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Wednesday, 10 February, 1999, 20:25 GMT
Failing doctors 'will be banned'
17:52 10-02-99 surgeons ac
Doctors' skills will be assessed on a regular basis
Doctors have voted that they should be demoted or even struck off if they do not pass regular MOTs on their skills.

The move represents the biggest shake-up in the regulation of the profession since the NHS was founded in 1948.

The measures will come into effect in two years' time.

Patients' groups say this is too long and have called for the establishment of an independent clinical inspection team to police medicine.

Accepted principal

Previously doctors, once registered, did not have to prove their competence again. The only way to find out if a doctor was incompetent was if they made a mistake.

Doctors accepted the principle of regular tests to show they are they are up to date on best practice in November, but did not agree how to make the system effective.

The 81 members of the General Medical Council (GMC), doctors' regulatory body, have voted to accept proposals published last week, with a number of amendments.

Under the plans, there will be a link between a doctor's performance in any assessment and their registration to practise.

It means that doctors who fail to prove their skills are up-to-date will be struck off.

The measures will cover GPs and hospital specialists to begin with, but will eventually cover all doctors.

The need for such measures became apparent in the wake of the Bristol babies case.

Three doctors were found guilty of serious professional misconduct over the death of 29 young children following heart operations at Bristol Royal Infirmary.

The measures aim to restore public confidence in the medical profession, which has suffered several recent knocks.


Doctors will have to submit to local and national assessments. Those who refuse to take part will be removed from the register.

17:52 10-02-99 gmc ac
The GMC voted overwhelmingly to accept last week's proposals
Those who fail will first receive help from their immediate employers. In the absence of any improvement they will be referred to GMC performance procedures.

Sir Donald Irvine, chairman of the GMC, said the council's day long debate had been "good humoured" and "constructive".

He explained how the new system would work.

"For all doctors there would be a local process whereby a profile would be kept of that doctor at all times," he said.

"It would include evidence of keeping up-to-date and other matters. The contents would be for more detailed examinations, but there would be a profile of that doctor and that profile would trigger revalidation on the register."

The link between demonstration of fitness to practise and continuing registration was passed by 62 votes to five, with 14 abstentions.


But Vanessa Bourne, chair of the Patients' Association, said she was concerned the tests would not be introduced for two years, meaning the first checks would not take place for seven years.

"In the mean time, how many Bristols will occur? One bad apple makes the rest of the barrel smell bad," she said.

The Patients' Association is calling for an independent inspection unit to be set up to check up on doctors.

However, Mr Barry Jackson, president of the Royal College of Surgeons,welcomed the move.

He said: "The surgical royal colleges and specialists associations have already expressed unanimous support for this essential step towards effective self-regulation of the profession."

He added: "It is essential we work in conjunction with patients to ensure that the proposed measures are open, transparent and effective."

The British Medical Association supported the move.

The BMA chairman Dr Ian Bogle said: A clear message has gone out to the public and to Government from the medical profession.

"That message is that doctors want to provide the highest possible standards of care for all their patients and that they are committed to showing that if they are on the register of the GMC it means that they are competent to practise.

GMC president says why the plans make a difference
Sir Donald Irvine says cases like Bristol belong to the past
BBC Health correspondent Fergus Walsh
BBC Health correspondent Fergus Walsh: "Doctors say self regulation works"
See also:

15 Mar 99 | The Bristol heart babies
10 Feb 99 | Health
10 Feb 99 | The Bristol heart babies
10 Feb 99 | Health
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