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The main proposals in this White Paper, Trust, Assurance and Safety, The Regulation of Health Professionals in the 21^st Century, include:

• The professional regulators will be independent of Government and led by an equal partnership of independently appointed professionals and members of the public.
• All health professionals will be required to demonstrate periodically that they are fit to practise by revalidating their professional registration.
• Moving from the criminal standard of proof to the civil standard with a sliding scale in fitness to practice cases.
• A stronger role for the medical Royal Colleges.
• Introducing a system of regional GMC Affiliates who will provide support to local employers in addressing concerns about doctors and independently quality assure local revalidation processes.

Shipman inquiry
The publication of this White Paper coincides with a response to the fifth report of the Shipman inquiry. The document sets out a plan to help healthcare organisations identify healthcare professionals whose performance or conduct may put patients at risk.

Patricia Hewitt also announced her intention to consult on proposals for a radical overhaul of the processes for death certification, a key recommendation of the Shipman Inquiry. The DoH hopes that these changes will ensure a unified system of death certification that provides much more effective scrutiny and stronger safeguards for the public.

Radical overhaul
Health Secretary, Patricia Hewitt said: 'People in the UK still rightly hold the health professions in the very highest regard. We take for granted that they deliver excellent care as a matter of routine. It is therefore even more bewildering when that trust is betrayed. These rare cases of abuse have reminded us that even members of caring professions can fall away from the high standards to which they commit themselves.

'These changes are radical and significant and offer the opportunity for a long term settlement. They enable us to put an end to the disagreements of the past and to focus clearly on patient safety and public and professional confidence.'

Chris Beasley, the chief nursing officer, said: 'Importantly, the White Paper does not solely focus on the medical profession, but recognises that there can be no weak links in the chain of care for patients. Bringing greater consistency across the professions, the proposals will help ensure a system that is easier for both patients and professionals to understand and deal with.'

Copies of all reports can be found on the DoH website.