Angry Doctor

Friday, February 23, 2007

Quis custodiet ipsos custodes?

angry doc is always keen to find out about developments in the NHS, which he believes has a certain predictive value on how the local medical scene will develope.

And this piece of news certainly has got his attention:


Doctors' regulatory power 'to go'

Doctors are set to lose the power to regulate themselves and senior medics will face regular MOT-style checks under a planned shake-up of regulation.

The overhaul, which will now be debated by parliament, has been announced by ministers following the Shipman murders and other medical scandals.

A stricter system of death certification is also to be introduced.

The General Medical Council is set to lose its power to adjudicate on fitness-to-practise cases.

The GMC will also have to change its membership to 50% doctors, 50% lay people in a move away from the much criticised profession-led regime.

You can read the White Paper here.

It will take angry doc all weekend to digest that, but on the first scan it consists of a series of motherhood statements with little indication of what actions will be implemented on the ground, with the exception of the part picked up by the BBC report, which is that doctors will, as a profession, lose their privilege to self-regulation.

Will the same thing happen to doctors in Singapore?

Certainly the threat of the loss of that privilege has been talked about, usually in the vein of 'if we don't watch ourselves, they'll put someone else to watch over us'.

Implicit in that sentiment is the fact that (probably) most doctors dread the idea of being regulated by laymen over their professional conduct.

angry doc certainly does.

Not, you understand, because he thinks Singapore Medical Council (SMC) is "more interested in looking after doctors than protecting patients" as is alleged of the GMC. In fact, angry doc has previously expressed concern over SMC's motives in the disciplinary process.

But motivation aside, if angry doc's 'fitness-to-practise' is to be called into doubt, he would still much rather be judged by people who knew what practising medicine is all about.

Still, a White Paper is but a written document; the test will be in the eventual implementation. angry doc has no doubt Dr Crippen will be keeping us updated on this topic.



  • Actually I already see it happening. In legal suits, the judge rules. The judge is a lawyer by training not a doctor.

    Not much of a difference.

    It will be interesting to see how this turns out in the UK. Of course we must remember that the UK government's health expenditure is more than 80% of the UK's total health expenditure. So of course the government feels it should have a bigger say about how doctors practise.

    In Singapore, GHE is only about 30%. Not to mention the THE as a percentage of GDP for Singapore is about 4.5%.

    By Anonymous Anonymous, At February 24, 2007 10:41 am  

  • Indeed. The law allows a judge to be the judge on all legal matters, but then he is an expert in the interpretation of the law; and when it regards specialised fields, the judge is assisted in his opinion by testimonies of expert witnesses in those respective fields.

    Also, the 'jurisdiction' of the Medical Council covers a 'lower' level of 'wrongs' than the court's. Things which may not see you hauled to a court can still render you unfit to practise; a doctor can do no wrong legally, but still be deemed to have behaved in a manner that brought disrepute to the profession; whereas a conviction in a court of law can automatically render one unfit to practise.

    What I was more worried about, of course, is being judged to done something wrong when I have in fact acted in accordance to current best practices and given reasonable standard of care. Professional pride perhaps, but by the same token I don't see myself fit to sit on a panel to judge if an airliner pilot handled his plane properly.

    By Blogger angry doc, At February 24, 2007 6:11 pm  

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