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Medical Profession (Miscellaneous Amendments) Order 2008

I welcome Schedule 2, and thank the noble Baroness. I have to declare an interest: I am one of those doctors. My specialty came into being late and when, having trained in general practice, I contacted the GMC and said, ““I’m down on your general practice list. I should be on the consultants’ list””, they said, ““Don’t worry. It’s fine—you’re on the register””. I wrote to the GMC and was reassured that I did not need to change anything. So when everything changed and I missed the boat, I spent some time waiting for my contract to be terminated. I am delighted, as are others in my specialty, that the small number of us will be able to rectify this situation in retrospect. It was not wilful; it was simply the way the specialties evolved. I hope that that answers the question—and I hope that the GMC will let me register. I hope that the GMC will now send out a very simple form to consultants—I presume that it needs to go to the trust as well to verify that they are bona fide and practising as consultants—and that everything happens quite quickly. In that way, there will be 100 per cent recording in the appropriate parts of the register. We are all on the register; we are just in the wrong parts. I also have a concern about orphan specialties. There are a few with very small numbers, such as breast physicians. The specialty will determine the recertification process, so it will be important that there is enough flexibility and the categories are broad enough to ensure that somebody who is practising in a narrow area gets recertified in that area and is not forced to go through a load of hoops that no longer apply to the way they practise medicine. I have a warning regarding recertification and revalidation. Attitude is the biggest problem, and it is the hardest to assess. Communication skills can be assessed, but that is a bit fuzzy. My department has been doing it for some years and we have developed a toolkit for when people run into problems. Factual knowledge in isolation is the easiest to assess. The trouble is, it is the synthesis of all aspects—skills, competencies, attitudes, communications, scientific knowledge—that makes a good doctor. It seems from the research that one of the most sensitive ways to find out who is a good doctor and who is not is to ask other doctors to rate them and ask whether they would allow themselves or their nearest and dearest to be treated by them. The 360-degree appraisal type of approach is probably the best assessment in the long term, but it has to be meaningful. If it happens too often, it becomes ritualistic and a tick-box exercise. I give that as a slight warning but greatly welcome my personal change in status.