GMC agrees new structure

BMJ 2001; 323 doi: (Published 04 August 2001) Cite this as: BMJ 2001;323:250
  1. Mark Hunter
  1. Leeds

    A compromise seems to have been reached on the vexed question of self regulation of the medical profession in the United Kingdom.

    At a meeting in London at the end of July, the General Medical Council agreed to reduce membership of its ruling body from the current 104 members to just 35. Of these, 14 will be lay members, bringing the lay proportion of the council up to 40%

    The move treads a fine line between the demands of the professional bodies, which had been calling for a council no smaller than 51 members, and patients' organisations, which were arguing for at least 50% lay representation. The GMC has also taken some regard of government demands for the GMC to modernise itself

    Legislation is expected later in the year to support the new plan, with the implicit understanding that if changes are not made to improve efficiency, transparency, and public accountability, regulation may be taken out of the profession's hands.

    The GMC's president, Donald Irvine, has made it clear that he believes this is the profession's last chance to prove that it can regulate itself.

    The changes to GMC governance follow months of wrangling over the structure of the new council. Although the current 104 strong council is widely acknowledged to be unwieldy and, in the wake of the Bristol scandal and the Harold Shipman murders, no longer holds the public confidence, no clear consensus has emerged on what changes should be made.

    Professional bodies felt that reducing the council membership would impair its ability to judge on all aspects of the profession. However, a suggested two tier system, in which the larger second tier would act as an electoral college for the first, was rejected by the council. It was concerned that “the larger body would dilute the effectiveness of the smaller body; and that the tensions created between the two would be unproductive.”

    It was therefore a major breakthrough when, earlier in July, the BMA's council dropped its demands for a 51 member council and agreed to support the 35 member model.

    In turn, the council addressed fears over lack of inclusivity by agreeing to appoint an additional pool of medical and lay members to support the GMC's statutory functions.

    For the time being, the BMA seems to be giving the new structure the benefit of the doubt. However, a spokeswoman made it clear that this support remained “contingent on it being shown in future negotiations that the model can deliver effective self regulation.”

    The BMA is now seeking urgent talks with the GMC to discuss the structure of the new committee. Patients' groups, however, remain to be convinced.

    “Forty per cent lay representation is not enough,” said a spokeswoman for the Patients Association. “It looks as if the GMC is more interested in looking after the interests of doctors than protecting patients.”

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