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At the heart of general practice since 1960

NHS managers want easy quality markers scrapped

The Shipman death toll rises as a wide-ranging review of the GMC is announced ­ Joe Lepper and Rob Finch report

The Government has ordered a radical overhaul of the 'role, structure and functions' of the GMC.

A wide-ranging review of patient safety announced this week will consider major changes to revalidation and

the fitness to practise procedures.

It will almost certainly recommend the GMC be stripp-ed of its adjudicating role in fitness to practise cases.

The decision follows the Shipman Inquiry's scathing fifth report. It concluded revalidation was not fit for purpose and that the GMC acted in the interests of doctors rather than patients.

Announcing the terms of the review, Health Secretary John Reid said: 'We want to end the idea that the GMC is a representative body for doctors. It is not. Its primary role must be to protect patients.'

The move came as a further blow to the GMC. It has argued relatively minor adjustments are needed to revalidation and that it has made most of the structural changes demanded by Dame Janet Smith's inquiry.

GMC members appeared resigned to the council losing its power to adjudicate fitness to practise cases.

Dr Brian Keighley, council member and a GP in Stirlingshire, said the GMC was 'prepared to look at other models', including an independent body taking on adjudication.

Dr Krishna Korlipara, a council member and a GP in Bolton, said he was in favour of the GMC losing the role.

He said: 'It would be good in terms of public perception that adjudication is done in as robust a way as possible and I think that is best achieved outside of the GMC.'

The review will be chaired by Chief Medical Officer Sir Liam Donaldson. An advisory group includes GMC president Sir Graeme Catto, BMA chair James Johnson and RCGP chair Dr Mayur Lakhani.

Dr Lakhani said he was not surprised by the strong terms of the review. He said: 'An outcome based on minimal change will not deliver the results the profession needs.'

In a response to the Shipman Inquiry, discussed by the council this week, the GMC warned revalidation should not become a 'mechanism to detect bad doctors'.

What review will cover

Terms of reference

·Strengthen procedures for assuring the safety of patients in situations where a doctor's performance or conduct poses a risk to patient safety or the effective functioning of services

·Ensure the operation of an effective system of revalidation

·Modify the role, structure and functions of the GMC

GMC's current position

·Open to giving up its position as adjudicator in fitness to practise cases

·Warning that revalidation should not become merely a 'mechanism to detect bad doctors'

·Wants to host any central database of doctors

·Wants to speed up its post implementation review and evaluation of governance reforms

·Wants greater public accountability to increase public confidence in the GMC

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