Everything about The General Medical Council totally explained
The
General Medical Council (the
GMC) is the regulator of the
medical profession in the
United Kingdom. It licenses
doctors to practise, and has the power to revoke the licence, or place restrictions, in cases of questions about a doctor's fitness to practise. The current president of the council is Professor Sir
Graeme Catto.
History
The GMC was established in
1858 by
Act of Parliament.
Purpose
The purpose of the GMC is to protect, promote and maintain the health and safety of the community by ensuring proper standards in the practice of medicine. The council was formed in
1858. A practitioner not on the
Medical Register of the GMC is forbidden to hold themselves out as a registered medical practitioner in the UK. The GMC regulates
medical schools in the UK, and liaises with other nations' medical and university regulatory bodies over medical schools overseas, leading to some qualifications being mutually recognised. The Council is funded by annual fees required from those wishing to remain registered and fees for examinations.
Powers, activities and sanctions
A registered medical practioner may be referred to the GMC if there are doubts about their fitness to practise. These are divided into concerns about health and other concerns about ability or behaviour. In the past these issues were dealt with separately and differently, but now pass through a single fitness to practise process.
The GMC and its members, with substantial agreement in principle from government and from the professional bodies in UK medicine (for example the
BMA, the Royal Colleges), represent their regulatory activity as aimed with an overwhelming priority at assuring the safety of individual patients. As the regulatory body for a profession and because the perceived reliability of the profession is significant in assuring treatment is sought and followed, the GMC has from its establishment explicitly regarded maintaining public confidence in the profession. Hearings may result in reprimands, restrictions on practice, temporary suspension or erasure from the register.
The GMC also administers the
Professional and Linguistic Assessment Board test (PLAB), which has to be sat by non-
European Union overseas doctors before they may practice medicine in the UK.
The main guidance that the GMC provides for doctors is called
Good Medical Practice. This outlines the standard of professional conduct that the public expects from its doctors and provides principles that underpin the GMC’s fitness to practise decisions. Originally written in 1995, a revised edition came into force in November 2006 following a two-year consultation process. The content of Good Medical Practice has been changed with a major focus on working in partnership with patients, one of the new duties for doctors outlined in the revised document. The care and treatment of children and equality and diversity are the other specific new areas of guidance introduced to reflect the key themes which arose during the consultation.
Modes of licensing
Two types of GMC licencing exist: provisional and full. Provisional registration is granted to those who have completed medical school; this may be converted into full registration upon satisfactory completion of the first year of postgraduate training ("house jobs"). In the past, a third type of registration ("limited registration") was granted to foreign graduates who had completed the PLAB examination but required a period of work in the UK before their registration could be converted to "full". Limited registration was abolished on 19 October 2007.
Reform
Since 2001, the GMC has itself become answerable to the
Council for Healthcare Regulatory Excellence (CHRE, initially "Council for the Regulation of Healthcare Professionals"), which oversees GMC activity and may overturn previous verdicts.
Following recent legislation the GMC is implementing a comprehensive and wide-ranging reform of the organisation and its role. This is a result of considerable social change, but also highly publicised scandal cases such as
the Shipman affair
One of the recent changes is the shift of emphasis from simple registration to
revalidation of doctors, more similar to the periodic process common in American states, in which the professional is expected to prove his or her professional development and skills. The revalidation process was expected to start in
2004, although it's being delayed by the publication and implementation of the Shipman Inquiry Report.
Criticism
Self-regulation and complaints handling
Due to its nature the GMC is positioned between the medical profession and the public, and has drawn criticism from both sides - from professionals for being overly harsh in fitness to practise decisions and from the public for being too mild. Calls have been made to abolish self-regulation by the profession, but a 2000 vote by doctors was 80% in favour of continued self-regulation, although many demanded reforms, one of which became revalidation.
Concern has also resulted from several studies which have shown that GMC handling of complaints appear to differ depending on race or "overseas qualification", but it has been suggested that this might be due to indirect factors.
Shipman Inquiry
The GMC was most heavily criticised by Dame
Janet Smith as part of her inquiry into the issues arising from the case of Dr
Harold Shipman. "Expediency," says Dame Janet, "replaced principle." Dame Janet maintained that the GMC failed to deal properly with Fitness to Practise (FTP) cases, particularly involving established and respected doctors.
In response to the Shipman report, Sir
Liam Donaldson, the
Chief Medical Officer, published a report titled
Good doctors, safer patients, which appeared in 2006. Donaldson echoes concerns about GMC FTP procedures and other functions of the Council. In his view, complaints are dealt with in a haphazard manner, the council causes distress to doctors over trivial complaints while tolerating poor practice in other cases. It accuses the Council of being "secretive, tolerant of sub-standard practice and dominated by the professional interest, rather than that of the patient". Former President of the General Medical Council, Sir Donald Irvine, called for the current Council to be disbanded and re-formed with new members.
Other healthcare regulatory bodies
UK
Many of the above bodies, together with the GMC, are represented on the
Council for Healthcare Regulatory Excellence.
Elsewhere
Many other countries, including
New Zealand,
South Africa and
Singapore, have a central regulator similar to the GMC. In the
USA and
Australia, each state has its own regulatory board for doctors. In
Germany, each state has an
Ärztekammer with lawful authority to regulate the medical profession, there's no federal level authority for the Federal Republic of Germany. Nevertheless, the
Bundesärztekammer, a voluntary association of private law, was founded to support the professions' interests.
Further Information
Get more info on 'General Medical Council'.
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