GMC reform: protecting patients does not mean finding and chastising wrongdoers

I agree with Abbasi that something must done about the General Medical Council.1 But, for action to take place, we need to have an objective in mind. Do we want to get rid of the GMC or do we want to reform it? If the latter, into what? Clearly, we need an organisation to oversee doctors’ training and to keep a record of all doctors who have the required training to be registered to practise in their various specialties. The GMC, or someone else, needs to keep on doing this.

As for the other functions, there is no evidence that the process of appraisal and revalidation has improved patient care. But it most certainly takes resources away from the direct treatment of patients and cost hundreds of millions, if not billions, to run. It could be a positive process, providing support, encouragement, and guidance. But it has turned into a summative, tick box exercise, the primary function of which is punitive. This, unfortunately, seems to be the inexorable direction of travel for the GMC.

Protecting patients does not mean finding and chastising wrongdoers—it is about promoting the profession; helping doctors improve; asking where they need help, in a supportive way; and building in quality. Doctors should not be seen as potential “criminals” who need constant review, with threats hanging over them, which is how many now feel.

This atmosphere of “we are always watching you” has created a world of defensive, over-investigative medicine, with gross over-inflation of what are now written patient records. Writing things down is seen to take precedence over doing things for fear of what might happen if you don’t.

The punitive role should be removed from the GMC. Doctors should be assumed to be innocent unless proven guilty. Beyond reasonable doubt. If a doctor does something seriously wrong, this should be dealt with by a completely different organisation—probably the legal system or, at least, one that follows the agreed principles of UK jurisprudence.

Reform is probably impossible.