GMC: Guiding doctors

The General Medical Council has regulated doctors for almost 150 years.

Based in London, it is run by a secretariat and a council of 104 members.

The secretariat, which is headed by a chief executive, is responsible for the day to day operation of the GMC.

The power to make major decisions on policy and strategy lies with Council.

Main responsibilities

Licensing doctors to practice in the UK

Investigating complaints against doctors

Striking doctors off if they are unfit to practice

Issuing guidelines to doctors on best practice

Promoting high standards of medical education

Three quarters of those sitting on council are doctors. Most are elected by the profession every five years, others are appointed by the medical royal colleges.

There are 25 lay representatives who are appointed by the Health Secretary. They generally come from a wide range of backgrounds, such as parliament and patient groups.

The GMC has two key functions which are spelt out in British law and which it sums up in the motto "Protecting patients, guiding doctors".

'Protecting patients'

The GMC protects patients by deciding who can and who cannot practise medicine in the UK.

It is responsible for ensuring all doctors - GPs, hospital doctors, those working in the NHS and private sectors - are properly qualified and preventing any 'rogue' doctors from treating patients.

Its main job, in this respect, is to maintain the medical register. Only doctors who are named on the register are allowed to practise in the UK.

Doctors are placed on the register or given a license to practise medicine after they graduate from university or, if they trained abroad, after passing an exam set by the GMC.

But it can also take that license away. This normally occurs after an investigation of an individual doctor - often following a complaint from a patient.

Complaints are assessed by a medical screener or investigator who is a member of council. They decide whether the doctor has a case to answer or not.

If there is, a meeting of the GMC's preliminary proceedings committee (PPC) will decide what further action, if any, needs to be taken and how the case should be investigated.

The GMC can take action against an individual doctor if:

they have been convicted of a criminal offence in the UK

serious concerns have been raised about their professional performance

there is an allegation of serious professional misconduct

problems with their health could put patients at risk

Generally a doctor who is under investigation is free to continue to work until their case is heard by the GMC and they are struck off.

Sir Graeme Catto is the current GMC president

However, the GMC can temporarily suspend a doctor for a maximum of 18 months while they await a full hearing if the allegations are of a very serious nature.

Depending on the nature of the allegation, complaints are dealt with through one of three channels:

The conduct procedures: deal with doctors who have been convicted of a criminal offence or are accused of serious professional misconduct. Its professional conduct committee meets in public and is similar to a criminal trial, where the doctor is asked to answer specific allegations and witnesses are called.

The performance procedures: involve a general investigation of a doctor's performance. Its fitness to practise committee meets in private and considers general performance rather than a particular allegation.

The health procedures: are concerned with a doctor's health, for instance if they have addiction or mental problems and their work is suffering. Its health committee hears the cases of those doctors who have not agreed a programme of treatment aimed at helping them return to work.

Through these procedures, the GMC can:

suspend a doctor for two years until they can show they are fit to return to work

recommend re-skilling or rehabilitation for a doctor

place restrictions on a doctor's practice, such as only allowing them to work under supervision

strike a doctor off the medical register for a minimum of five years

Erasure from the medical register is the ultimate sanction the GMC can take against any doctor. A doctor who is struck off is unlikely to ever practise in the UK again.

'Guiding doctors'

The GMC is also responsible for ensuring doctors are suitably qualified and work to high standards.

As part of that, its members ensure medical schools are teaching a common curriculum to high standards.

GMC facts

Established in 1858

Run by a Council of 104 elected members

A quarter of Council members are lay representatives

Answerable to the Privy Council

Headed by a medical president

It also issues regular guidance to doctors on a wide variety of issues, such as patient confidentiality and good medical practice.

The GMC has been under pressure in recent years to reform following a string of high profile cases which have dented public and professional confidence in its ability to regulate doctors.

Cases like the Bristol hospital scandal, disgraced gynaecologists Rodney Ledward and Richard Neale and the serial killer Harold Shipman have affected its standing among doctors and the general public.

Reform

In an attempt to restore confidence and deal with a growing number of complaints, the GMC has embarked on a programme of major reform.

As part of that programme, the GMC has:

improved its complaints process, so it can hear more cases, more quickly

strengthened the sanctions it can take against individual doctors

taken steps to introduce five-yearly MOTs or revalidation for doctors

pledged to boost lay membership of its Council and reduce its overall size so it can take decisions more quickly

Under government reforms, the GMC will be answerable to the new UK Council for Health Regulators which will oversee the work of all the regulatory bodies.

By the time all these reforms are complete the GMC will have changed more in recent years that it has in any other time in its long history.