Education And Debate

Competence, professional self regulation, and the public interest

BMJ 1998; 316 doi: (Published 06 June 1998) Cite this as: BMJ 1998;316:1740
  1. Rudolf Klein, professor of social policy (
  1. Centre for the Analysis of Social Policy, University of Bath, Bath BA2 7AY

    Editorial by Treasure News by Dyer

    The case of the three doctors in Bristol represents a landmark in the history of the self regulation of the medical profession in the United Kingdom in terms of its length, its salience in the eyes of the public, and the issues it has raised. It has stretched over eight months and involved more than 60 days of hearings before the General Medical Council—probably the most extended and expensive case in the history of the GMC. It is the stuff of which headlines are made; it is highly charged emotionally since it concerns the deaths of children after heart operations. And it has provided a test case for the GMC's policy of seeking to ensure that all members of the profession accept their collective responsibility for maintaining standards and practising within the limits of their competence.1

    Until the GMC has determined its verdict, in the light of their findings of the facts, it would be improper to comment on the actions of the individuals being investigated. However, the case raises some wider questions, both for the medical profession and for the NHS. This paper explores some of these questions from the perspective of a lay observer, drawing on an analysis of the transcripts of the proceedings.

    Summary points

    There seems to be some confusion about how doctors should interpret their responsibility for protecting patients from harm from other doctors

    Doctors seem to need training in communicating with each other

    There may be a need for more explicit and stringent training requirements before surgeons are permitted to operate independently

    There may be a need for more explicit requirements for retraining when results are poor

    A frustrating procedure

    The proceedings have been long and drawn out because they have involved the detailed examination of the circumstances of every death in …

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