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The GMC: expediency before principle

BMJ 2004; 330 doi: https://doi.org/10.1136/bmj.330.7481.1 (Published 30 December 2004) Cite this as: BMJ 2004;330:1

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Response to "The GMC: expediency before principle"

Dear Sir,

Inexplicable omissions in Richard Smith’s intemperate leading article “The GMC: expediency before principle”(1) prompt me to break an unhappy silence.

In late 1994 the British Medical Association organised a “Core Values Conference” for the whole profession (BMA, Royal Colleges, Deans, GMC). It addressed the challenges facing the profession as outlined by an eminent lay member of the GMC which, led by its then President, Lord Kilpatrick, had already formulated performance review procedures and called for action by us all. During the following turbulent years – and intensively during 1997 and early 1998 – discussions in each part of the profession culminated in an historic commitment “Self-regulation and clinical governance at local and national levels” co-signed by the chairmen of all the leading medical organisations, which was sent to the Secretary of State for Health, Frank Dobson and others on 2 July 1998. In a covering letter, Sir Norman Browse, chairman of the Joint Consultants Committee, on behalf of the whole profession, expressed the belief that the document complemented the Government’s contemporaneous clinical governance proposals, and that they would “together solve problems at an early stage and at local level”. The italics are mine, to emphasise that the profession’s united commitment was to deliver accountability through acting proactively at the earliest possible stage in the identification of any problem involving a colleague through its various mechanisms. The “culture change” to which the whole profession thereby committed itself was to delivering early prevention at source, rather than leaving problems to the GMC to resolve when it was already too late.

What, one might ask, happened to this initiative, because I believe that, had it been vigorously pursued, much if not all the trauma of the past six years could have been avoided. What I do know is that within days of its release a number of the co-signatories, myself included, had demitted office and Sir Donald Irvine, as President of the GMC, had produced his revalidation proposals. It is difficult to resist the conclusion that the shifting of the focus to these proposals (now seen to be flawed) distracted the profession as a whole from the more promising combined operation on which it had embarked.

Sir Alexander W Macara
Chairman
BMA Council, 1993-98

(1) BMJ 2005; 330; 1-2

Competing interests: None declared

Competing interests: No competing interests

07 January 2005
Sir Alexander W Macara
Chairman, National Heart Forum
London WC1H 9LG