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Saturday, 15 July 2006 08:59 | BNN: British Nursing News Online · www.bnn-online.co.uk
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Prof Sir Liam Donaldson, the chief medical officer has proposed tougher regulation of doctors and a reduction in the powers of the General Medical Council (GMC).
The new system, which will cost aroundŁ150 million, double the present one, aims to detect failing doctors sooner and, crucially, lowers the standard of proof from criminal standard to the lesser civil level.
The GMC would continue to prosecute doctors but no longer be their judge as well and it would also lose its influence over medical education. More power would be given to the royal colleges.
Sir Liam said his report, "Good doctors, safer patients", would go through a four-month consultation and was the first comprehensive review of medical regulation for more than 30 years.
"The vast majority of doctors deliver care to patients with skill and compassion," he said. "The proposals are designed to help these doctors to maintain their standards, as much as they are designed to identify poor practice.
"Patient safety has been my primary concern. There must be a robust re-validation process. At present, a senior doctor can go through a 30-year career without undergoing a single assessment of their fitness to practise; an airline pilot would face over 100 checks over a similar time."
The report follows the inquiries by Dame Janet Smith into Harold Shipman, the GP who murdered about 250 patients. Dame Janet widely criticised the GMC.
Sir Liam said: "Patients put their trust in their doctors. 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 safe care."
The British Medical Association said doctors were likely to be "hugely critical" of the proposal to change the burden of proof in misconduct cases. "No one wants to put people at risk by bad practice," said James Johnson, the chairman. "But it seems wrong to be able to take away a doctor's livelihood because of something found on a balance of probability. It opens the door to miscarriages of justice”.
Mr Johnson, a surgeon, said the BMA welcomed the recommendation that the majority of GMC members would still be doctors, that cases would be dealt with more quickly and locally and that there would be increased focus on rehabilitation and retraining. But it was concerned that members would be appointed not elected.
It had considerable reservations about the plan to take adjudication of cases away from the GMC and give it to another, as yet unnamed, body. Mr Johnson said a further recommendation to make medical students register with the GMC and sit a national examination in addition to graduating was likely to draw strong opposition.
Sir Graeme Catto, the president of the GMC, welcomed many of the proposals but, considering that fitness to practise procedures had been enhanced recently, wondered whether the case for change had been made.
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