The GMC: expediency before principle

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7485.254 (Published 27 January 2005) Cite this as: BMJ 2005;330:254

Summary of responses

  1. Birte Twisselmann, technical editor
  1. BMJ

EDITOR—The three articles discussing the forensic examination of the General Medical Council conducted by Dame Janet Smith as part of her inquiry into the issues arising from the case of general practitioner Harold Shipman sparked considerable controversy.13

Most respondents focused on the GMC rather than the report, although some took issue with the suggestion of having more medical members appointed than elected to the council. Another worry was that the conflict was playing into the government's and Department of Health's hands and becoming politicised, to the detriment of the medical profession.

One strand of the debate was whether the remit of the GMC should in fact be protecting patients (in addition to regulating doctors). Sufficiently strong self regulation would arguably protect patients, which would, in turn, protect doctors. Mostly, however, the GMC was severely criticised. Anecdotal examples of the GMC's conduct, especially towards those who expressed criticism of it, were numerous.

Several correspondents were in favour of some sort of revalidation system, and the GMC president, Graeme Catto, invited suggestions for refining the revalidation procedures. Numerous doctors pointed out that the atmosphere in the wake of revalidation was threatening and mistrustful and not in any way congenial to good medical practice or a happy professional life. One argued that the council has not acknowledged all the revisions and improvements that have happened in medical training, and the plans for revalidation are therefore bureaucratic and vague.

The GMC was perceived as having lost the trust of the public and the professionals it regulates. Must it be staffed by doctors or could it be staffed by other types of professionals—“inspectors,” even?

The belief underlying most responses was that the GMC rather than the workforce it regulates is in need of reform. But expediency before principle is common because to think that no patient will ever be harmed by a doctor's incompetence is pretending. It comes down to whether the profession wants to keep the privilege of regulating itself or give it up, a way forward favoured by some. However, as one general practitioner in Leeds concludes, there will always be Shipmans—no matter what regulatory processes are in place.


  • Competing interests None declared.


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