Medical regulators could merge in government shake up

Authors: Abi Rimmer 

Publication date:  06 Nov 2017


Plans to overhaul the way doctors, nurses, and other healthcare professionals are regulated have had a mixed response.

A key aim of the Department of Health’s plans to reform medical regulation is to ensure that organisations have a “consistent and flexible range of powers that allow them to take a prompt and proportionate approach to concerns about an individual’s fitness to practise.”

To meet that objective, the department has proposed shrinking the number of medical regulators from the current nine to three or four.

Consultation documents on upgrading the regulation of healthcare professions were launched at the end of October,[1] with a remit for the four UK governments to look into which professions needed statutory regulation.

Other proposals include promoting more joint working among regulators and having a single database where the public can search the registration status of doctors and other healthcare workers.

It is uncertain how the General Medical Council will be affected, although the department has said that the case for continuing statutory regulation for some professions, including doctors, was clear.

The GMC has welcomed the chance to discuss reforms. It has been calling for some time for legislation that would allow it to modernise its processes.[2] Charlie Massey, the GMC’s chief executive, said that he appreciated the fact that the government had recognised the current legislation was not fit for a 21st century health service.

“As it stands, the legal framework is too prescriptive and makes many of our processes slow, inflexible, and heavy handed. We have done what we can to modernise the way that we work, such as reducing the number of unnecessary investigations, but the current law is a roadblock preventing further improvements,” Massey said.

“What we need is legislation that allows us to be swift and efficient in carrying out our primary duty—keeping patients safe—while reducing the burden on doctors. We hope the government will act on their commitment and introduce legislation that is fit for purpose as soon as possible.”

However, the proposals for joint working between regulators have not been welcomed by the profession.

Although the BMA said it would support reasonable changes to medical regulation, Chaand Nagpaul, chair of the association, said that it believed that “professional regulation of doctors should continue to be separate from the regulation of other professions and providers.”

Chaand said, “It is vitally important that the different complexities of each profession, which have numerous training structures, career routes, and healthcare responsibilities, are taken into account.”

The medical indemnifier the Medical Protection Society (MPS) also warned against an amalgamation of the medical regulators. Pallavi Bradshaw, senior medicolegal adviser at MPS said, “We will be reviewing the detail in this consultation carefully—an amalgamation exercise which could result in the specific expertise of each profession’s regulator being lost would be concerning.” She added, “Any new regulators, replacing the existing nine, would need to be able to distinguish between the hugely differing roles within the many professions they would oversee.”

The consultation closes on 23 January 2018 and will be followed by a government response.

Key proposals on reforming regulators include:

  • Cutting the number of organisations from nine to three or four

  • Speeding up decisions about poor performance and misconduct

  • Establishing a shared online, search engine type system that would cover all registered healthcare professionals, which would “make it easier for patients, the public, and employers to access details about whether a health professional is registered and about that professional’s registration”

  • Setting up a single adjudicator responsible for all fitness to practise decisions, built on the GMC’s Medical Practitioners Tribunal Service. This will “provide greater consistency of decision making on all fitness to practise cases, making the process fairer for regulated professionals and for patients and the public”

  • Establishing a single organisation conducting back office functions for all of the medical regulators

  • Allowing regulators to better support professionalism by checking members’ skills and behaviour are up to date

  • Promoting joint working between regulators

References

  1. Department of Health. Promoting professionalism, reforming regulation. [Link]
  2. General Medical Council. GMC statement of the Queen’s Speech. 2017. [Link]

Abi Rimmer The BMJ

Cite this as BMJ Careers ; doi: