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The government is also expected to recommend that fitness-to-practise cases be judged on a sliding scale of proof where evidence required is determined according to the severity of the misdemeanour.

Sources have told GP that the government's response to CMO Sir Liam Donaldson's review of regulation, due to be announced next week, could seriously undermine the GMC and the concept of self-regulation.

Doctors will want to reconsider what they are paying for, said one insider: 'There must come a point where professionals say "if we have no input or ownership, we don't really want to be part of it".'

Adjudication in fitness-to-practise cases was one of the areas that the GMC had hoped to retain (GP, 10 November 2006 - GMC backs changes to standard of proof).

It is unclear who would take on the responsibility for adjudication, but in the CMO's original report he suggested the GMC be responsible for investigating and assessing serious fitness-to-practise cases, but independent panels comprising legal, medical and lay representatives conduct the actual adjudication.