GMC: Guarantor and protector

The Medical Profession: Part 1 - Joe Chattin delivers the first article in a new series of informative briefings for hospital doctors begins by looking at the history of the GMC

Whoever speaks about the regulation of the profession in the UK today is at once speaking about the General Medical Council.

It is an offence for anyone to holding themselves out to the public as medical practitioner unless he or she is registered by the General Medical Council.

Today, there are approximately 245,000 doctors registered with the GMC.

Statutory Registration and the maintenance of a Register of tested and qualified persons is the essential component in protecting the public and the profession from the dangers and damage of quackery.

Official recognition in the UK of the need to protect the public from quacks – persons who pretend, professionally or publicly, to have skill, knowledge, or qualifications they do not possess – goes back to the early 15th century.

In 1421, a number of physicians petitioned Parliament demanding that nobody without proper medical qualifications should be allowed to practise medicine. The first Statute regulating the profession appeared in 1511 and placed the task of regulating doctors in the hands of the local clergy!

In 1518, the College of Physicians began to license doctors in London. The story is one of piecemeal developments until 1858. It was then that the Medical Act established the GMC and created the modern the system of medical regulation in the UK.

It is apposite to note that the full title of the GMC as it is conferred by the 1858 Act is the General Medical Council of Medical Education and Registration of the United Kingdom.

This captures, much better than the usual acronym, the scope of the GMC’s activities in securing the aim of those physicians who 600 years ago demanded that no-one without proper medical qualifications should be allowed to practice medicine.

The GMC sets the standards which medical schools must meet and implements checks to ensure that medical students graduate with the basic knowledge and potential to provide first-rate medical care.

The council also sets the standard for training in Foundation Years 1 & 2 and conducts checks to ensure these standards are met. And it is the principal source of the ethics and norms of the profession and how medical practitioners should conduct themselves in the practice of medicine.

The GMC publication Good Medical Practice and its attendant specific guidance documents set the down the duties which doctors are required to observe in the conduct of their practise. The intention here is to be educative as well as prescriptive.

The maintenance of the Medical Register is the key duty of the GMC and from this stems the responsibility to ensure that those registered remain capable of practising medicine to the standards of clinical performance and professional conduct as is necessary to secure the protection of the profession and the public.

The role of guarantor and protector of the capability and conduct of medical practitioners inescapably requires acting on concerns about doctors and an exacting process of examination.

Since 2012, the GMC has taken on the responsibility for relicensing registered practitioners and there has been a separation of its functions of investigator and adjudicator of concerns arising about a practitioner’s performance.

The Medical Practitioner Tribunal Service is now responsible for adjudicating complaints and the results of investigations.

Regulation of the medical profession requires that the regulator interposes itself between the professions and the public in acting as guarantor and protector for both.

The GMC has a very complex role to play, its scope stretching from guaranteeing the standard of medical education and the promulgation of norms and ethical codes to the responsibilities of policing the profession and the elimination of inadequate and dangerous practice.

The profession itself has been the proponent of thorough and statutory regulation, and has been the means of funding it: this is a point which is sometimes missed.

Joe Chattin is HCSA Head of Industrial Relations