Profile of the GMC: Discipline I: The hordes at the gates.

To be found guilty of serious professional misconduct is dreadful for any doctor. It is also a chilling moment when one doctor watches another being found guilty of the charge. On the morning ofMonday 6 March I sat in the public gallery at the General Medical Council and watched as Dr James Mills was found guilty of serious professional misconduct. The gravity of the moment stuck terror into me, and for a moment I was in awe of the profession of which I am an unconventional part. This effect is intended. One of the reasons for finding doctors guilty of serious professional misconduct is to keep other doctors in line. But to appreciate the huge anxiety that surrounds the charge is to begin to understand why the GMC sometimes seems so remote and such an anachronism. At the moment it is the disciplinary activities of the GMC that give rise to the most publicity and controversy. Member of parliament Nigel Spearing has several times tabled a bill trying to force the council to accept a lesser charge than serious professional misconduct, and he does not intend to give up.' 2 He argues that the GMC being able to charge doctors only with serious professional misconduct is like a court being able to charge people only with murder and not with manslaughter. Jean Robinson, a lay member of the GMC, has greatly displeased some of the council' by publishing a report on what she sees as serious shortcomings in its disciplinary procedures.4 Maryon Rosthenthal, an American sociologist, argues in a book that the council is not taking on as many cases as it should because of limited resources.' The BMA has meanwhile tried to reduce the number of cases being referred to the GMC from medical service committee hearings, and Dr Michael O'Donnell, a longstanding member of the council, has argued that the council's methods of responding to incompetent doctors are inadequate and need improvement.6 These criticisms, particularly those of Michael O'Donnell, have encouraged the council to set up a working party to examine alleged neglect or disregard of professional responsibility. The report is due this month but is expected to keep to the party line that it would be wrong for the GMC to take on many more cases. The council believes that these complaints are much better dealt with locally.