The BMA agrees that the powers of the General Medical Council should be enhanced to allow it to better protect the public.
In its response to the NHS Executive's consultation document, Modernising medical regulation: interim strengthening of the GMC's fitness to practise procedures, the association agrees that interim suspension should be possible where a doctor's conduct is putting patient safety at risk. It points out that suspension has severe implications for a doctor's income and contractual relationship. For GPs, the BMA suggests that the NHS tribunal would be a more effective body to order suspensions as this would protect doctors' pay and contractual relationships.
The NHS Executive proposes that doctors whose names are erased from the register should not be able to apply for restoration in less than five years. The BMA agrees with the GMC that the period should be three years. It points out that after five years it would be virtually impossible for a doctor to make up the lost ground. It might be argued that a five year ban, which would amount to a life exclusion, would be in contravention of human rights legislation. The BMA would like the GMC's professional conduct committee to set a minimum erasure period for each case.
The association also points out that the proposals on disclosure of information could contravene human rights legislation, particularly when the Human Rights Act becomes law in October.
The BMA supports the proposal to allow non-GMC members to serve on its fitness to practise committees to help with the backlog of cases and give greater flexibility.
Government wants to help GPs
As part of the govenment's modernisation plans for the NHS the prime minister has spelt out ways in which GPs' workload could be adapted to provide a better service and more job satisfaction.
The proposals were set out in a letter from the health minister, John Denham. He said that GPs could spend less time on practice administration—there would shortly be a study into how the regulatory and bureaucratic burden on GPs could be eased—on repeat prescribing by extending the role of pharmacists; on dealing with minor ailments by making more use of practice nurses and training receptionists better; and on unnecessary out of hours calls by working more closely with NHS Direct.
Mr Denham says that by using electronic links and direct booking systems less time would be spent on chasing up tests and arranging outpatient appointments; nurses and other practice therapists could do checks and validation of claims; and the use of professional development plans and new technology would save time spent on unproductive and unfocused training days.
The minister suggests that GPs should use guidelines from the National Institute for Clinical Excellence and the National Electronic Library for Health, when it is established, to find the latest evidence base for investigations, treatment, and prescribing.
Responding to the proposals, which he described as a “constructive approach,” the chairman of the General Practitioners Committee, Dr John Chisholm, said that the ideas complemented the committee's own policy review which is looking at how general practice should evolve over the next decade.
GPs angry at allocation of out of hours money
GPs have expressed their anger over a radical change in the distribution of money for out of hours development for 2000-1.
The money that was allocated last year to rural and isolated areas on the basis of high levels of need has this year been allocated on a capitation basis to all health authorities in England with the rest of the fund. The out of hours review, which was announced in March (18 March, p 808), will consider how to distribute the money in future. The Department of Health has challenged the General Practitioners Committee to provide evidence that the targeted funding has provided cost effective support to rural areas and that its withdrawal will cause developments set up to fail.
The chairman of the GPC, Dr John Chisholm, is seeking an urgent meeting with the health minister. He said that the decision will cause “considerable difficulties to GPs in the areas that benefited last year.” He has asked GPs to let him know if they are having to fund an increasing proportion of the costs of existing arrangements out of their practice profits.
Review team appointed
Three members of the Department of Health's review team have been appointed—Dr David Carson from City and East London Health Authority, Ian Trimble, and Nicholas Reeves, a lay member of Ealing primary care group. The team is preparing a visiting programme and those to be consulted include the Consumers Association, community health councils, a nurse with experience of NHS Direct and an NHS Direct manager, the GPC, and the Royal College of General Practitioners. The GPC is pressing for formal access to the review team. The timescale is short, with an interim report to be published in July and a final report in August.
NI doctors want to meet Tony Blair
Doctors' and nurses' representatives in Northern Ireland have asked to meet the prime minister about the continuing crisis in the province's health service.
The chairmen of the BMA Northern Ireland council and of the Northern Ireland board of the Royal College of Nursing (RCN) have told Tony Blair that the province desperately needs a healthcare strategy. They are concerned that unless this happens the new moneys announced for the NHS will be used only to address deficiencies.
As there is no effective decision making body in the province the BMA and the RCN have asked the prime minister to ensure that the healthcare policy inertia which has existed since 1997 should not be allowed to continue and that the new resources being injected are used to develop a health service that mirrors developments in the rest of the United Kingdom.