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The White Paper, Trust, Assurance and Safety - The Regulation of Health Professionals in the 21st Century, is the result of reviews by chief medical officer, Professor Sir Liam Donaldson and former head of DoH human resources, Andrew Foster, following the Shipman Inquiry.

The reviews put forward various proposals including outsourcing the adjudication of fitness-to-practise cases, which was angrily rejected by both the NMC and the GMC.

However, nurses were offered the option of having 'fitness-to-practise assessment panels' led by the NMC but selected from a pool of professionals trained by the Council of Healthcare Regulatory Excellence.

The reviews also suggested that nurses should be 'revalidated' every five years by their employers, leading to the suggestion that GPs would be obliged to decide if practice nurses were entitled to stay on the register.

Independent Nurse's sister paper GP newpaper obtained information that the DoH has decided the GMC will lose its powers of adjudication on fitness-to-practise cases and will no longer have a medical majority on its council. If true, this means doctors will no longer be truly self-regulated.

The leak gives rise to fears that nurses will be treated similarly in the interests of streamlining regulation across the healthcare professions.

Sandra Arthur, NMC president, has previously said she is worried that changes to the GMC will have a direct impact on changes considered for the NMC.

Doctors have already reacted angrily to the leak pointing out that if it is true they will reconsider paying their GMC fees. The NMC has refused to comment on the leak.

judy.sands@haymarket.com and edward.davies@haymarket.com