Interview: GMC reforms 'must be seamless'

Changes to the GMC's remit will be for the better, its chief executive Niall Dickson tells Susie Sell.

Mr Dickson: GMC will appeal if it disagrees with OHPA decisions
Mr Dickson: GMC will appeal if it disagrees with OHPA decisions

Just two weeks into his new role as GMC chief executive, former BBC social affairs editor Niall Dickson was called back to his old stamping ground to appear on Newsnight.

The inquest into the death of a patient treated by German locum Dr Daniel Ubani was in full swing, and Mr Dickson had been enlisted to discuss laws preventing the GMC from checking the language skills and competence of EU doctors before they practise in England.

A subsequent call for a review of the laws has been a key focus for Mr Dickson since he started at the GMC in January, but with changes to the regulator's functions set to take place over the next year, it is just one of many.

The GMC's chairman Professor Peter Rubin was quick to point out the organisation faces 'a challenging time' when he announced last year that Mr Dickson would replace Finlay Scott.

Adjudication handover
From April 2011, the GMC's current adjudication function in fitness-to-practise cases will be handed over to the Office of the Health Professions Adjudicator (OHPA).

Mr Dickson wants the move to be seamless, both for doctors and GMC staff. He acknowledges that the GMC 'will have to help (the OHPA) set itself up'.

'We will be having a discussion with (the OHPA) as it takes this over,' he says. 'And I imagine that it will be taking on lots of our panellists. I do not imagine that it will start with a blank sheet of paper.'

Mr Dickson also says the GMC will continue producing guidance for tribunals about 'what we think are appropriate sanctions in relation to standards that we set through good medical practice'.

While Mr Dickson says there will be a 'sense of loss' at the GMC over the reduction of its remit, he believes the handover is a 'good thing' that will make its role clearer.

'At the moment there is a "Chinese wall" within the GMC whereby the panel has a degree of autonomy as it makes its decisions,' he says.

Power to appeal
The transfer over to the OHPA will, however, give the GMC a new power of appeal.

'Where we disagree with a tribunal or panel decision, and we think it is a serious disagreement, we will appeal,' Mr Dickson asserts. 'I am sure the tribunal and panels will operate very effectively, but we will have that power.

'People will therefore see clearly that it is not us making the judgment, but it is us who are the guardians of the patients and the public, and the guardians of the trust that the public has in the profession.'

Under his watch Mr Dickson also believes the relationship between the GMC and the profession will be changing.

The key channel through which this will happen is, of course, revalidation. 'I think in the past we have been seen very much as an organisation that did things to doctors when things went wrong,' he says.

'I want us to be seen as an organisation that supports doctors who are striving to ensure their competence and fitness to practise. That is a fundamental difference.'

Listening to the profession
As the GMC's role shifts, Mr Dickson says his key focus will be an increase in communication with the profession, and making the GMC 'better at listening'.

'Our standards work does provide a blueprint for the way in which we should go,' he says. 'It is very thorough and it involves a lot of consultation. We need to do that in other areas of our work - even more than we are doing now.'

Indeed, the GMC has now launched a consultation on the revalidation process, which Mr Dickson says will 'clear some of the ground' and debunk some of the 'myths' surrounding revalidation, such as the idea that there will be exams after year five.

He remains aware of major challenges, not least the threat a shortage of cash across the NHS may pose.

'I think there are a significant number of people within the profession who are still sceptical or uncertain about (revalidation) - even if they support the principle,' he says.

'We have to get the implementation right in order to win them over and to make sure this thing really takes off.'

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