Profile of the GMC. Discipline II: The preliminary screener--a powerful gatekeeper.

The preliminary screener of the General Medical Council is a powerful person. He (and it was always a he until February of this year) must decide which disciplinary cases will proceed and which will not. The screener will discuss some cases with other members of the council, and a report on his activities is submitted to the preliminary proceedings committee. Critics of the GMC worry that so much power is concentrated in one man and that his accountability is limited.' The preliminary screener has not been required to discuss cases with the lay members of the council, although he may have done sometimes. A working party that reported at the end of last month has, however, suggested that lay members should participate more in this preliminary screening. Some regard this as an important advance, but others see it as a sop to public opinion designed to maintain self regulation of the profession. Jean Robinson, the lay member of the council who has criticised the council's disciplinary procedures,' believes that the work of the preliminary screener should not be done by one person. She thinks that it should be done by a four person committee with two medical and two lay members; two lay members are needed because "it is very difficult being an isolated lay member on a medical committee." The personal opinion of the immediate past president of the council, Sir John Walton, is that lay members should participate more in the work of the preliminary screener, and this has now been proposed.