The General Medical Council should do more to protect patients, according to a fifth inquiry into the serial killer GP Harold Shipman.
The inquiry has proposed changes to the system including how GPs are monitored and disciplined, ensuring a doctor's past history is disclosed to a potential employer and a better complaints system.
The GMC says it has improved practices in the five years since the conviction and is confident that "another Shipman" could not happen.
Do you have confidence in your GP? Are GPs properly vetted and managed by the GMC? Will patient care be under threat if GPs spend more time on form filling? Send us your views using the form.
This debate has now been closed. Thanks for your comments.
Any group of people that hold the power of life and death needs to be regulated tightly. The argument that only doctors have the knowledge to judge other doctors actions just doesn't wash: we put lay people with no legal knowledge on juries, don't we?
Rob, London, UK
So, a lot of people here regard us doctors as self-serving and only interested in our own ends, rather maligning our integrity. So how would they grade the average doctors integrity and self-sacrifice in the interests of their fellow men in comparison to, say, politicians, journalists, or, dare I ask, lawyers or health service managers?
JG, Huddersfield UK
The GMC would be more effective if it introduced a proper system of clinical appraisal for doctors rather than the current one which allows doctors to fail to disclose anything which might put them in a negative light. The appraisal system lacks teeth.
It is no wonder most of the best quality professionals in health care, teaching, IT etc are going abroad. We will end up with semi professionals in major areas of society.
T Newman, Bournemouth UK
They may be confident that "another Shipman could not happen", but do they trust their own mothers to anyone they don't already know?
Gerry Noble, Salisbury, UK
This is yesterday's news. The GMC has already carried out the most wide ranging reform of any of the regulatory bodies. I would love to see the regulatory bodies governing lawyers and MPs given over to a majority of the public. Dame Janet Smith should put her own profession's house in order before having the gall to criticise others.
Paul Thorpe, Taunton UK
Why can't everyone stop whining about the NHS in general and Shipman in particular. We have one of the best health schemes in the world, yet all we do is moan. Sure, it's not perfect...but what other country can boast a 'perfect' system?
Carl, John O'Groats
In teaching, manufacturing, transport or just about any occupation you can think of, experience tells us that it is impossible to regulate to the point of infallibility. The more regulation we add, the more time it consumes, the less attractive the job becomes, and the less proper work gets done. Leave people to get on with their jobs! There have been very few Shipman's and the reaction is out of all proportion to the risk.
Mark Fulford, Southampton, UK
I agree completely with the findings of the inquiry. In my experience with a complaint made to the GMC I found that it protected the doctor involved even though there had been many complaints over the years regarding his actions. I was left feeling totally let down by the whole procedure which in itself took many years. I no longer have confidence in GPs and I do not think that they are managed or vetted properly by the GMC. I do not feel that patient care will be compromised if they were monitored more effectively when a concern is voiced about them.
Y Phillips, Kent
The trouble is people seem to want it all - they want the reassurance of rigorous independent regulation of all professionals, yet they also want to enjoy 'efficient' services where doctors, teachers and other public employees are available to help them all the time too. There's an inherent conflict here. I think the succession of 'moral panics' about our public services are largely the result of scaremongering by journalists, and I don't believe endless regulatory mechanisms will do anything except cost us more. Whatever happened to trust in our professionals? We mustn't lose perspective.
Dominic, Bury St Edmunds, UK
It is always a few that spoil it for the many. GPs today do a courageous job with ever increasing demands from patients. Those in power always have a great deal of responsibility. Be tough on GPs and patient care will suffer. Like out of hours, access to a GP will be a thing of the past. No other country is as tough on our doctors as the UK. With revalidation and other measures taking place being a GP in the UK would be career suicide. Replace GPs with Nurses, Teachers with Teachers Assistants, Police with Community Wardens and Nurses with Healthcare Assistants and all under an umbrella of tick box management is that what we really want?
John Sebastian, London
So the GMC is an old boys club for doctors? When anybody can gratuitously complain about a doctor who then has many months worrying about the outcome. I know from personal experience how such an experience can upset your personal and professional life. The GMC will not prevent another Shipman - clever people are often able to get around systems and avoid detection. In the meantime the bulk of GP's who are honest and hardworking spend more time attending meaningless appraisals and filling in forms for the range of different quangos invented by politicians to make the public feel more protected.
I was brought up to believe that the definition of "Profession" was a job which was self-regulated. I'm a practicing GP, but it seems to me that my definition is out of date. Quite frankly we need to ditch the GMC as soon as possible, I would much rather be monitored, vetted and sacked by a body made up of honest journalists.
Dr Sion Williams, Wales
Sorry but no system run by self-interested people will ever be trustworthy. It's time that GPs (and come to that MPs) were investigated by a proper independent body with "expert" help called in where appropriate. It's time to break up these cosy cliques.
Simon Edge, Leigh-on-Sea, Essex, UK
Excuse my ignorance, but is the GMC currently not directly accountable to Parliament? Wow. I'd certainly assumed it was!
Ricardo, London, UK
I am a nurse in the states, I used to be a nurse in England. Before I emigrated I looked on the American propensity to sue physicians as unhealthy, but I don't any more. If physicians will not appropriately manage unprofessional members of their own number, I believe the courts are a good place for the wronged members of the public to see justice done. A criminal record will stay with a physician even if his colleagues were unwilling to make his failure public.
Ray Mansure, Arizona, British ex-pat
I worked in the health sector for 13 years and I am certain that the GMC and other NHS regulatory bodies do not have the safety of patients as their first concern. As a nurse once said to me 'patients are OK but they do make the place untidy'.
Chris, Hastings UK
We live now in an 'it must never happen' society. Despite the fact that human beings are - and always will be - capable of perpetrating dreadful atrocities on others, we seem to feel that it is someone else's fault when this happens. The truth is that many serial killers escape detection for so long because they appear to be so ordinary and plausible.
Shouldn't "struck-off" actually mean just that?! "Struck-off" currently means, the doctor can't work for 5 years, but after that they could re-apply. The GMC will OK the application, and keep no record of the doctor's previous "crimes".
David, Glasgow, Scotland
Perhaps the GMC should take a couple of aspirin and go to bed for a few days? That's what most of its members seem to recommend as the cure to all ills.
Pete, Nottingham, UK
The GMC exists to protect the reputation of the medical profession and, by extension, doctors themselves. They are never going to be able or willing to act in the best interests of patients,
Richard Read, London, UK
The arrogant claim by the GMC that it is confident that a similar incident could no happen again is in stark contrast to the findings of the inquiry and shows why the GMC cannot be trusted to look after the patient's interest
Malcolm Bryce, Leicester, UK
Because of public pressure, in part due to the Shipman case the GMC have to investigate every stupid complaint made against doctors. This is costing millions and is keeping doctors away from their patients by forcing them to defend themselves against crank legal claims.
Doctors are amongst the most lightly regulated professions in the UK. Dame Janet's comments that doctors regulate for themselves rather than patients will have a familiar ring to anyone who has had reason to complain. The power and reach of senior doctors is phenomenal, they can bring to bear the finest lawyers in their defence and let's not forget that they are also amongst the top earners in society able to afford protection that many of us cannot. Perhaps I am a cynic but having worked with doctors for 20 years I have become aware that they are doctors first and everything else second.
I B, Cumbernauld Scotland
Most doctors themselves are disillusioned with the GMC. The GMC has been ineffective at protecting and safeguarding the interests of both patients and doctors. Regulation needs to come from an independent source. Furthermore, the GMC is funded by doctors' subscriptions. Such funding can be seen as both unfair (almost all doctors work in the public sector - why should they pay for their regulation) or a conflict of interest.
Hospital doctor, London
I am a doctor. The GMC is truly self-serving. There is clearly public perception that the GMC is run by doctors for doctors. Doctors do not derive any benefits from this bloated organisation - rather we are charged hefty fees for the "privilege" of registration regulation. I'm all for dissolution of the GMC and publicly-funded regulation of medical practice.
What the public have to understand is that the GMC has many roles, of which the investigation of malpractice/negligence is only one. The GMC is also responsible for setting standards and curricula for medical education (the training of medical students), and regulating the structure of the profession. These are tasks which lay-members would not be able to perform. Moreover, on issues of professional competence, only other doctors, with the appropriate knowledge can judge whether or not a doctor has been negligent!
D J MacKenzie, Glasgow, Scotland, UK
So now every doctor is assumed to be a murderer until proved otherwise. Once the tabloid-led lynch mobs have finally destroyed the medical profession in this country and we are forced to go scrounging in the third world for their replacements, perhaps then sanity and common sense will prevail. Until then any aspiring and dedicated doctors would be well advised to go elsewhere and minister to a more deserving society which has more important priorities than indulging in gratuitously destructive hysteria.
B. Millet, London UK
I found it wryly amusing to hear a lawyer telling the GMC that it is too quick to look after doctors' interests. As if the Law Society never does the same thing when people complain about their solicitors!
David Hazel, Fareham, UK
The GMC is run by doctors, for doctors, and in cases time and again over the years have shown that it's a club to protect its members' interests. The pomposity of the claim that 'mere members of the public could not possibly understand the complexities of medicine' tells you everything you need to know. Break it up, please. Doctors can't be trusted any more to regulate themselves.
Russell Long, Tunbridge Wells, UK
Most GPs do an excellent job, working long hours and delivering an excellent quality of care despite enormous patient and government pressures. Making life more difficult for them, by imposing more bureaucracy, will not make patients any safer but simply reduce the time they have dealing with patients' medical needs. Another "Shipman" will always find a way around red tape.
Paul Fludder, Brighton UK
I have little confidence in the GMC being as thorough as they should be in the cases of doctors who abuse or exploit patients. The GMC needs to have the same tests applied to doctors as will now be applied to social workers by the GSCC. If a doctor has a conviction for an offence which could present a risk to any patient they should simply not be able to work as a doctor at all.
Dave Tradgett, Cheltenham UK
When will people accept, once and for all, that self regulation doesn't work - be it for MPs, solicitors, doctors or any other of the many holier-than-thou self interest groups.
John Tomlinson, UK
It disturbs to think that, in theory, GPs struck off the NHS register some years back for serious misconduct in this country can turn up like bad pennies in far-flung corners of a much more vulnerable Third World where safeguards are almost non-existent. Charity organisations and the WHO should be working more closely together to ensure these more dangerous individuals cannot slip so easily through the net.
Patrick V. Staton, Guildford. UK
The majority of GPs are good, sound hard working people. There are however the problem ones such as Shipman who do not come to light until tragedy happens. The GMC should not be overseeing complaints against their own members. An independent body ought to be appointed. No-one can be 'confident' of preventing another Shipman. If it is the nature of the beast it will happen, unless of course the GMC have learned how to read the minds of others.
Paul, Huddersfield West Yorkshire