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GPs buried under trusts' workload dump

GPs rally round embattled GMC

The battle to preserve self-regulation intensified this week with a warning that any alternatives may not be better – Ian Cameron reports

The GMC has received qualified support in its fight for survival from leading figures in the medical profession, who are warning the Shipman Inquiry against 'overkill' when it reports in the summer.

MPs, academics and representatives from health organisations said alternatives to self-regulation would not nec- essarily be an improvement. They also cautioned that a 'draconian' regulatory regime could deter potential doctors from a career in medicine.

The GMC will also be heartened to hear the director of

the Council for the Regulation of Healthcare Professionals, which is fighting the GMC in the High Court for the right to challenge not guilty verdicts in professional conduct cases (Pulse, March 8), say self-regulation 'can continue'.

But the messages of support for the GMC were tempered in virtually every case by the caveat that it must step up its reform programme to maintain the backing of doctors and the support of the public.

Dr Ron Singer, president of the Medical Practitioners Union and a GP in north London, said the GMC still gave the impression despite its reforms that it assumed all doctors 'tend to get things right'.

He added: 'There doesn't seem to be a level of honesty and openness that among 100,000 doctors there is going to be a proportion that are not fit for practise.'

But he believed the Shipman Inquiry's recommendations to address deficiencies would be overkill. 'It's gone well beyond looking at how you stop doctors being serial killers to looking at how you know anything is going wrong with any GP. It may be the inquiry pushes things too far in the direction of regulation.'

That view is supported by MP and former GP Dr Howard Stoate. Dr Stoate, MP for Dartford in Kent and a member of the health select committee, said 'appropriate and measured' change to the GMC was necessary, not a change to the entire regulation of doctors.

'My worry is that in order to calm public fears regulation might become too onerous,' he said. 'If it's too draconian and the entire regulatory framework is changed it will get in the way of patient care, which would be a shame as the idea there are lots of Shipmans out there is fanciful.'

Both the BMA and the RCGP also back the GMC. Chair of the RCGP council Dr David Haslam said professionally led regulation was 'essential to maintaining the quality and independence from government of the medical profession'.

GPC joint-deputy chair Dr Simon Fradd argued there are no 'perfect' alternatives. He said: 'If you take the powers away from the GMC and give them to someone else you will still get failures.'

The Council for the Regulation of Healthcare Professionals, set up in April last year, is set to take a significant chunk of the GMC's powers away even before the Shipman Inquiry reports.

If it wins its battle to be able to refer cases to the High Court where it believes the GMC has erred in finding a doctor not guilty, the GMC will no longer be the final

arbiter of fitness to practise.

But the council's director, Sandy Forrest, said the organisation was part of the 'checks and balances' on regulators and he did not foresee it taking over from the GMC, whatever the Shipman Inquiry's verdict.

'There's a general acceptance that self-regulation can continue as long as there are checks and balances – part of which is provided by us,' he said. 'That's not the only option but the maturity of this approach is we acknowledge the strengths and weaknesses of the current system.'

The question remains whe-ther the Shipman Inquiry – and the Government, which has vowed to implement the inquiry's recommendations – believes these weaknesses are terminal.

Certainly comments by inquiry chair Dame Janet Smith on the final day of public hearings that she was 'far from satisfied' with the GMC do not bode well for its future. Others are also less than confident.

Dr Linda Patterson, medical director at the Commission for Health Improvement, said self-regulation is not the only way.

'All regulation is changing – it must be committed to improving, accountable, open and consistent. It's not for us to judge whether that's being taken forward at the GMC, but you can question whether standards should be set and judged by the same body.'

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