The Issue

According to Kieran Walshe, a 2000–01 Harkness Fellow in Health Care Policy and Practice, and his coauthor, the public in the United Kingdom has lost confidence in health care professionals as a result of recent inquiries and scandals. Yet, the approaches to regulatory reform of the medical professions have to date been piecemeal and lacking in strategic direction, they say. 

What the Study Found

The authors recommend that a comprehensive regulatory approach by the U.K.'s General Medical Council (GMC) to the health care professions should:

• Harmonize the statutory powers, administrative processes, and decision making powers of the various professional regulatory bodies.
• Explicitly define the scope of professional practice. Professions such as nurse and physician are traditionally defined in terms of the training required to practice. As new roles are created, such as pharmaceutical assistant or emergency care practitioner, it will also be important to define the competencies various health professions require.
• Maintain actual professional competence more rigorously. The authors suggest that all professionals should be required to take a test of clinical competence, rather than merely meet requirements for professional development or continuing education.
• Improve the governance and accountability of the health professions. Regulatory bodies should be governed by appointed members who represent broad stakeholder interests.

While there is likely to be resistance to these proposed reforms from professional bodies and other interest groups, the authors conclude that "recognition is growing of the need for radical change rather than more tinkering with the status quo."