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The GMC is pressing for an early switch away from the status quo where the criminal standard of proof is expected in fitness-to-practise cases.

Under the civil standard, panellists have to assess whether a doctor is guilty on the balance of probabilities.

The criminal standard demands a higher level of proof: 'beyond reasonable doubt'.

However, the future of the sliding scale, where more serious cases require higher standards of proof, is unclear.

The GMC is understood to have abandoned the idea of a sliding scale, saying that cases will either be judged on a civil or criminal standard.

The DoH was unavailable for comment. However, proposals for the sliding scale and standard of proof change are contained in the White Paper on medical regulation, entitled ‘Trust, Assurance and Safety', published in February.

Moving to the civil standard offers ‘twin benefits', GMC chief executive Finlay Scott said.

'It enhances our ability to improve patient safety while retaining fairness, objectivity and transparency towards doctors.'

Professor Sir Graeme Catto, GMC president, has said that the switch to the civil standard should not lead to more doctors being suspended or erased from the register.

By applying the standard flexibly, more serious allegations and consequences will demand stronger evidence to weight the balance of probabilities.

The switch to the civil standard requires a change to statutory rules rather than primary legislation.

'Regardless of whether it is included in the government's legislative programme, we should press the DoH in England to agree that the change to the civil standard of proof should be prioritised,' the GMC said.

'We should not delay implementing this proposal without good reason.'

Internal preparations for a seamless transition, including

rewriting guidance and training staff and legal assessors, are due to start at the end of July.

The rule change is expected by December, with implementation in April 2008.

'We will only switch when we are confident we can deliver both improved patient safety and fairness to doctors,' Mr Scott said.

Dr Hugh Stewart, MDU medico-legal adviser, said 'The MDU is against any proposed change to a civil standard of proof in GMC hearings.

'When a doctor's whole career is at stake, the allegations against them should be tested against the criminal standard. If a sliding civil standard of proof were to be introduced, then the procedure for deciding which standard should be applied to which allegations would need to be fair and transparent.'

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