GMC to consult on radical structural changesBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7267.980 (Published 21 October 2000) Cite this as: BMJ 2000;321:980
The United Kingdom's General Medical Council is asking doctors and the public for their views on several options for changing its size and structure and increasing the number of lay members who participate in its work.
Last July the GMC set up a working group after months of complaints from doctors and the public about, for example, the slowness of the council's procedures and the small number of lay members. These complaints culminated in a vote of no confidence in the council “as presently constituted and functioning” at the BMA's annual meeting (8 July, p 69).
In its document The Structure, Constitution and Governance of the GMC the GMC has set out several options for council membership: 25 members; about 100, as now; about 60; or a small statutory board of 15 to 25 members combined with a larger conference of 120 to 200 members, which would act as an electoral college for the board.
It is the final option that the governance working group favours. The board would have a medical majority while the conference would be split evenly between lay and medical members. The board would meet every four to six weeks; elect a medically qualified president, who would chair the board; initiate and define policy; and consult the conference as appropriate.
The group suggests that the conference should meet twice a year in public in different places in the United Kingdom and have a lay chairman. As well as electing the board members, the conference would receive and respond to reports from the board, provide a forum for discussion, and be a visible link between the people represented by the GMC—such as doctors, patients, and medical school deans—and the board.
The document also asks for comments on its proposal to separate the two roles that the GMC plays in determining a doctor's fitness to practise. At present the GMC is perceived as both prosecuting and sitting in judgment on doctors.
The number of complaints to the GMC is likely to rise from 3000 in 1999 to an estimated 4300 in 2001. To cope with the rising number of complaints, the GMC has had to expand the time that its committees spend on dealing with them. In 1994 the professional conduct committee met for 20 weeks. Next year three or four panels are expected to meet for 40 to 50 weeks each.
The GMC's president, Sir Donald Irvine, said, “The GMC has been criticised for being slow and out of touch. The proposed changes are part of our sweeping programme of reform, which includes professional standards for doctors, an education system which produces doctors with the qualities that patients expect, regular checks on doctors' performance—revalidation and new powers to deal with doctors who fall short of our standards.
“These latest proposals will enable the GMC to carry out these responsibilities both effectively and fairly.”
The council has asked for comments on the options by 15 November, and it will consider the responses in December. The document will be sent to a wide range of professional and patients' bodies and is on the GMC's website (www.gmc-uk.org).