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John Martyn Chamberlain - One of the best experts on this subject based on the ideXlab platform.

  • Malpractice, Criminality, and Medical Regulation: Reforming the Role of the GMC in Fitness to Practise Panels
    Medical Law Review, 2016
    Co-Authors: John Martyn Chamberlain
    Abstract:

    A recent Law Commission Review emphasised that Medical fitness to practise panels (also called Medical practitioners tribunals) are an important legal mechanism for ensuring that public trust in Medical Regulation is maintained when a complaint is made against a doctor. This article examines trends over time in panel outcomes to identify their effectiveness in ensuring public protection. Although a rise in complaints, and a change from the criminal to civil standard of proof, has not led to more doctors being struck off the Medical register, increasingly action is being taken to provide advice, issue warnings, and agree rehabilitative forms of action with doctors. It is argued that these trends are congruent with the broader adoption of a risk-based approach to professional Regulation. Legal reforms to maintain public trust must ensure that the shift towards risk-averse forms of professional accountability do not sacrifice public safety and due process for the sake of political pragmatic exigency.

  • Medical Regulation, Fitness to Practice and Revalidation: A Critical Introduction
    2015
    Co-Authors: John Martyn Chamberlain
    Abstract:

    Medical sociology has long been concerned with the role played by specialist forms of expertise in enabling the governance of ‘troublesome’ social groups- including, the unwell, the ‘deviant’ and the criminally insane. However, only recently has it begun to explore how the state ensures the public is protected from acts of Medical malpractice, negligence and criminality. Against the background of a series of high-profile scandals, including the case of Dr Harold Shipman who murdered over 200 of his patients, this topical and authoritative book examines how the Regulation of doctors has been modernised by the introduction of the quality assurance process Medical revalidation. In doing so, it questions if there indeed is evidence to support the argument that revalidation serves the public interest by ensuring individual doctors are fit to practice. Highlighting areas of good practice and areas for further research and development, the book is ideal for academics and postgraduates interested in Medical sociology, Medical education, health policy and related subjects.

  • The Sociology of Medical Regulation: An Introduction
    2012
    Co-Authors: John Martyn Chamberlain
    Abstract:

    This book provides a comprehensive examination of the complex issues surrounding the Regulation of the Medical profession. It offers up-to-date information on the current legislative framework and institutional arrangements surrounding the Regulation in the United Kingdom. Well organized and written in an accessible way, it offers an insight into key sociological theories surrounding Medical Regulation. It gives a historically situated analysis of the contemporary relationship between medicine, the state and the public, and an overview of relevant social scientific research. Case studies highlight the practical or applied circumstances in which issues can occur. Readers will gain insight into possible future directions for Medical governance.

  • Sociological Deconstructions II: Governmentality and Restratification
    The Sociology of Medical Regulation, 2012
    Co-Authors: John Martyn Chamberlain
    Abstract:

    This chapter continues to focus on the development of the sociological study of the professions and professional Regulation as initially outlined in Chap. 4. Leading on from the critique of the neo-Marxist perspective outlined in Chap. 4, this chapter begins by discussing the contribution of Foucault and the governmentality perspective to the study of the professions and professional Regulation. Here, the chapter highlights how the governmentality perspective reinforces the need to place analysis of reforms in Medical Regulation, as well as professional Regulation more generally, against the broader background of shifts in how good government is conceptualised and practised within neo-liberal western nation-states. In doing so, this chapter notes how the emergence of calls for more transparent and accountable performance management systems in relation to professional Regulation is bound up with the emergence of the risk saturated conditions associated with the risk society. Consequently, rather than seeing a whole-scale decline in Medical autonomy, it is argued we are instead seeing a slight compression of its borders alongside a shift in the conditions under which it can be practised, with the result that its enactment becomes a more contested exercise in performance management, particularly when Medical error occurs. Here, the chapter notes the similarities between the governmentality and neo-Weberian perspectives via analysis of the literature surrounding the question of if Medical autonomy is in decline. In doing so, this chapter introduces the restratification thesis and discusses how rank-and-file practitioners appear to be coming under greater surveillance and control from elite peers as they seek to maintain the principle of professional self-Regulation in the face of calls from patient and managers for increased Medical transparency and accountability. This sets the scene for exploration of the impact of the restratification thesis on professional practice via analysis of revalidation in Chap. 6 and the handling of fitness to practise cases in Chap. 7. End-of-chapter self-study tasks are provided so the reader can engage in further study in relation to chapter contents.

  • Doctors, Patients, Managers and the State
    The Sociology of Medical Regulation, 2012
    Co-Authors: John Martyn Chamberlain
    Abstract:

    This chapter outlines developments in Medical Regulation as a result of the emergence of biomedicine. It discusses how the shift to hospital medicine led to the institutionalisation of Medical autonomy and the principle of self-Regulation in the form of the General Medical Council through the 1858 Medical Act. This chapter outlines key developments in Medical Regulation, tracing as it does so both the golden age of Medical power in the first half of the twentieth century as well as how from the 1960s onwards medicine increasingly came under pressure from patient’s rights and consumer movements as well as the rise of hospital management and a growing state concern with efficiency and risk containment. In doing so, this chapter notes how both these external pressures for reform utilised a growing routinisation and standardisations of Medical work, via the emergence of evidence-based medicine and the clinical protocol, as a mechanism from which to place Medical practitioners under greater third-party managerial surveillance and control as well as to promote patient choice. This state of affairs occurred against the background of the contemporary risk-adverse governing conditions discussed in Chap. 2. This chapter outlines current developments in Medical Regulation, notably the introduction of revalidation as well as changes in how fitness to practise cases are managed. This chapter concludes by highlighting both the limitations of contemporary surveillance and control of Medical expertise as well as how the profession/state relationship requires further attention. This sets the scene for discussion in Chaps. 4 and 5 of sociological perspectives which are concerned with analysing Medical Regulation. End-of-chapter self-study tasks are provided so the reader can engage in further study in relation to chapter contents.

Donald Irvine - One of the best experts on this subject based on the ideXlab platform.

  • doctors in the uk their new professionalism and its regulatory framework
    The Lancet, 2001
    Co-Authors: Donald Irvine
    Abstract:

    The new professionalism evolving in UK medicine is fundamentally different from the past. Founded on the General Medical Council's (GMC) Good Medical Practice, the new professionalism is an explicit statement of professional duties, responsibilities, values, and standards for doctors, developed and agreed on by the public and the profession. Compliance is being secured by embedding the culture of Good Medical Practice into Medical education and by linking it directly with Medical registration (licensure). From 2004 doctors will have their abilities assessed regularly by peers and by members of the public to ensure that they remain up-to-date and fit to practise medicine. Disciplinary action will follow if they are not. To ensure patient safety, the new professionalism requires professional leadership with great public input to Medical Regulation, a modern GMC, and a closer fit between the licensure of doctors and the quality assurance of the organisations in which they work.

Daniel K Benjamin - One of the best experts on this subject based on the ideXlab platform.

  • Medical Regulation and health outcomes the effect of the physician examination requirement
    Health Economics, 2010
    Co-Authors: Anca M Cotet, Daniel K Benjamin
    Abstract:

    This paper investigates the impact on health outcomes of the Regulation prohibiting physicians from prescribing drugs without a prior physical examination. This requirement could improve health by reducing illegal access to prescription drugs. But it reduces access to health care by making it more difficult for patient and physician to use many forms of telemedicine. Thus, this Regulation generates a trade-off between access and safety. Our empirical results suggest that the physician examination requirement leads to an increase of approximately 14 percent in the number of days lost each month to illness and an increase in mortality rates of 0.4 percent, the equivalent of 33 more deaths per 1 million people. The magnitude of the impact is larger in rural areas, and in areas with low physician density.

  • Medical Regulation AND HEALTH OUTCOMES: THE EFFECT OF THE PHYSICIAN EXAMINATION REQUIREMENT: THE EFFECT OF PHYSICIAN EXAMINATION REQUIREMENT ON HEALTH
    SSRN Electronic Journal, 2010
    Co-Authors: Anca M Cotet, Daniel K Benjamin
    Abstract:

    This paper investigates the impact on health outcomes of the Regulation prohibiting physicians from prescribing drugs without a prior physical examination. This requirement could improve health by reducing illegal access to prescription drugs. But it reduces access to health care by making it more difficult for patient and physician to use many forms of telemedicine. Thus, this Regulation generates a trade-off between access and safety. Our empirical results suggest that the physician examination requirement leads to an increase of approximately 14 percent in the number of days lost each month to illness and an increase in mortality rates of 0.4 percent, the equivalent of 33 more deaths per 1 million people. The magnitude of the impact is larger in rural areas, and in areas with low physician density.

Kieran Walshe - One of the best experts on this subject based on the ideXlab platform.

  • Reforming Medical Regulation: a qualitative study of the implementation of Medical revalidation in England, using Normalization Process Theory.
    Journal of Health Services Research & Policy, 2019
    Co-Authors: Abigail Tazzyman, Jane Ferguson, Alan Boyd, Marie Bryce, John Tredinnick-rowe, Tristan Price, Kieran Walshe
    Abstract:

    ObjectivesThe introduction of Medical revalidation in 2012 has been a controversial and radical change to Medical Regulation in the UK. It involved changes to the way organizations manage Medical p...

  • Medical Regulation: more reforms are needed.
    BMJ, 2014
    Co-Authors: Kieran Walshe, Julian Archer
    Abstract:

    Doctors should support them, while bringing evidence to bear on their development and implementation

  • Time for radical reform
    BMJ, 2005
    Co-Authors: Kieran Walshe, Lawrence Benson
    Abstract:

    Changes to UK professional Regulation have lacked strategic direction. The current reviews offer an opportunity for fundamental reform that can regain public confidence Despite substantial reform of the regulatory systems for UK healthcare professionals over the past decade,1 public and political faith in the professions and their regulators is lower than ever before. In part this results from authoritative criticism in several public inquiries2—most notably the Bristol and Shipman inquiry reports.3 4 But another factor has been the constant litany of apparent failure to deal with incompetence, serious dishonesty, sexual misconduct, and unchecked wrongdoing such as the cases of Richard Neale,5 Clifford Ayling,6 Rodney Ledward,7 Peter Green,8 and Dick van Velzen.9 Recent legal reforms created a new Council for Healthcare Regulatory Excellence to oversee the regulators. The council has the power to refer regulators' decisions on fitness to practise that it regards as unduly lenient to the High Court for review. This process has also thrown up a series of apparent failures of professional Regulation that do little to build public confidence.10 The changes to professional Regulation have been painfully slow (see box). Progress has often been achieved only in the face of considerable resistance from powerful professional lobbies.11 Yet, as the Shipman inquiry's comprehensive critique of Medical Regulation shows, much remains to be done. In the wake of the Shipman inquiry, the Department of Health has established not one but two reviews to explore the further reform of Medical Regulation12 and non-Medical professional Regulation.13 More change now seems likely, but what form should those changes take and what can we learn from the process of regulatory reform to date? The changes to professional Regulation mapped out in the box show an incremental and piecemeal approach to …

Abi Rimmer - One of the best experts on this subject based on the ideXlab platform.

  • queen s speech missed once in a generation opportunity says gmc
    BMJ, 2014
    Co-Authors: Abi Rimmer
    Abstract:

    The Queen’s speech missed a “once in a generation” opportunity to reform Medical Regulation, the General Medical Council has said. The GMC had hoped that the Regulation of Health and Social Care Professionals Bill would be included in the Queen’s speech on Wednesday 4 June. The bill is designed to modernise Medical legislation and to provide regulators such as the …

  • Queen’s speech missed “once in a generation” opportunity, says GMC
    BMJ, 2014
    Co-Authors: Abi Rimmer
    Abstract:

    The Queen’s speech missed a “once in a generation” opportunity to reform Medical Regulation, the General Medical Council has said. The GMC had hoped that the Regulation of Health and Social Care Professionals Bill would be included in the Queen’s speech on Wednesday 4 June. The bill is designed to modernise Medical legislation and to provide regulators such as the …