Leading article: Protecting patients, not doctors

Every patient expects his or her doctor to be competent, trustworthy and kind. Sadly the medical profession has not been able to guarantee that these conditions are always met. Manchester GP Harold Shipman's murderous activities went undetected for decades, and there has been a string of other medical scandals in which patients have been harmed, abused or put at risk as a result of failures of medical regulation.

Yesterday, Sir Donald Irvine, former president of the General Medical Council, called for the disbanding of the GMC and its reforming with new members, medical and lay, who can give it "a convincing fresh start". Sir Donald was giving his enthusiastic backing to the report 10 days ago by Sir Liam Donaldson, the Government's chief medical officer, which proposed the biggest shake-up of medical regulation in 150 years.

Sir Liam's proposals include tougher checks on doctors' performance, a reduced standard of proof for those accused of doing wrong and the removal of the GMC's powers to act as judge and jury in disciplinary cases. The GMC would instead become like the Crown Prosecution Service, presenting evidence to a lay-dominated tribunal. The profession has reacted with predictable fury. The British Medical Association pledged to fight what it said marked "an erosion of professionally led regulation" while the GMC has also signalled its opposition.

The public may feel differently. Both Sir Liam and Sir Donald are fond of comparing doctors with pilots, who are subject to rigorous checks throughout their professional careers. As Sir Donald put it: "I am not interested in flying with an airline that has not been subject to the proper checks. It is part of what you pay for."

The GMC would prefer "lighter touch" regulation, with a focus on the doctors who give cause for concern. Sir Liam has sympathy with this, but points out that they are not easy to spot.

That is unlikely to be acceptable in today's risk-averse world. After 30 years of failed attempts to reform medical regulation, Sir Liam has concluded that the GMC is incapable of "protecting patients, supporting doctors", as its slogan claims. It is not entirely the GMC's fault - it has found itself caught between an increasingly demanding public and an increasingly disgruntled profession. Sir Donald's verdict that it should be disbanded and reformed is a harsh one - but necessary, too.