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09-30-2007, 01:55 PM
BMA Chairman, Dr Hamish Meldrum, has written1 to all members of the Association outlining his serious concerns about the proposed changes to the regulation of the medical profession in the UK.

Dr Meldrum describes the government's plans to change the way doctors are regulated in the UK, including moving away from the current criminal standard of proof [beyond reasonable doubt] to a civil standard of proof [the balance of probabilities], as an 'assault on our profession'.

The government announced its intention to change the regulation laws for UK doctors in the February 2007 white paper 'Trust, Assurance and Safety - the Regulation of Health Professionals in the 21st Century', but the General Medical Council [GMC] is already consulting on its plans to move to the civil standard of proof.

Dr Meldrum says:

"If a doctor stands to lose his or her livelihood then nothing less than the current criminal standard of proof will do and we will do all we can to maintain this. We believe a lesser standard of proof could result in unjustified adverse findings against the doctor."

He added:

"The prime objective of any regulatory system for the medical profession should be to protect patients and to support doctors with performance difficulties. We know that the vast majority of doctors perform well and safely and, of course, acknowledge that it is imperative that patients are protected from the small number of cases of unsafe doctors. The BMA fully supports measures that promote excellence in medical practice and that help to reduce instances of poor standards, negligence or criminality among doctors. However, we do not believe that stripping out the fundamental aspects of professionally-led regulation is the correct way to ensure patient safety and believe that some of the proposals are not only unfair to doctors but will compromise their clinical independence with consequent risks to patient care."

At the BMA's annual meeting in June, feelings ran high among doctors about the proposed changes to medical regulation in the UK with many representatives saying this was one of the most important issues facing the profession.

Alongside serious concerns about proposals to change the standard of proof, the BMA is alarmed at other aspects of the plans to amend the way in which doctors are regulated. For example:

- The BMA does not believe it is necessary to change to an independent adjudicator - this will essentially mean the end of professionally-led regulation. Given the GMC has reformed its functions, the BMA does not accept that the medical profession should lose the authority to regulate itself. The Association is also concerned that no details on the nature of these tribunals and how they would work have been made available.

- The BMA expresses significant concerns about the operation and role of 'responsible officers' and 'GMC affiliates' - these roles could seriously blur employment and regulation functions.

- Revalidation - while the BMA is supportive of doctors being regularly reassessed, it will resist strongly any attempts to impose unrealistic and time-consuming mechanisms that will remove doctors from time with their patients.

- The BMA will oppose plans to end elections by the profession for the medical GMC members and replace these with direct appointments made by the Public Appointments Commission. The BMA believes this will seriously threaten the independence and credibility of the GMC.

In his letter to BMA members, Dr Meldrum has asked for their support in maintaining professionally-led regulation for the benefit of both patients and doctors.

1 The future regulation letter can be accessed on the BMA website here. (http://www.bma.org.uk/ap.nsf/content/Futureregulationletter0907)

The Health and Social Care Bill, due to be introduced in the next Parliamentary session, is expected to facilitate the changes to the regulation of the medical profession.

http://www.bma.org.uk (http://www.bma.org.uk/)