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Last Updated: Friday, 14 July 2006, 10:15 GMT 11:15 UK
Doctors to face competence checks
Harold Shipman
The Shipman Inquiry flagged up concerns
Doctors are to face regular MoT-style checks to ensure they are fit to work under a radical overhaul of regulation.

The government review also proposes the General Medical Council should be stripped of its powers to adjudicate over complaints against doctors.

It comes after the inquiry into serial GP killer Harold Shipman said the GMC was weighted in favour of doctors.

The GMC said it was in favour of the MoT-style checks, but other proposals would need careful consideration.

There must be a robust revalidation process
Sir Liam Donaldson

Announcing the plans, Sir Liam Donaldson, the Chief Medical Officer for England, said the MoT, also known as revalidation, would have two strands, covering general and specialist skills.

The proposals, which will go out for consultation until the end of November, also propose setting up an independent tribunal to judge when serious complaints are made against doctors.

The GMC will be expected to investigate the complaints, but not to make a final decision on guilt, or whether further action should be taken.

The burden of proof required in fitness to practice cases will also be lessened from criminal standards - beyond all reasonable doubt - to civil standards - on the balance of probability.

Complaints will initially be dealt with at a local level by a GMC affiliate which will be appointed in each hospital and primary care trust with the most serious cases being passed up to the GMC to investigate and present the case to the tribunal.

The chief medical officer said the GMC should also be made accountable to parliament by facing yearly questions from a committee of MPs.

Inquiry

Sir Liam said: "Patient safety has been my primary concern. There must be a robust revalidation process.

"At present, a senior doctor can go through a 30-year career without undergoing a single assessment of their fitness to practise, whereas an airline pilot, meanwhile, would face over 100 checks over a similar timescale.

"Patients put their trust in their doctors often at a major moment in their lives.

"They are right to do so but my review has shown that the public and doctors think that this trust must be underpinned by a strong system to assure good practice and safe care."

SIR LIAM'S KEY RECOMMENDATIONS
Revalidation - Doctors to face MOT-style checks every five years to ensure they are fit to work
Complaints - The role of judging whether a doctor is fit to practice when serious complaints are heard is to be taken away from the GMC and given to an independent tribunal
Burden of proof - It will only need to be proved "on the balance of probability" a doctor is unfit to work rather than the current criminal standards

Proposals have also been made to set up similar tribunal systems for the eight non-medical regulators governing the likes of nurses and chiropractors.

The reviews were prompted by the inquiry into the Shipman murders.

The GP killed about 250 of his patients from 1972 to 1998.

Sir Graeme Catto, president of the General Medical Council, said revalidation and making the GMC accountable to parliament were welcome, but said other recommendations needed careful consideration.

"We believe in a system of medical regulation that fosters the delivery of safe, high quality care for patients, is based on clear standards which are fair, transparent and open, and above all, which can command the support and confidence of patients, the public and doctors.

"If the report leads to the continued development of such a system, it is to be welcomed."

James Johnson, chairman of the doctors' trade union, the British Medical Association, attacked the plans to change the burden of guilt.

"It seems wrong to be able to take away a doctor's livelihood because of something found on a balance of probability rather than proving something beyond reasonable doubt.

"It opens the door to miscarriages of justice which will devastate the lives of doctors and their families."

But Joyce Robins, co-director of Patient Concern, welcomed the proposals, but said a consultation period was unnecessary.

"Why can't we just implement these desperately needed changes to improve protection of patients?"

Ann Alexander, of law firm Irwin Mitchell, which represents the families of Shipman's victims, said: "This report is a considered, but equally, a radical reform proposal."


SEE ALSO
Q&A: Doctor regulation
14 Jul 06 |  Health
Doctor checks 'to be easier'
01 Mar 03 |  Health

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