General Medical Council
Overview
 
The General Medical Council (GMC) registers and regulates doctors
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 practising in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

. It has the power to revoke or restrict a doctor's registration if it deems them unfit to practise. The current chair of the council is Professor Sir Peter Rubin
Peter Rubin
Sir Peter Charles Rubin is the current Chair of the General Medical Council of the United Kingdom, replacing Professor Sir Graeme Catto on 20 April 2009....

.
The GMC was established by the Medical Act 1858
Medical Act 1858
The Medical Act 1858 was a British Act of Parliament which created the General Medical Council to regulate doctors in the UK.Describing its purpose, the act notes that "it is expedient that Persons requiring Medical Aid should be enabled to distinguish qualified from unqualified Practitioners".The...

.
The purpose of the GMC is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.
Encyclopedia
The General Medical Council (GMC) registers and regulates doctors
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 practising in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

. It has the power to revoke or restrict a doctor's registration if it deems them unfit to practise. The current chair of the council is Professor Sir Peter Rubin
Peter Rubin
Sir Peter Charles Rubin is the current Chair of the General Medical Council of the United Kingdom, replacing Professor Sir Graeme Catto on 20 April 2009....

.

History

The GMC was established by the Medical Act 1858
Medical Act 1858
The Medical Act 1858 was a British Act of Parliament which created the General Medical Council to regulate doctors in the UK.Describing its purpose, the act notes that "it is expedient that Persons requiring Medical Aid should be enabled to distinguish qualified from unqualified Practitioners".The...

.

Purpose

The purpose of the GMC is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine. The GMC controls entry to the List of Registered Medical Practitioners ('the medical register'), which a doctor must be on in order to practise medicine in the UK legally. It defines the principles and values which underpin good medical practice, to which all doctors practising in the UK must adhere. The GMC also regulates and sets the standards for medical schools in the UK
Medical school (United Kingdom)
In the United Kingdom, medical school generally refers to a department within a university which is involved in the education of future medical practitioners...

, and liaises with other nations' medical and university regulatory bodies over medical schools overseas, leading to some qualifications being mutually recognised.

Activities and powers

The GMC's priority is ensuring patient safety. Because trust in medical professionals is significant in ensuring people seek treatment, the GMC has regarded maintaining public confidence in the profession as crucial. The GMC controls who can practise as a doctor, sets the principles and values that doctors are expected to follow, and can take action where doctors have not met those standards. Its powers are established in law, principally by the Medical Act 1983.

The GMC is funded by annual fees required from those wishing to remain registered and fees for examinations. Fees for registration have risen significantly in the last few years: 2007 fees = £290, 2008 fees = £390, 2009 fees = £410, 2010 fees = £420, 2011 fees = £420, with a 50% discount for doctors earning under £26,000.

Registering doctors to practise in the UK

Doctors must be on the GMC’s List of Registered Medical Practitioners in order to practise medicine in the UK. Registration with the GMC confers a number of privileges and duties. The most common types of GMC registration are provisional and full. Provisional registration is granted to those who have completed medical school and enter their first year (F1) of medical training; 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 Professional and Linguistic Assessment Board
Professional and Linguistic Assessment Board test
The Professional and Linguistic Assessment Board test is the assessment procedure conducted by the General Medical Council of the United Kingdom that is required for overseas doctors outside the European Union before they can practice medicine in the UK....

 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 and now international medical graduates can apply for provisional or full registration depending on their level of experience – they still have to meet the GMC’s requirement for knowledge and skills and for English language.

The GMC administers the Professional and Linguistic Assessment Board test
Professional and Linguistic Assessment Board test
The Professional and Linguistic Assessment Board test is the assessment procedure conducted by the General Medical Council of the United Kingdom that is required for overseas doctors outside the European Union before they can practice medicine in the UK....

 (PLAB), which has to be sat by non-European Union
European Union
The European Union is an economic and political union of 27 independent member states which are located primarily in Europe. The EU traces its origins from the European Coal and Steel Community and the European Economic Community , formed by six countries in 1958...

 overseas doctors before they may practice medicine in the UK.

Setting standards of good medical practice

The GMC sets standards of professional and ethical conduct that doctors in the UK are required to follow. 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 GMC also provides additional guidance for doctors on specific ethical topics, such as treating patients under the age of 18, end of life care, and conflicts of interest.

Medical education

The GMC regulates medical education and training in the United Kingdom. It runs 'quality assurance' programmes for UK medical schools and postgraduate deaneries
Deanery (NHS)
An NHS Deanery is a regional organisation, within the structure of the UK National Health Service , responsible for postgraduate medical and dental training...

 to ensure that the necessary standards and outcomes are achieved.

In February 2008 the then Secretary of State for Health
Secretary of State for Health
Secretary of State for Health is a UK cabinet position responsible for the Department of Health.The first Boards of Health were created by Orders in Council dated 21 June, 14 November, and 21 November 1831. In 1848 a General Board of Health was created with the First Commissioner of Woods and...

, Alan Johnson
Alan Johnson
Alan Arthur Johnson is a British Labour Party politician who served as Home Secretary from June 2009 to May 2010. Before that, he filled a wide variety of cabinet positions in both the Blair and Brown governments, including Health Secretary and Education Secretary. Until 20 January 2011 he was...

, agreed with recommendations of the Tooke Report which advised that the Postgraduate Medical Education and Training Board
Postgraduate Medical Education and Training Board
The Postgraduate Medical Education and Training Board was the non-departmental public body responsible for postgraduate medical education and training in the United Kingdom . PMETB is no longer in operation, following its merger with the General Medical Council on 1 April 2010...

 should be assimilated into the GMC. Whilst recognising the achievements made by PMETB, Professor John Tooke
John Tooke
Professor Sir John Edward Tooke FRCP FMedSci is the Inaugural Dean of the Peninsula College of Medicine and Dentistry, and of the Peninsula Medical School which was its first constituent...

 concluded that regulation needed to be combined into one body; that there should be one organisation that looked after what he called 'the continuum of medical education', from the moment someone chooses a career in medicine until the point that they retire. The merger, which took effect on 1 April 2010, was welcomed by both PMETB and the GMC.

Concerns about doctors

A registered medical practitioner may be referred to the GMC if there are doubts about their fitness to practise in the UK. 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 has powers to issue advice or warnings to doctors, accept undertakings from them, or refer them to a fitness to practise panel. The GMC’s fitness to practise panels can accept undertakings from a doctor, issue warnings, impose conditions on a doctor’s practise, suspend a doctor, or erase them from the medical register ('struck off'). The GMC is concerned with ensuring that doctors are safe to practise. Its role is not, for example, to fine doctors or to compensate patients following problems. The outcomes of hearings are made available on the GMC website.

Reform

Since 2001, the GMC has itself become answerable to the Council for Healthcare Regulatory Excellence
Council for Healthcare Regulatory Excellence
The Council for Healthcare Regulatory Excellence is a UK health regulatory body set up under the National Health Service Reform and Health Care Professions Act 2002...

 (CHRE), which oversees GMC activity and may challenge fitness to practise verdicts which it considers too lenient.

The GMC is also accountable to Parliament
Parliament of the United Kingdom
The Parliament of the United Kingdom of Great Britain and Northern Ireland is the supreme legislative body in the United Kingdom, British Crown dependencies and British overseas territories, located in London...

 through the Health Select Committtee. In its first report on the GMC, the Committee described the GMC as "a high-performing medical regulator", but called for some changes to fitness to practise rules and practices, including allowing the GMC the right to appeal verdicts of its panels which it considers too lenient.

In the 2000s, the GMC implemented wide-ranging reforms of its organisation and procedures. In part, such moves followed the Shipman affair
Harold Shipman
Harold Fredrick Shipman was an English doctor and one of the most prolific serial killers in recorded history with 218 murders being positively ascribed to him....

. They followed a direction set by the UK government in its white paper, Trust, Assurance and Safety . One of the key changes was to reduce the size of the Council itself, and changing its composition to an equal number of medical and lay members, rather than the majority being doctors.

In 2011, the GMC proposed further changes to separate its role in investigating cases from its role in managing doctors' hearings by establishing a new body to run hearings, to be called the Medical Practitioners Tribunal Service. The GMC had previously been subject to criticism for combining these two roles under one roof.

A forthcoming reform to medical registration is the introduction of revalidation
Revalidation
Revalidation is a mechanism for UK doctors to prove their skills are up-to-date and they remain fit to practise medicine. It is intended to reassure patients, employers and other professionals, and to contribute to improving patient care and safety....

 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. Revalidation is scheduled to start in 2012.

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.

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.

The mortality and morbidity amongst doctors going through these procedures has been open to question. In 2003/4 9 of 212 doctors undergoing Fitness to Practice died. Overall, the suicide rate of people undergoing a GMC's Fitness To Practise Panel is very high , fuelling doubts about their sentences being proportionate and fair.

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
Harold Shipman
Harold Fredrick Shipman was an English doctor and one of the most prolific serial killers in recorded history with 218 murders being positively ascribed to him....

. "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
Liam Donaldson
Sir Liam Joseph Donaldson was the Chief Medical Officer for England, the 15th occupant of the post since it was established in 1855...

, the then Chief Medical Officer, published a report titled Good doctors, safer patients, which appeared in 2006. Donaldson echoed concerns about GMC FTP procedures and other functions of the Council. In his view, complaints were dealt with in a haphazard manner, the GMC caused distress to doctors over trivial complaints while tolerating poor practice in other cases. He accused 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.

Penny Mellor

In July 2010 the GMC was severely criticized in an open letter in the British Medical Journal
British Medical Journal
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...

 by Professionals Against Child Abuse for the decision to include Penny Mellor on the GMC's Expert Group on Child Protection. According to the letter, Penny Mellor had been convicted and imprisoned for conspiring to abduct a child, and had led protracted hostile campaigns including false allegations against doctors and other professionals involved in child protection cases. She had also campaigned against Sir Roy Meadow
Roy Meadow
Sir Samuel Roy Meadow is a British paediatrician and professor, who rose to initial fame for his 1977 academic paper on the now controversial Munchausen Syndrome by Proxy and his crusade against parents who, he believes, wilfully harm or kill their children. He was knighted for these works...

 and Professor David Southall
David Southall
Professor David Southall, OBE, is a UK paediatrician who is a controversial expert in Fabricated or Induced Illness , and who has performed significant research into sudden infant death syndrome....

, who were erased from the medical register by the GMC but subsequently re-instated after court rulings.http://paca.org.uk/2010/08/25/open-letter-to-the-chair-of-the-gmc-professor-rubin/ Penny Mellor subsequently resigned from the Expert Group.

UK

  • Health Professions Council
    Health Professions Council
    The Health Professions Council is a statutory regulator of 210,000 health professionals from 15 professions in the United Kingdom. It was set up in 2003 under the National Health Service Reform and Health Care Professions Act 2002, to replace the Council for Professions Supplementary to Medicine ....

     (regulates other health professions in the UK)
  • Nursing and Midwifery Council
    Nursing and Midwifery Council
    Established in 2002, the Nursing and Midwifery Council is a statutory body set up by the Parliament of the United Kingdom through the . The NMC is the UK regulator for nursing and midwifery professions with a stated aim to safeguard the health and wellbeing of the public...

     (regulates nurses and midwives)
  • General Optical Council
    General Optical Council
    The General Optical Council is an organisation in the United Kingdom which was set up by the Opticians Act 1958 to maintain a register of opticians and to uphold the Act. Its purpose is to regulate the services provided by opticians and optometrists...

  • General Dental Council
    General Dental Council
    The General Dental Council is a United Kingdom organisation which regulates all dental professionals in the country. Established in 1956 by an amendment to the Dentists Act 1948, now updated in the Dentists Act 1984, it keeps an up-to-date register of all qualified dentists and other dental care...

  • General Chiropractic Council
    General Chiropractic Council
    The General Chiropractic Council is the statutory governmental body responsible for the regulation of chiropractic in the United Kingdom.It was established by the Chiropractors Act 1994, which originated in a Private Members Bill promoted by David Lidington, to protect the public by regulating...

  • General Osteopathic Council
    General Osteopathic Council
    The General Osteopathic Council is one of the 13 health and social care regulators in the UK that are set up with the primary aim of protecting the public. It is regulated by the Council for Healthcare Regulatory Excellence....

  • General Pharmaceutical Council
    General Pharmaceutical Council
    The General Pharmaceutical Council is the body responsible for the independent regulation of the pharmacy profession within England, Scotland and Wales, responsible for the regulation of pharmacists, pharmacy technicians and pharmacy premises...

  • Pharmaceutical Society of Northern Ireland
    Pharmaceutical Society of Northern Ireland
    The Pharmaceutical Society of Northern Ireland is the regulatory and professional body for pharmacy in Northern Ireland.As the regulatory body, it seeks to protect public safety in pharmacy by:...

  • United Kingdom Accreditation Forum
    United Kingdom Accreditation Forum
    Founded in June 1998 by a group of leading healthcare accreditation organisations, the United Kingdom Accreditation Forum is a London-based network of healthcare accreditation organisations formed with the intention of sharing experience regarding good practice in accreditation, as well as sharing...



Many of the above bodies, together with the GMC, are represented on the Council for Healthcare Regulatory Excellence
Council for Healthcare Regulatory Excellence
The Council for Healthcare Regulatory Excellence is a UK health regulatory body set up under the National Health Service Reform and Health Care Professions Act 2002...

.

Elsewhere

Other countries, including New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...

, South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...

 and Singapore
Singapore
Singapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...

, have a central regulator similar to the GMC. In the USA and Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

, each state has its own regulatory board for doctors. In Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...

, each state has an Ärztekammer with lawful authority to regulate the medical profession, there is 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. The Irish Medical Council
Irish Medical Council
Comhairle na nDochtúirí Leighis - Medical Council is the regulator of the medical profession in the Republic of Ireland. It licenses medical practitioners to practise, and has the power to place restrictions on or revoke such licences, in cases of questions about a doctor's fitness to practise...

 acts as regulator in the Republic of Ireland
Republic of Ireland
Ireland , described as the Republic of Ireland , is a sovereign state in Europe occupying approximately five-sixths of the island of the same name. Its capital is Dublin. Ireland, which had a population of 4.58 million in 2011, is a constitutional republic governed as a parliamentary democracy,...

.

Further reading

  • MacAlister, D.
    Donald MacAlister
    Sir Donald MacAlister, 1st Baronet KCB was a physician, and Principal and Vice-Chancellor and, later, Chancellor of the University of Glasgow.- Early life :...

     Introductory Address on the General Medical Council (lecture, 1906)

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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