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At the heart of general practice since 1960

Practice-based commissioning rules toughened

With the GMC confident only 'evolutionary' changes are needed to its reforms, GPs fear having to work in a straitjacket ­ Ian Cameron reports

The GMC insists it will only have to make relatively minor changes to its reform programme as a result of the Shipman Inquiry's scathing fifth report.

In a bullish response to Dame Janet Smith's criticisms, GMC president Professor Sir Graeme Catto said it would approach her recommendations 'with confidence'.

He said the council may speed up changes to revalidation and fitness to practise procedures but would not have to start from scratch. He also denied the GMC put doctors before patients and said the fifth report from the inquiry had given 'clear-cut' support for self-regulation.

In her report, Dame Janet said the GMC put doctors' interests ahead of protecting patients' and that its plans for revalidation were not fit for purpose.

She recommended stripping the GMC of its powers to adjudicate doctors' fitness to practise and said it had to overhaul its constitution.

Sir Graeme told Pulse the GMC would modify its procedures and constitution after 'considered judgment'.

He said: 'There's a great deal more to do and we might need to do it faster.

'But I think we can approach the recommendations with confidence ­ without being complacent that we've got everything cracked. It's about evolutionary change rather than rubbing out and starting again.'

Sir Graeme said he accepted some of Dame Janet's recommendations, including the need to make clinical governance sign-offs for revalidation positive and to be more open and transparent in

supplying information about doctors.

He added the GMC could take the lead in developing a national database of GPs.

The GMC will also take legal advice on proposals that an independent body take over adjudication of fitness to practise cases.

But Sir Graeme said the accusation the GMC was 'unhelpful' in disclosing information about doctors was no longer accurate.

Dr Krishna Korlipara, a GP in Bolton and member of the GMC who gave evidence to the inquiry, said there was 'not one iota' of evidence that the GMC favoured doctors over patients.

'We should neither throw away these recommendations, nor accept them wholesale without scrutiny,' he said.

What the

report said

GMC's response

1 GMC should be stripped of adjudication functions in fitness to practise cases

Partial agreement. Will take legal advice.

2 GMC puts doctors' interests before patients'

Disagrees. Thinks this is no longer the case.

3 Local clinical governance sign-offs for revalidation are not sufficient; local panels should scrutinise evidence

Partial agreement. Favours a more 'positive' statement on fitness to practise, local panels a matter for NHS.

4 Council may be too small; elected medical members should not be in the majority

Partial agreement. Will debate further internally.

5 GMC must continue to strive to be open and transparent about all its procedures

Agrees. 'No excuse' for not meeting this demand.

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