regular competence checks
Doctors are to lose the power to regulate themselves and senior medics will face regular MOT-style checks under a planned shake-up of regulation.

The changes are designed to improve patients' confidence in the regulatory system in the wake of a series of high-profile medical scandals, including the case of serial killer Dr Harold Shipman

Professor Sir Graeme Catto, General Medical Council

Mr James Johnson, British Medical Association

Roger Goss, Patient Concern

Anna Dixon, King's Fund

Professor Ian Gilmore, Royal College of Physicians

Andrew Lansley, Shadow Health Secretary

Dr Hugh Stewart, Medical Defence Union


"The White Paper incorporates so many of the proposals we published in November last year.

"They were designed to ensure a regulatory system that commands the confidence and support of all those who receive and provide healthcare.

"The GMC has already undertaken a very significant programme of reform.

"However, there is more to do. Regulation is a dynamic process - it should not stand still.

"It must be scrutinised, challenged and improved to take account of our changing society and the changing healthcare environment."

He described the removal of the GMC regulation powers as "not a significant loss".

"The GMC has been doing the job very well but there is an issue over perception... so it is right that an independent body does that."


"The vast majority of doctors perform well and safely but patients must be protected from the rare cases of unsafe or poorly-performing doctors so that the public can maintain the trust it shows in the medical profession.

"Part of that trust lies in the fact that good doctors will act as their patients' champions, if necessary fighting for the right drug, the best treatment, and the patients' freedom to choose where they receive it.

Sadly the White Paper proposals could lead to a climate of defensive medicine
Mr James Johnson
Chairman, British Medical Association

"Our concern is that under these White Paper proposals, a doctor's ability to continue working in this way, without fear of falling foul of political imperatives, will be jeopardised.

"Do patients want their doctor to be regulated by the state to do what the government tells them to do, or do patients want their doctor to continue to relate to them as individuals and do what is best for them?

"Doctors recognise the need for change to reassure patients and the GMC has already greatly changed.

"The BMA supports measures that promote excellence and help reduce instances of poor standards, or negligence. Patients have a right to expect nothing less.

"But doctors need to have confidence that the regulatory system will lead to support and retraining if necessary and not be merely punitive.

"Sadly 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 their patients."


"The government has accepted what patient advocates said, overlooking the profession's predictable protests.

"Thank goodness for an end to the General Medical Council's role as investigator, prosecutor, judge and jury for serious patient complaints. This will enhance public confidence in getting a fair hearing.

"Medical colleges will have to define the skills and standards of performance that their members must demonstrate to retain membership. Doctors will regularly have to prove that they stay competent, safe and therefore trustworthy throughout their working lives.

"It beggars belief that such obvious safety requirements never occurred to the profession's regulators before Shipman or the British Royal Infirmary scandal.

"Hopefully Shipman's patients and the Bristol babies will ultimately not have died in vain."


"We welcome the White Paper's proposals to establish an independent adjudication body, separate from the General Medical Council, which will achieve greater independent oversight and ensure professionals get a fair hearing.

"We hope that other professional regulators will take up the opportunity this presents for achieving greater independence of their own adjudication functions.

"Having equal numbers of lay people and health professionals sitting on the new professional regulatory bodies, and making sure medical representatives are appointed rather than elected, will lead to more transparent and fairer decision making.

"The government's commitment to define more clearly who is eligible to be a lay member is also to be welcomed.

"If regulators are to act in the public interest these members should represent society."


"At long last the profession can move on to set in place the measures needed to both protect patients and demonstrate the high standards of medicine achieved by UK doctors.

"Patients need to know that their doctor can treat them safely and to a high clinical standard - the new national framework will give both doctors and patients more confidence in the regulatory system.

"In particular we welcome the vital and valuable role of the medical Royal Colleges in setting clinical standards for medical practice.

"We have decades of experience to draw on, and have been in the forefront of developing new methods of continuing assessment for doctors."


"The outrage rightly felt as a consequence of the Shipman and other cases must not cause us to lose sight of the fundamental importance of trusting the healthcare professions to provide care for their patients.

"The government is fixed on trying to deal with the one-in-a-million incompetent or malign doctor but this just undermines the confidence that the public has in all other doctors.

"The best protection for patients is professional self-regulation, with effective systems of peer review and clinical governance.

"This should not be regarded as removing the responsibility of professions to police themselves; it must be a way in which we support the healthcare professions in maintaining the confidence of patients and the public."


"We are very disappointed at the government's intention to change the current criminal standard of proof to a 'flexibly applied civil standard' for fitness to practise procedures.

"We are sceptical about the suggestion in the White Paper that in some cases, the 'sliding civil standard' is virtually indistinguishable from the criminal standard.

"When a doctor's whole career and livelihood is at stake, the allegations should be tested against the highest standard of proof.

"There should be robust safeguards and, if doctors are under threat of being erased or suspended from the Register, the allegations against them should be proved 'beyond all reasonable doubt'."

Q&A: Doctors' regulation
21 Feb 07 |  Health

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