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New day, new crackdown

A clampdown on GPs has been on the cards ever since the damning cclusions of the Shipman inquiry, but until now most eyes had been focused on plans for wide-ranging reforms of the GMC.

A clampdown on GPs has been on the cards ever since the damning cclusions of the Shipman inquiry, but until now most eyes had been focused on plans for wide-ranging reforms of the GMC.

But all along it seems ministers had another layer of regulation hidden away up their sleeves, which could prove every bit as draconian for GPs, but without even the fig leaf of self-regulation. The new Care Quality Commission was very nearly going to be called Ofcare, to signal its similarity with fierce regulators in other spheres, including Ofsted. It looks likely to prove as popular with doctors as Ofsted is with teachers.

He who dares... loses?

GPs will have to submit to regular inspections, with their prescribing, commissioning, PMS work or enhanced services all coming under particular scrutiny. It feels worryingly like a punishment reserved for those who dared to be innovative or ambitious, and given the Government's known antipathy towards PMS GPs, there's every chance the inspection findings will be used to claw back cash and threaten contracts.

All of which brings us to the keenest concern over the new proposals. The Care Quality Commission may be planning to bill itself as an independent regulator, but its analogues in other professions are frequently seen as strong arms of the Government, there to enforce ministerial will. If the department is interested in restoring GP morale, it will make absolutely sure this is not allowed to happen.

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