Introduction

Over the last two decades there has been heightened political, legal and public interest in the field of doctors’ fitness to practise as a result of a series of medical regulatory failings in prominent medical malpractice cases, such as the respective Bristol and Alder Hey cases, as well as medical acts of criminality, including multiple homicide in the case of the general practitioner Harold Shipman (Chamberlain, 2012). Consequently, the question of how best to legislate to protect those in need of medical treatment from the incompetent and criminal actions of doctors is of fundamental significance and interest to members of the public, government, practitioners, academics and lawyers, among others.

This book examines the topic of medical fitness to practise and revalidation, and how we as a society ensure that doctors remain competent in their chosen specialty through a critical sociolegal lens that draws on the disciplinary fields of medical sociology, criminology and law. Revalidation involves a thorough assessment of a doctor’s fitness to practise using a mixture of appraisals, patient feedback and continuing professional development activities. It is the first time that doctors have been required by law to submit themselves to a regular performance appraisal of their practice, if they wish to stay on the medical register and continue to legally practise medicine in the United Kingdom (UK).

First introduced in 2012, but not being completely rolled out nationally until 2016, and still very much being implemented for the first time at the time of writing, revalidation has been positioned by government and medical elites as being a new transparent and inclusive regulatory tool designed to modernise medical governance as well as to better ensure patient safety and health service delivery. Furthermore, in regard to the hearing of complaints against a doctor via medical fitness to practise panels (FPPs), the General Medical Council (GMC) has sought to address concerns regarding possible institutional bias by establishing the Medical Practitioners Tribunal Service (MPTS) in 2012 (GMC 2013). While in 2014 the Law Commission’s comprehensive review of healthcare professionals noted that medical FPPs are a vitally important legal mechanism for ensuring that public trust in medical regulation is maintained when complaints are made about a doctor. Consequently it has acted to strengthen the investigatory and adjudication process, by legislating to ensure that they are autonomous structures, independent of the GMC (Law Commission 2014a, 2014b, 2014c).