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The GMC has backed calls for a civil standard of proof to apply in fitness-to-practise cases, and the end of professionally-led regulation.

In its response to ‘Good Doctors, Safer Patients’, the council called for a sliding scale of proof to apply according to the severity of potential sanctions, a suggestion already backed by CMO Sir Liam Donaldson (GP, 3 November).

The GMC response says: ‘The rigour of the criminal standard of proof, or a standard close to it, is appropriate when contemplating erasure. The consequences of sanctions are less profound and the standard of proof can be applied more flexibly.’

The GMC has also called for a 50–50 split between lay and medical representation on its council. However, the GMC rejected the CMO’s suggestion it should be stripped of its adjudication role in fitness-to-practise cases.

GMC chief executive Finlay Scott said: ‘If the DoH decides, despite objective evidence, that we would do well to separate adjudication from the GMC, we would want to ensure that the new system was fair and workable.’

The GMC opposed the transfer of responsibility for regulating undergraduate medical education to the Postgraduate Medical Education Training Board and said it should continue to oversee the PLAB test. It rejected plans for a network of local GMC affiliates in every NHS organisation.

GMC president Sir Graeme Catto said: ‘One way to bridge the gap between local and national regulation could be affiliates at SHA level.’

GPC chairman Dr Hamish Meldrum said: ‘The BMA does not want to see a change in the standard of proof. The sliding scale would be a change from the criminal standard and means getting into difficult legal territory.’

nick.bostock@haymarket.com