The General Medical Council has proposed an historic change to its make-up that would effectively end self-regulation of the medical profession.

The General Medical Council has proposed an historic change to its make-up that would effectively end self-regulation of the medical profession.

In a letter to health secretary Patricia Hewitt, GMC president Sir Graeme Catto has offered to introduce a 50/50 split between medical and lay members on the council. It would mean that doctors would no longer have the final say on how the medical profession was regulated.

Lay members currently make up 40 per cent of the GMC, and the proposal to increase their stakeholding follows a review of regulation of the medical profession by chief medical officer for England Professor Sir Liam Donaldson entitled Good Doctors, Safer Patients, published earlier this year.

Ending doctors' majority on the GMC was not one of 44 recommendations made by Sir Liam, but Sir Graeme said it was 'inevitable' that such a change would happen.

He said it was vital that the GMC retained its independence from government, which was important 'to safeguard both doctors and patients alike'.

'We want to take that principle of independence further,' he said. 'We believe that the council should have a balanced composition, reflective of those who provide and receive healthcare across the UK.'

In another major concession, the GMC agreed to lower the standard of proof needed to strike off a doctor. It said it would accept the civil standard of 'on the balance of probabilities' rather than the current 'beyond reasonable doubt', for hearings in which doctors' fitness to practice was at stake.

This proposal, which was included in Sir Liam's review, followed a recommendation by Dame Janet Smith in her inquiry into the killings by Dr Harold Shipman. The British Medical Association has strongly opposed the suggestion.

Health minister Andy Burnham described the GMC's response to Sir Liam's review as 'constructive, thoughtful and progressive'.