Analysis And Comment

Independence is key to better regulation

BMJ 2006; 333 doi: (Published 02 November 2006) Cite this as: BMJ 2006;333:966
  1. James Johnson, chairman (
  1. 1 British Medical Association, London WC1H

    The chief medical officer's proposals represent an important shift away from the principles of professionally led regulation.1 They dispense with elected medical representation on the General Medical Council, remove the medical majority, and transfer the GMC's adjudication function to an independent tribunal. The GMC now also espouses the concept of independent rather than professionally led regulation. Independence is fundamental to any profession. Neither the public nor practitioners are best served if medicine cannot marshal its own evidence and expertise against a near monopoly employer and the twists and turns of government policy.

    Independence is not, however, a sufficient bulwark. The five principles of better regulation are accountability, consistency, proportionality, transparency, and targeting.2 Donaldson proposes that the GMC be directly accountable to parliament, and that is welcome. The GMC must be accountable to patients, but it must also maintain a strong line of accountability to the profession that campaigned for it, submits to it, and funds it. If, as a society, we look to doctors to lead developments and innovation in clinical care for the benefit of patients, we must proceed with great caution before embracing a set of measures that may seriously undermine doctors' sense of ownership of their profession. That …

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