Exclusive: GMC to lose adjudication role

The GMC is set to lose both its powers of adjudication in fitness-to-practise cases and its council's elected medical majority, GP has learned.

The government is also expected to recommend that fitness-to-practise cases be judged on a sliding scale of proof where evidence required is determined according to the severity of the misdemeanour.

Sources have told GP that the government’s response to CMO Sir Liam Donaldson’s review of regulation, due to be announced next week, could seriously undermine the GMC and the concept of self-regulation.

Doctors will want to reconsider what they are paying for, said one insider: ‘There must come a point where professionals say “if we have no input or ownership, we don’t really want to be part of it”.’

Adjudication in fitness-to-practise cases was one of the areas that the GMC had hoped to retain (GP, 10 November 2006).

It is unclear who would take on the responsibility for adjudication, but in the CMO’s original report he suggested the GMC be responsible for investigating and assessing serious fitness-to-practise cases, but independent panels comprising legal, medical and lay representatives conduct the actual adjudication.

Another option would be to pass responsibility to the Council for Healthcare Regulatory Excellence (CHRE), which was granted the right to appeal against GMC acquittals in October 2004.

GMC chief executive Finlay Scott has said: ‘If the DoH decides, despite objective evidence, that we would do well to separate adjudication from the GMC, we would want to ensure that the new system was fair and workable.’

The make-up of the GMC council will be altered to incorporate more lay members and those appointed by competency rather than elected by the profession according to information given to GP.

The CMO’s report suggested that all members of the council should be appointed independently by the Public Appointments Commission rather than elected by doctors, but insiders are expecting a compromise.

The sliding scale of proof for fitness-to-practise cases was suggested by the CMO and backed by the GMC last November.

But GPs have called the change ‘career threatening’ and said it could result in a ‘regulation lottery’ (GP, 17 November).

The BMA was also hoping for a criminal standard of proof to remain in fitness-to-practise cases, but the sliding scale now looks likely.

GPC chairman Dr Hamish Meldrum said that there were ‘already Chinese walls and divisions in the GMC’ that kept judgments independent but said he would want to see detail of how any external body might work.

He added that it was very important that the GMC have the confidence of the profession if professional regulation were to mean anything.

The GMC said it would not comment on the report before its official release.

Expected changes

  • Adjudication hived off from GMC in fitness-to-practise cases.
  • Council to lose elected medical majority.
  • Fitness to practise judged on sliding scale of proof.

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