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General Medical Council sets out revalidation strategy for doctors
POLICY AND PEOPLE
General Medical Council sets out revalidation strategy for doctors
T
he UK’s General Medical Council (GMC) launched a wide-ranging public consultation exercise on June 22 for its proposals to ensure doctors keep up-to-date and remain fit to practise. Public confidence in the GMC’s ability to deal with incompetent doctors has fallen dramatically in the past few years (see Lancet 2000 355: 2010). The GMC has admitted that “recent cases of clinical failure confirm the need for reform”. In 1999, in response to these concerns, and in line with wider governmental reforms to the national health service, the GMC decided that the medical register should become “an up-to-date statement of each doctor’s fitness to practise”. In the Revalidating Doctors document the GMC has suggested a three-stage revalidation procedure. First all doctors will have a folder of information that describes what the doctor does and what standards the
doctor achieves. This information will be reviewed regularly and in most cases will be dealt with by annual appraisals. Every 5 years doctors will face “periodic revalidation” by a group of medical and lay people. At this point this revalidation group will decide whether a doctor is still fit to practise or whether that the doctor should be referred to the GMC. If a doctor’s abilities are called into question by the group the doctor proceeds to the final stage of the process. At this point the GMC could suspend, erase, or make subject to conditions any doctors whose fitness to practise has been called into question. The GMC has asked for views at each stage of the process. For example, it asks whether all complaints made against a doctor should be included in the folder, or only complaints that are serious enough to raise questions about a doctor’s reg-
istration and whether anonymous complaints should be excluded. The GMC also invites discussion on whether a 5-year revalidation cycle is appropriate. To ask doctors to undergo revalidation more frequently could interfere with doctor’s ability to deliver care, it suggests. The GMC also asks how lay members of the revalidation group should be recruited and whether such people should have any health-sector related experience. How locum doctors will fit into the revalidation process also raises questions. The GMC asks: “who should regularly review the locum doctor’s folder and who should carry out the 5-year assessment?” All responses to the proposals should reach the GMC by Sept 25. A comprehensive revalidation model will be discussed by the GMC in February, 2001, and finalised three months later. Haroon Ashraf
Amnesty highlights repression of Asian women
News in brief
ernments of such countries and their or most of the world’s popularespective law-enforcement agencies tion, 1999 brought repression, of persistent bias against women, and poverty, or war, according says that most abuses to Amnesty against south Asian International’s annual women occur often with report . “In country Rights were the apparent conafter country, imprisnot granted to nivance of the police onment, torture and and local authorities. political killings were include this Amnesty has appealed used by governments image in to the international to silence opposition community to stop such and maintain their hold electronic abuses. on power”. media. Please “Women in south Most notable among refer to the Asia face many humanthe human-rights rights problems that abuses highlighted in printed directly affect their the report include conjournal. health, including poor tinued repression of access to health care, women in south Asia. lack of prenatal care, For example, hundreds c h r o n i c of women were killed malnutrition—both in Pakistan in the name Abuse is far too common because of poverty and of “honour” for having because of cultural beliefs about food sexual relations, for marrying someconsumption—family violence and, one against the wishes of their famifor girls, benign neglect”, says lies, or for seeking a divorce. Patricia Omidian, a medical anthroWomen’s rights are systemically viopologist from Islamabad. “[If they lated by the Taliban government are] married off in their early teens, who are ruling 90% of Afghanistan. they are twice as likely as adults to In Bangladesh, women still face die in childbirth—the region’s materbeing attacked with acid or being nal mortality rate of 600 per 100 000 murdered for their dowries by their livebirths of is among the highest in relatives. In India, human rights the world”, warned Omidian. abuses against women from lower socio-economic classes are commonplace. The report accuses the govKhabir Ahmad
UK organisations urge debt relief On June 21, the British Medical Association and two UK organisations launched a “last ditch” campaign to persuade world leaders to write off the debts of the poorest nations. The launch took place outside the Japanese Embassy ahead of next month’s G8 summit in Okinawa. The BMA, Medact (an organisation of health professionals acting against international barriers to health), and the Medical Students’ International Network, urged health professionals to sign an e-mail version of the Jubilee 2000 Coalition’s debt-cancellation petition (see www.medact.org).
F
THE LANCET • Vol 355 • June 24, 2000
New medical schools for England In a move aimed at increasing the number of doctors in the NHS, the Higher Education Funding Council for England announced last week the setting up of two new medical schools. Based at the University of East Anglia, and jointly at the Universities of Exeter and Plymouth, the new schools will begin enrolling in 2002. In addition, an “access to medicine” course at King’s College, London, will aim to encourage students from underrepresented communities to pursue medical careers.
2229
For personal use only. Not to be reproduced without permission of The Lancet.
General Medical Council sets out revalidation strategy for doctors
T
he UK’s General Medical Council (GMC) launched a wide-ranging public consultation exercise on June 22 for its proposals to ensure doctors keep up-to-date and remain fit to practise. Public confidence in the GMC’s ability to deal with incompetent doctors has fallen dramatically in the past few years (see Lancet 2000 355: 2010). The GMC has admitted that “recent cases of clinical failure confirm the need for reform”. In 1999, in response to these concerns, and in line with wider governmental reforms to the national health service, the GMC decided that the medical register should become “an up-to-date statement of each doctor’s fitness to practise”. In the Revalidating Doctors document the GMC has suggested a three-stage revalidation procedure. First all doctors will have a folder of information that describes what the doctor does and what standards the
doctor achieves. This information will be reviewed regularly and in most cases will be dealt with by annual appraisals. Every 5 years doctors will face “periodic revalidation” by a group of medical and lay people. At this point this revalidation group will decide whether a doctor is still fit to practise or whether that the doctor should be referred to the GMC. If a doctor’s abilities are called into question by the group the doctor proceeds to the final stage of the process. At this point the GMC could suspend, erase, or make subject to conditions any doctors whose fitness to practise has been called into question. The GMC has asked for views at each stage of the process. For example, it asks whether all complaints made against a doctor should be included in the folder, or only complaints that are serious enough to raise questions about a doctor’s reg-
istration and whether anonymous complaints should be excluded. The GMC also invites discussion on whether a 5-year revalidation cycle is appropriate. To ask doctors to undergo revalidation more frequently could interfere with doctor’s ability to deliver care, it suggests. The GMC also asks how lay members of the revalidation group should be recruited and whether such people should have any health-sector related experience. How locum doctors will fit into the revalidation process also raises questions. The GMC asks: “who should regularly review the locum doctor’s folder and who should carry out the 5-year assessment?” All responses to the proposals should reach the GMC by Sept 25. A comprehensive revalidation model will be discussed by the GMC in February, 2001, and finalised three months later. Haroon Ashraf
Amnesty highlights repression of Asian women
News in brief
ernments of such countries and their or most of the world’s popularespective law-enforcement agencies tion, 1999 brought repression, of persistent bias against women, and poverty, or war, according says that most abuses to Amnesty against south Asian International’s annual women occur often with report . “In country Rights were the apparent conafter country, imprisnot granted to nivance of the police onment, torture and and local authorities. political killings were include this Amnesty has appealed used by governments image in to the international to silence opposition community to stop such and maintain their hold electronic abuses. on power”. media. Please “Women in south Most notable among refer to the Asia face many humanthe human-rights rights problems that abuses highlighted in printed directly affect their the report include conjournal. health, including poor tinued repression of access to health care, women in south Asia. lack of prenatal care, For example, hundreds c h r o n i c of women were killed malnutrition—both in Pakistan in the name Abuse is far too common because of poverty and of “honour” for having because of cultural beliefs about food sexual relations, for marrying someconsumption—family violence and, one against the wishes of their famifor girls, benign neglect”, says lies, or for seeking a divorce. Patricia Omidian, a medical anthroWomen’s rights are systemically viopologist from Islamabad. “[If they lated by the Taliban government are] married off in their early teens, who are ruling 90% of Afghanistan. they are twice as likely as adults to In Bangladesh, women still face die in childbirth—the region’s materbeing attacked with acid or being nal mortality rate of 600 per 100 000 murdered for their dowries by their livebirths of is among the highest in relatives. In India, human rights the world”, warned Omidian. abuses against women from lower socio-economic classes are commonplace. The report accuses the govKhabir Ahmad
UK organisations urge debt relief On June 21, the British Medical Association and two UK organisations launched a “last ditch” campaign to persuade world leaders to write off the debts of the poorest nations. The launch took place outside the Japanese Embassy ahead of next month’s G8 summit in Okinawa. The BMA, Medact (an organisation of health professionals acting against international barriers to health), and the Medical Students’ International Network, urged health professionals to sign an e-mail version of the Jubilee 2000 Coalition’s debt-cancellation petition (see www.medact.org).
F
THE LANCET • Vol 355 • June 24, 2000
New medical schools for England In a move aimed at increasing the number of doctors in the NHS, the Higher Education Funding Council for England announced last week the setting up of two new medical schools. Based at the University of East Anglia, and jointly at the Universities of Exeter and Plymouth, the new schools will begin enrolling in 2002. In addition, an “access to medicine” course at King’s College, London, will aim to encourage students from underrepresented communities to pursue medical careers.
2229
For personal use only. Not to be reproduced without permission of The Lancet.