- The health professions regulatory bodies are independent statutory bodies whose role it is to set and enforce standards of professional competence, conduct and ethics for individual health professionals.
- In February 2011 the Government published the Command Paper Enabling Excellence: Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers. The paper sets out the Government’s vision for the future of workforce regulation including increasing the independence and accountability of the regulatory bodies.
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Following the publication of Enabling Excellence the Council for Healthcare Regulatory Excellence (CHRE) was commissioned to lead a sector wide review of the cost-efficiency and effectiveness of each regulator within its remit. As an initial part of this work it was asked to look at:
- The merits of appointing the chairs of the regulators’ governing councils’ or electing them from within the governing council; and
- o Whether there was a case for reducing the size of the governing councils of the regulators.
- The CHRE published an interim report, Board size and effectiveness: advice to the Department of Health regarding health professional regulators, on these two issues in September 20111. The report is available at: http://www.chre.org.uk/satellite/414/
- The report, recommended that ‘boards with a range of 8-12 members are associated with greater effectiveness’ and advised that ‘the chair should be independently recruited and appointed rather than elected from within the board membership’.
- The Department considers that there is merit in the arguments put forward by the CHRE and intends, subject to the outcome of consultation, to implement its recommendations.
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The draft orders attached to this document propose a revised constitution in relation to the GMC and the GDC only. They make provisions in respect of the following:
- The appointment of the chairs of the regulatory bodies’ governing councils; and
- A reduction in the size of the governing council.
- In the Council for Healthcare Regulatory Excellence’s report the governing councils of the regulatory bodies are referred to as ‘boards’. In this consultation document where direct quotes from the report have been used the term ‘board’ is retained, however, in the remainder of the document, the term ‘governing council’ has been used as ‘council’ is the term used in the legislation concerning the constitutions of the regulatory bodies.
Comments on
Department of Health
General Medical Council and General Dental Council (Constitution) (Amendment) Orders
The Royal College of Physicians of Edinburgh (the College) welcomes the opportunity to respond to the Department of Health’s consultation on the GMC and GDC (Constitution) (Amendment) Orders.
The College has the following answers and comments on the specific consultation questions:
Question 1
Do you agree that with smaller councils it should still be possible to ensure that the necessary expertise in organisational governance is secured?
The College recognises the need for change in organisational governance at this time and the desire to have efficient and consistent governance structures in place in regulatory bodies.
A governing council with, for example, twelve to fourteen members should still be able to represent a wide variety of professional experience and knowledge of organisational governance. There will be an onus on ensuring that the selection and recruitment process for the governing council ensures that this is the case, so that the council is in the best possible position to lead the GMC in setting and enforcing standards of professional competence, conduct and ethics for individual health professionals.
Question 2
Do you agree that we should move to a system of appointed chairs rather than elected chairs for both the GMC and the GDC?
Yes. A system of appointed chairs allows vacancies to be widely advertised and open to a large field of candidates, rather than restricting the chair to a member of the governing council.
Providing the appointment is made against clear criteria, the new system will help to attract a broad selection of applicants and widen choice and range, thereby benefiting the governing council.
Question 3
Do you agree that the size of the boards of the GMC and the GDC should be between 8 and 12 members?
No. A board of this size would make delivering the necessary skills and competences across a range of complex specialist professional areas and different legal jurisdictions difficult. The College notes that other regulators have fourteen members which would offer the GMC more flexibility to ensure good governance on complex and varied issues.
The College is concerned that a board of only eight to twelve members would struggle to achieve this.
Question 4
Do you agree that it makes most sense to reduce the GMC and GDC governing councils to 8 which is the lowest point in this range? If not, what size do you believe the governing council of the GMC and GDC should be and why?
No. Eight members would not allow a range of interests to be represented on the governing council and would not be able to adequately encompass members from different backgrounds that would help to ensure that the outlook of the governing council would not become overly narrow.
The skills, experience and competences of council members must also reflect an understanding of all jurisdictions in the UK.
It is vital that the Council commands the confidence of the profession and the public, and the College feels the limitations of a board with only eight members would be too great to overcome in this respect. A board with a minimum of twelve to fourteen members would be preferable.
Question 5
Do you agree that the quorum of a council should be 50% of the total + 1?
The College is anxious that if a board with eight to twelve members is progressed, it would be difficult to guarantee a variety of experience and views for all critical decision taking. Also the composition of the governing council will need to be carefully balanced.
A quorum of 50% plus 1 would be adequate. However, a prerequisite for this would be minimum representation of the medical profession and lay members and the College seeks clarity on the definition of quorum for the new governing council in terms of securing a minimum number of medical members.
Question 6
Do you think there are any additional equalities issues that need to be considered?
It is unlikely that these proposals will raise any additional equalities issues, providing legislation on this subject and best practice is adhered to during the transition period and beyond.
Question 7
Do you have views or evidence as to the likely effect on costs or the administrative burden of the proposed changes?
No comment.
Question 8
Do you think there are any benefits that are not already discussed relating to the proposed changes?
No comment.
Question 9
Do you have any comments on the draft order itself?
The draft order is not in line with the recommendations we have made above, and specifies the smallest size of proposed governing council mentioned in the consultation document of eight members with a quorum of five.
We therefore do not support the detail specified in the draft order.