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Ministers climb down on affiliates

The Government has bowed to pressure over GMC affiliates, which will now be introduced on a smaller scale.

Ministers are to seek parliamentary approval to establish an affiliate in each English strategic health authority area, to tackle concerns about GPs' performance at local level. This is a watering-down of the Chief Medical Officer's original plan to have an affiliate in every PCT.

A pilot in England will test the system before a full-scale rollout takes place.

The climbdown comes after the idea was criticised by both the BMA and the GMC in their responses to the consultation on the CMO's report Good Doctors, Safer Patients.

At the time, the GMC said it was 'not persuaded' that the proposals were the right solution and the BMA's chair, Mr James Johnson, said the plan was 'completely crazy', proposing instead that the scheme should operate at SHA level.

In addition, the cost of running the scheme was estimated at £43m a year in England.

The new English affiliates will be appointed by and accountable to the GMC. They will lead and establish devolved GMC offices and they will issue 'recorded concerns' about doctors, which will be based on local investigations.

This is designed to enable less serious disciplinary or performance issues to be dealt with more quickly at a local level.

Dr Richard Vautrey, GPC negotiator, said: 'The proof will be in the pudding, but it seems better than the original proposals.'

He added that locating affiliates at SHA level would take away some of the 'vagaries' of small-scale working and allow the system to develop more professional expertise.

Professor Sir Graeme Catto, GMC president, described the plan as a 'bold proposition' and said the GMC would participate fully in development of affiliates.

Working alongside lay affiliates, GMC affiliates will oversee local disciplinary, investigatory and regulatory action, ensuring its impartiality. They will provide support for employers and ensure local relicensing procedures are fit for purpose. They will also produce an 'annual report', to share lessons learned across the health service.

Scotland, Wales and Northern Ireland will each get a national affiliate who will work within existing structures until after the pilot. The more local work originally proposed for GMC affiliates in Good Doctors, Safer Patients will be picked up by medical directors and others in similar roles.

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