The British Medical Association has reacted stiffly to warnings from health minister Alan Milburn that professional self-regulation is 'under test' in the wake of well publicised scandals.

BMA council chair Ian Bogle acknowledged 'a need to address urgently problems of unacceptable performance' but said: 'Our aim must be to identify poor performance at an early stage and retrain doctors if possible.'

Dr Bogle added: 'If that is possible, public statements about individual doctors would be counter- productive.' But he said the BMA would support publicity 'if retraining is not appropriate or does not work and the public interest demands information about individual performance.'

Mr Milburn delivered his warning at a conference organised by Sheffield University's school of health and related research in London last week.

He tore up his speech on primary care groups and said new systems would be introduced to ensure there was 'no hiding place for doctors or managers who refuse to identify the reasons for a problem'.

He said 'hit squads' of doctors, nurses and managers would be appointed to take over NHS services by the Commission for Health Improvement if concerns were raised about falling standards. CHI would also be able to order 'quality spot checks', and issue 'public interest reports' if it uncovered 'risks so serious that patients are placed at risk', he said.