The future regulation of the medical profession in the UK

The government proposes that the civil standard of proof should replace the criminal standard, beyond reasonable doubt, in fitness to practice cases.

It is iniquitous that a whole career can be jeopardised “on the balance of probabilities”.   I would imagine that if that were to be implemented many colleagues would contest such decisions through the Courts.  Far too much is at stake for them not to do so.   The BMA is quite rightly seeking legal advice.

Had the same standard applied to Blair over Iraq he would now be part way through a Pentonville sentence.  The same applies to far too many government ministers.

It is proposed by the government that an independent adjudicator body be formed.  Its purpose will be to undertake independent formal adjudication for the professional bodies.

Quite why this is needed is beyond understanding considering the GMC has spent the last ten years examining its every function to the point of self extinction as a professional self regulatory body.

I have grave reservations about the independence of any “independent” adjudicator appointed by the present sleazy government with its transparently “hidden” agendas directed against the profession.   This proposal must be strongly opposed as a totally unnecessary and expensive QUANGO no doubt to be filled with government supporters.

"GMC affiliates" and "responsible officers" are to be appointed at regional level in England and country level in the rest of the UK.   They will be appointed by the GMC and responsible to it.   Their task will be to guide, advise and support local employers and to monitor the investigatory work of health care organisations.  The responsible officer will be the doctor's employer's medical director and will have a disciplinary function.  

To say that these apparatchiks will be appointed by and responsible to the GMC, when the GMC itself is to be virtually abolished by having no elected medical representation, gives me no reassurance at all.   Yet another QUANGO, depending for its existence on producing the results the government demands, is gestating.   It has all the hallmarks of the feverish ramblings of a drunken Marxist struggling to persuade his few neurones to meet.  It will do nothing to improve the morale of the profession or to make the NHS an attractive employer to doctors.

The "responsible officer" concept will, at a stroke, place the NHS employer in the position of prosecutor, judge and jury in disciplinary cases.  The government, with its Stalinist tendencies may think that to be a good idea and, no doubt scores of lawyers will as the number of dispute cases reaching the Courts will testify.   The profession will make its views clear.

It is proposed, or should it be, intended, that all members of the GMC Council should be appointed by the Public Appointments Commission and that elections by the medical profession for medical members should cease.

The BMA are prepared to accept that the composition of the GMC should be derived from a long list produced by the Commission.   This strikes me as nothing short of weak appeasement.  The Commission would, no doubt, stuff such a list with its own fellow travellers, even the medical members, should there be any.   

Should the government attempt to force the proposals through then I believe that the BMA should draw their attention to the source of GMC funding, the profession and, simultaneously, ballot the profession with the intention to cease its financial support for such a blatant government apparatus by refusing to pay the Annual Retention Fee, currently £290.   I confidently believe this would have the universal support of the profession.

They say “He who pays the piper calls the tune” but since we will not be allowed to call the tune, the piper should not expect us to pay him.

The puppet GMC could threaten to strike non-payers of the Register but the whole profession...?   A bloody battle could ensue.   Preferably this should occur during a General Election period,

Recertification and relicensure are proposed before a doctor is permitted to continue to practice.

Revalidation still remains an indeterminate mish-mash.  

Relicensure will apply to all doctors and will no doubt carry its own fee.   What is meant by the phrase about relicensure being “designed to give assurances that the doctor continues to meet generic standards of practice”?    Which genius thought that up?   

What about my case, for instance?   I am going to get the hell out of general practice PDQ to concentrate on advising and helping doctors on dispensing practice and pharmacy set-ups.  What are the “generic standards” which will apply to me?  What about my medical journalism work?    Is the government proposing that unless I pay the GMC retention fee and satisfy these nebulous standards I will be unable to work?  I imagine if they do there would be a case under the Human Rights legislation.  I would expect the BMA to support me in that.

I doubt I will be alone in this.

Recertification means reassessment but even that has not been properly thought out but the BMA is anxious lest it will be too unrealistic and take doctors away from patients for too long.  It, too, will be very expensive, and who will pay?

I say no more about recertification than that its implementation will ensure that I and hundreds, if not thousands, of others close to retirement will promptly leave the profession.

Remember, all these proposals come from an arrogant government whose ministers and whose late prime minister have disgracefully debased the standards of public office for the past 10 years.

Finally, is it too much to expect that the profession’s representative body will do rather more than, as the BMA Chairman recently told the profession, attempt to “mitigate the effects of this assault on our profession”?    They should forget public opinion, for once.   This is make or break for the British Medical Profession.  The BMA must not allow us to be ground into the dust by this devious, crooked, self-serving government.   We owe them nothing.

The measures must be opposed with all the vigour possible.

Should they be enforced then my advice to colleagues would be to leave the NHS, if possible, by emigrating or by retiring.