Failure to act on good intentions

doi:10.1136/bmj.330.7500.1144

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Aneez Esmail, professor of general practice (aneez.esmail@manchester.ac.uk)1

¹ Division of Primary Care, School of Medicine, University of Manchester, Rusholme Health Centre, Manchester M14 5NP

The GMC's response to rapidly changing attitudes towards the medical profession seems to have been to bury its head in the sand

Introduction

As a result of the Shipman inquiry, the chief medical officer of England has been instructed to carry out a review of the General Medical Council's proposed system of revalidation and reassess its role, structure, and functions. If the inquiry's recommendations are implemented it will result in the most far reaching reforms ever envisaged of the GMC. Much of the commentary in the medical press about the recommendations has been fairly negative, and because of the nature of the inquiry and the fact that it has now completed its work, it is difficult for the chairman to respond publicly to criticisms. Although I cannot speak on behalf of the chairman, I was her medical adviser and am therefore able to explain the thinking behind its recommendations. In contrast to many doctors, I believe that the reforms will strengthen the GMC, preserving self regulation but crucially offering the public and doctors better safeguards.

Findings of the inquiry

The GMC had never been subjected to such an in-depth scrutiny by a public inquiry. Thousands of pages of evidence, mainly provided by the GMC, were considered, and the processes relating to their new fitness to practise procedures and revalidation were put under intense scrutiny. Surprisingly, the GMC admitted that it had serious deficiencies. In his opening statement to the inquiry, the GMC's counsel gave an overview of these deficiencies, which covered the operation of procedures, the consistency and quality of decision making, and the way that procedures were developed and operated. Admission of such fundamental inadequacy will give little solace to any doctor who has been brought before its fitness to practise procedures and felt that they had been wrongly disciplined or any patient who …