Welcome for GMC vote on doctor checks

welcomed.

The GMC voted last week to require all doctors, in principle, to maintain a professional profile demonstrating that they are fit to practise and up to date.Those who refuse to comply could be struck off. But doctors whose performance raises doubts will be offered help to bring them up to scratch.

The decision was made despite a last-minute attempt to water down the proposals. Dr Edwin Boorman, former chair of the British Medical Association's junior doctors committee, argued that they would be unwieldy and open to legal challenge.

But GMC president Sir Donald Irvine said existing measures were inadequate and that changes were needed to preserve public confidence.

The preventive approach was welcomed by Dr Gordon Paterson, public health and acute services director at Grampian health board and acting medical director at Angus trust.

He said: 'The public and the medical profession must welcome these measures. Any process which periodically reviews doctors' performance and either confirms his adequacy or identifies areas where some improvement is required must lead to a general increase in the standards of care.'

Dr Paterson said it was difficult to speculate on whether the proposed system would have avoided problems at Stracathro Hospital, where two surgeons were suspended recently. 'You can never say never,' he said.

He also argued that there should be a system of continuing clinical audit, linked to the clinical governance systems being set up throughout the NHS.

United Bristol Healthcare trust chief executive Hugh Ross said the preventive approach of the proposed system 'may well have been of help in Bristol in the past'.

'Had problems been acted on methodically and thoroughly, there would have been a full and open debate,' he said.

The new rules would go a 'long way', but would not catch all bad doctors, according to Dr Noel Padley, medical director of South Kent Hospitals trust, where consultant gynaecologist Rodney Ledward was struck off last year.

Dr Padley said: 'With our particular consultant, it was the way in which he conducted himself as much as his knowledge and skill that caused the problems.'

He added that the medical profession mirrored the general population in that there would always be 'one or two rogues' who would not be caught by legislation.

But the new rules 'will do a great deal to improve standards, and including everybody means that nobody escapes'.

'It has been a problem in the past that it has been too easy to pay lip service to continuing medical education without paying attention to the outcomes.'

Proposals for how the new system will work are being drawn up by a steering group, to be considered by the GMC in May. It is expected that it will take at least two years to introduce the system.

See news focus, page 10; comment, page 15.