General Medical Council
The General Medical Council is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by controlling entry to the register, and suspending or removing members when necessary. It also sets the standards for medical schools in the UK. Membership of the register confers substantial privileges under Part VI of the Medical Act 1983. It is a criminal offence to make a false claim of membership. The GMC is supported by fees paid by its members, and it became a registered charity in 2001.
History
The Medical Act 1858 established the General Council of Medical Education and Registration of the United Kingdom as a statutory body. Initially its members were elected by the members of the profession, and enjoyed widespread confidence from the profession.Purpose
All the GMC's functions derive from a statutory requirement for the establishment and maintenance of a register, which is the definitive list of doctors as provisionally or fully "registered medical practitioners", within the public sector in Britain. The GMC controls entry to the List of Registered Medical Practitioners. The Medical Act 1983 notes that, "The main objective of the General Council in exercising their functions is to protect, promote and maintain the health and safety of the public."Secondly, the GMC regulates and sets the standards for medical schools in the UK, and liaises with other nations' medical and university regulatory bodies over medical schools overseas, leading to some qualifications being mutually recognised. Since 2010, it has also regulated postgraduate medical education.
Thirdly, the GMC is responsible for a licensing and revalidation system for all practising doctors in the UK, separate from the registration system, since 3 December 2012.
Activities and powers
Due to the principle of autonomy and law of consent there is no legislative restriction on who can treat patients or provide medical or health-related services. In other words, it is not a criminal offence to provide what would be considered medical assistance or treatment to another person – and not just in an emergency. This is in contrast with the position in respect of animals, where it is a criminal offence under the Veterinary Surgeons Act 1966 for someone who is not a registered veterinary surgeon to provide treatment to an animal they do not own.Parliament, since the enactment of the 1858 Act, has conferred on the GMC powers to grant various legal benefits and responsibilities to those medical practitioners who are registered with the GMC – a public body and association, as described, of the Medical Act 1983, by Mr Justice Burnett in British Medical Association v General Medical Council.
Through which, by an Order in the Privy Council, the GMC describes "The main objective of the General Council in exercising their functions is to protect, promote and maintain the health and safety of the public".
The GMC is funded by annual fees required from those wishing to remain registered and fees for examinations. Fees for registration have risen significantly in the last few years: 2007 fees = £290, 2008 fees = £390, 2009 fees = £410, 2010 fees = £420, 2011 fees = £420, with a 50% discount for doctors earning under £32,000.
In 2011, following the Command Paper "Enabling Excellence-Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers", registration fees were reduced by the GMC in accordance with the Government's strategy for reforming and simplifying the system for regulating healthcare workers in the UK and social workers and social care workers in England and requiring that "t a time of pay restraint in both the public and private sectors, the burden of fees on individual registrants needs to be minimised."
Registering doctors in the UK
Registration with the GMC confers a number of privileges and duties. GMC registration may be either provisional or full. Provisional registration is granted to those who have completed medical school and enter their first year of medical training; this may be converted into full registration upon satisfactory completion of the first year of postgraduate training. In the past, a third type of registration was granted to doctors who had graduated outside the UK and who had completed the Professional and Linguistic Assessments Board examination but who were yet to complete a period of work in the UK. Limited registration was abolished on 19 October 2007 and now international medical graduates can apply for provisional or full registration depending on their level of experience – they still have to meet the GMC's requirement for knowledge and skills and for English language.The form and content of the register is specified in The General Medical Council Regulations 2015. Details recorded include name, address, date of qualification, gender, date of birth, photograph, fitness to practice history, restrictions and whether or not they hold a licence to practice. Not all details on the register are made available to the general public.
The GMC administers the Professional and Linguistic Assessments Board test, which has to be sat by non–European Union overseas doctors before they may practise medicine in the UK as a registered doctor.
A registered practitioner found to have committed some offences can be removed from the medical register.
Licensing and revalidating doctors in the UK
The GMC is now empowered to license and regularly revalidate the practice of doctors in the UK. When the licensing scheme was introduced in 2009, 13,500 of registered doctors chose not to be licensed. Unlicensed but registered doctors are likely to be non-practising lecturers, managers, or practising overseas, or retired. Whereas all registered doctors in the UK were offered a one-off automatic practise licence in November 2009, since December 2012 no licence will be automatically revalidated, but will be subject to a revalidation process every five years. No doctor may now be registered for the first time without also being issued a licence to practice, although a licensed doctor may give up their licence if they choose. No unlicensed but registered doctor in the UK is subject to revalidation. However, unlicensed but registered doctors in the UK are still subject to fitness-to-practice proceedings, and required to follow the GMC's good medical practice guidance.Setting standards of good medical practice
The GMC sets standards of professional and ethical conduct that doctors in the UK are required to follow. The main guidance that the GMC provides for doctors is called Good Medical Practice. This outlines the standard of professional conduct that the public expects from its doctors and provides principles that underpin the GMC's fitness-to-practise decisions. Originally written in 1995, a revised edition came into force in November 2006, and another with effect from 22 April 2013. The content of Good Medical Practice has been rearranged into four domains of duties. Their most significant change is the replacement of a duty to, "Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk," to a new duty to, "Take prompt action if you think that patient safety, dignity or comfort is being compromised". Alongside the guidance booklet are a range of explanatory guidelines, including a new one about the use of social media. The GMC also provides additional guidance for doctors on specific ethical topics, such as treating patients under the age of 18, end-of-life care, and conflicts of interest.Medical education
The GMC regulates medical education and training in the United Kingdom. It runs 'quality assurance' programmes for UK medical schools and postgraduate deaneries to ensure that the necessary standards and outcomes are achieved.In February 2008 the then Secretary of State for Health, Alan Johnson, agreed with recommendations of the Tooke Report which advised that the Postgraduate Medical Education and Training Board should be assimilated into the GMC. Whilst recognising the achievements made by PMETB, Professor John Tooke concluded that regulation needed to be combined into one body; that there should be one organisation that looked after what he called "the continuum of medical education", from the moment someone chooses a career in medicine until the point that they retire. The merger, which took effect on 1 April 2010, was welcomed by both PMETB and the GMC.
Misconduct and fitness to practise
A registered medical practitioner may be referred to the GMC if there are doubts about their fitness to practise. The GMC is concerned with ensuring that doctors are safe to practise. Its role is not, for example, to fine doctors or to compensate patients following problems. The outcomes of hearings are made available on the GMC website.Historically the handling of concerns had two streams: one regarding health, the other about conduct or ability, but these streams have been merged, into a single fitness-to-practice process. The GMC has powers to issue advice or warnings to doctors, accept undertakings from them, or refer them to a fitness-to-practise panel. The GMC's fitness-to-practise panels can accept undertakings from a doctor, issue warnings, impose conditions on a doctor's practice, suspend a doctor, or remove them from the medical register.