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The General Medical Council will be conducting a consultation later on in the year regarding its core guidance for Doctors. Here, Chief Executive of the Council, Niall Dickson, discusses why the guidance needs to change and what it will mean for the patient with Editor Scott Buckler.

Why is the General Medical Council launching a review of Good Medical Practice,  its core guidance for doctors?

We believe that guidance has to keep up with changes in society and expectations of patients. We last reviewed the guidance back in 2006 and we believe the time has come to look at it again. We will not be ripping it up and starting again, many of the principles which underpin good medical practice are enduring but we do believe there are changes happening and we need to communicate the expectations of patients and the views of doctors.

Do you believe the current guidance reflects patients’ expectations?

I think largely the guidance does reflect expectations, however, there are some areas such as the development of the internet and how it brings with it a growth of information that we want to explore further. The emphasis on different parts of the guidance may change. For example, we will see different changes to the way doctors are organised in England around primary care. This does not necessarily alter principles but raises issues which must be addressed.

How has a doctor’s role changed over the last decade?

I think if we go back a generation it is fair to say the medical profession has gone through significant changes. There was an assumption twenty or thirty years ago that your doctor was elevated in his profession, however, patients are more discriminative and critical of their doctors now. Patients are more likely to challenge now then they would have done. There are also changes in the way doctors operate and the tools they have at their disposal. Doctors have a great capacity to do well and also to do harm more than ever before. Cancer diagnosis was previously restricted to one doctor, now, there are many integral members and parts of such an important diagnosis, that it becomes a team effort rather than a sole responsibility.

The patient is able to access information about diagnosis, results and appointments more readily and easily than ever before. Patients will also be able to see the outcomes of assessments and the quality in which it is delivered. So there is much more transparency. As evidence around the workings of medicine becomes more apparent there tends to be more protocols which doctors have to follow. This can be good and bad. Good, because it derives best practice , bad as it can also be frustrating for general practitioners who may feel they are constrained. Most doctors feel rewarded with their job, however it is a protocol environment and doctors must remember to adhere to the rules and regulations.

Are GPs under more pressure given the proposed GP Consortia?

There is not a new ethical dilemma which GP’s face, however it highlights an area doctors already have to face. This is to say when they are making decisions on where funds should go and if they benefit from these decisions then they should ensure they follow the correct ethical guidance. At the heart of this is transparency and the decisions they make should be on what is best for patients and not what is best for the doctors.

Why is the UK looked upon fondly for its ethical principles?

The GMC has long been regarded as a leader in a number of aspects of medical regulation. The standards and development of the guidance relies heavily on consulting with doctors and those working in the field and the way in which we consult is highly respected worldwide. Each piece of guidance looks simple, however, there is much thought and testing with patients and doctors before the final guidance is produced.

Find out more about the review of Good Medical Practice at

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Written by Niall Dickson   
Friday, 16 September 2011 09:08
Last Updated on Friday, 16 September 2011 08:45

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