Modernising medical regulation: where are we now?

J Health Organ Manag. 2010;24(6):540-55. doi: 10.1108/14777261011088647.

Abstract

Purpose: This paper aims to outline and comment on the changes to medical regulation in the UK that provide the background to a special issue of the Journal of Health Organization and Management on regulating doctors.

Design/methodology/approach: This paper takes the form of a review.

Findings: Although the UK medical profession enjoyed a remarkably stable regulatory structure for most of the first 150 years of its existence, it has undergone a striking transformation in the last decade. Its regulatory form has mutated from one of state-sanctioned collegial self-regulation to one of state-directed bureaucratic regulation. The erosion of medical self-regulation can be attributed to: the pressures of market liberalisation and new public management reforms; changing ideologies and public attitudes towards expertise and risk; and high profile public failures involving doctors. The "new" UK medical regulation converts the General Medical Council into a modern regulator charged with implementing policy, and alters the mechanisms for controlling and directing the conduct and performance of doctors. It establishes a new set of relationships between the medical profession and the state (including its agencies), the public, and patients.

Originality/value: This paper adds to the literature by identifying the main features of the reforms affecting the medical profession and offering an analysis of why they have taken place.

Publication types

  • Editorial
  • Review

MeSH terms

  • Delivery of Health Care / legislation & jurisprudence*
  • Government Regulation*
  • Health Care Reform / legislation & jurisprudence*
  • Humans
  • Physicians / legislation & jurisprudence*
  • United Kingdom