Analysis And Comment Professional regulation

The path to safer patients

BMJ 2006; 333 doi: (Published 26 October 2006) Cite this as: BMJ 2006;333:906
  1. Jonathan Gornall, freelance journalist (
  1. 1 London E1 7LQ

    Consultation on the chief medical officer's controversial proposals for revalidation and recertification of doctors ends next month. Many questions remain about their implementation

    In the summer of 2004, the General Medical Council's education committee ran an essay competition for 16-18 year olds, asking them to imagine what doctors might be doing by 2050. The judges, who included GMC president Professor Graeme Catto, were impressed by the many thoughtful musings about the effect of genetics, ethics, and even robot technology. Yet none of the bright young authors came close to predicting any of the upheavals that would be triggered by another “essay” that arrived on Catto's desk on 9 December that year—by chance, the same day the six winners were presented with their prizes.

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    Liam Donaldson and Janet Smith see eye to eye

    The “essay” was the fifth report of the Shipman Inquiry. The inquiry's chair, Dame Janet Smith, found little in the GMC's past, present, or proposed future worthy of prizes.1 Although she rejected “any suggestion that, even if the GMC procedures had been satisfactory, they could have prevented Shipman's later criminality,” she thought that 30 years on from when Shipman had first come to the GMC's attention, it was still putting doctors first. What's more, she said, it had lost sight of its vision to reform. She declared the GMC's plans for revalidation, which it had been working on since 1988, “an expensive rubber-stamping exercise that would have misled the public,” and the council was subsequently forced to put the plans on ice.

    Fresh look at the problem

    John Reid, then secretary of state for health, announced in January 2005 that the government had asked Professor Liam Donaldson, the English chief medical officer, to conduct a review to determine what action was necessary to “strengthen procedures for assuring the safety of patients in …

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