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Doctor regulation shake-up plan Doctor regulation shake-up plan
(about 3 hours later)
A major shake-up in the way doctors are regulated in the UK is to be outlined by ministers.A major shake-up in the way doctors are regulated in the UK is to be outlined by ministers.
The government is acting after Chief Medical Officer Sir Liam Donaldson made the case for reform last year.The government is acting after Chief Medical Officer Sir Liam Donaldson made the case for reform last year.
Ministers are expected to accept his call for doctors to face MOT-style tests, while stricter checking of death certificates will also be put forward.Ministers are expected to accept his call for doctors to face MOT-style tests, while stricter checking of death certificates will also be put forward.
It comes after the inquiry into killer GP Harold Shipman criticised the way doctors were regulated.It comes after the inquiry into killer GP Harold Shipman criticised the way doctors were regulated.
Shipman, from Hyde in Greater Manchester, murdered more than 200 people over a period of 23 years.Shipman, from Hyde in Greater Manchester, murdered more than 200 people over a period of 23 years.
Let's hope the government will at last deliver where the medical establishment, left to itself, has so far failed us Roger Goss, of Patient ConcernLet's hope the government will at last deliver where the medical establishment, left to itself, has so far failed us Roger Goss, of Patient Concern
Dame Janet Smith, who chaired the inquiry into the case, accused the GMC regulatory body in her 2004 report of being more interested in looking after doctors than protecting patients.Dame Janet Smith, who chaired the inquiry into the case, accused the GMC regulatory body in her 2004 report of being more interested in looking after doctors than protecting patients.
She did not blame the GMC for failing to detect Shipman's killing spree but said the culture in the medical profession was to focus on doctors' interests.She did not blame the GMC for failing to detect Shipman's killing spree but said the culture in the medical profession was to focus on doctors' interests.
The MOT-style checks, or revalidation as it is also called, will be carried out every five years, ending the situation where once doctors qualify as GPs or consultants they no longer face formal reassessment.The MOT-style checks, or revalidation as it is also called, will be carried out every five years, ending the situation where once doctors qualify as GPs or consultants they no longer face formal reassessment.
Death certificates will also need to be signed off by someone appointed by the local NHS trust as well as the relevant doctor.Death certificates will also need to be signed off by someone appointed by the local NHS trust as well as the relevant doctor.
The government's white paper, Trust, Assurance and Safety: The Regulation of Health Professionals in the 21st Century, will also deal with other recommendations raised by Sir Liam.The government's white paper, Trust, Assurance and Safety: The Regulation of Health Professionals in the 21st Century, will also deal with other recommendations raised by Sir Liam.
He proposed handing adjudication of fit to practise cases to an independent body, leaving the GMC to investigate complaints.He proposed handing adjudication of fit to practise cases to an independent body, leaving the GMC to investigate complaints.
And he said the burden of proof in these cases should be changed to "on the balance of probability" rather than "beyond reasonable doubt" as it is now.And he said the burden of proof in these cases should be changed to "on the balance of probability" rather than "beyond reasonable doubt" as it is now.
He also suggested moving undergraduate medical education from the GMC to the Postgraduate Medical Education and Training Board.He also suggested moving undergraduate medical education from the GMC to the Postgraduate Medical Education and Training Board.
Another recommendation was to change the GMC membership to 50% doctors, 50% lay people to move away from the much criticised professional-led regime.
Burden of proofBurden of proof
When he launched the report, Sir Liam said: "Patients put their trust in doctors often at a major moment in their lives.When he launched the report, Sir Liam said: "Patients put their trust in 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.""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."
The British Medical Association, the doctor's trade union body, has objected to lowering the burden of proof, while GMC officials have said they want to keep responsibility for education and adjudication.The British Medical Association, the doctor's trade union body, has objected to lowering the burden of proof, while GMC officials have said they want to keep responsibility for education and adjudication.
Neither body has objected in principle to the so-called MOTs of doctors Neither body has objected in principle to the so-called MOTs of doctors.
But Dr Hamish Meldrum, chairman of the BMA's GPs committee, said it would depend on the practicalities and he would not want to see half of doctors "charging around the country appraising the other half".
Roger Goss, co-director of Patient Concern, said they were hoping for a strong response in the white paper not only for those affected by Shipman but in answer to other medical scandals.Roger Goss, co-director of Patient Concern, said they were hoping for a strong response in the white paper not only for those affected by Shipman but in answer to other medical scandals.
"Victims and survivors deserve the lasting memorial of an effective system for spotting and stopping people like them before they have inflicted horrendous harm on lots of patients."Victims and survivors deserve the lasting memorial of an effective system for spotting and stopping people like them before they have inflicted horrendous harm on lots of patients.
"Let's hope the government will at last deliver where the medical establishment, left to itself, has so far failed us.""Let's hope the government will at last deliver where the medical establishment, left to itself, has so far failed us."