Building on the GMC's achievementsBMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7501.1205 (Published 19 May 2005) Cite this as: BMJ 2005;330:1205
- Graeme Catto (firstname.lastname@example.org), president1
- 1General Medical Council, London NW1 3JN
Revalidation is under scrutiny. The GMC plans to play an important part in developing an effective system
The fifth report of the Shipman inquiry provided a thorough and considered analysis of the issues surrounding fitness to practise.1 We must all approach the report in the spirit of learning from the past and as a source of ideas for improving the protection of patients in the future. The government's proposals to improve death certification and for tighter regulation of controlled drugs2 will, alongside clinical governance, help stop another Harold Shipman. Nevertheless, the General Medical Council recognises that further changes are required to our processes.
Lessons from the inquiry
Some have argued that no general lessons can be drawn from the Shipman case. I believe that view is mistaken. Of course many of the circumstances were specific, but much broader, historical issues were raised. These include:
The absence of local systems that could detect emerging poor, dangerous, or criminal practice and take effective action at an early stage before patients came to harm
Uncertainty among patients about how to pursue a concern about a doctor, together with a profound feeling of disempowerment
Reluctance by some professionals to admit even the possibility that a doctor might be putting patients seriously at risk
Lack of coherence and coordination between the roles of the NHS and the GMC in protecting patients
And the lack of robust and systematic arrangements to verify that doctors are up to date and fit to practise.
Dame Janet Smith, the chairman of the inquiry, acknowledged that much has changed for the better, but we all have more to do, whether within our regulatory bodies, healthcare organisations, or clinical teams or as individual healthcare professionals. We need to ensure that further …