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An era of scrutiny and suspicion

The most dramatic overhaul of medical regulation in more than a century is set to prompt a surge in the practice of defensive medicine and potentially a mass exodus from the profession.

A snapshot survey by Pulse has revealed that 70 per cent of GPs expect their practice to become more defensive as a result of plans outlined in the regulation white paper. Seventy-five per cent of respondents said they were considering retiring earlier, emigrating or leaving the profession because of the reforms.

The white paper ends self-regulation and introduces a 'sliding scale' standard of proof for fitness-to-practise hearings. It also ends the GMC's elected majority of professional council members, with a guarantee of at least 50 per cent lay membership.

The GMC will lose its role in adjudication, which will pass to a new body, prompting 83 per cent of GPs in Pulse's survey to call for a cut in GMC fees. Respondents to the survey of more than 50 GPs said changes to the standard of proof would make them more wary of complaints.

Dr Robert Morley, executive secretary of Birmingham LMC, warned GPs would now be more likely to bow to patient pressure over unnecessary referrals, tests and prescribing. 'These changes are likely to make GPs take an

alternative course of action. There will be an additional cost to the NHS, and to patients because resources are going to be devoted to an area of less patient need.'

Dr David Roberts, a GP in Hitchin, Hertfordshire, said: 'I work part-time but as soon as the Government takes over re-validation in the form described I will retire completely. Gone.'

Dr Richard Baynham, a GP in Spilsby, Lincolnshire, said he was thinking of emigrating. 'I think Australia is a far more open, fairer system. It's not that I'm opposed to having to justify that I continue to keep myself up to date – but we're regulated enough. All it's going to do is make us jump through more hoops.'

Dr Steve McCabe, a GP in Portree, Scotland, and former BMA Scotland and UK council member, said: 'If it is forced through, the BMA should, at the very least, refuse to co-operate with any new systems. Personally I feel they should go much further and ballot the profession on industrial action, perhaps to the extent of leaving the NHS.'

GP Dr Krishna Korlipara, the GMC's longest serving elected member, urged doctors to use their influence with MPs and the media: 'At this stage, there is everything to fight for because it's only a white paper and we have every interest in seeing it defeated.'

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