Medical Regulation in the United Kingdom: Challenging Old and New Orthdoxies

This paper explores recent developments in the governance of the medical profession in the United Kingdom. In particular, it focuses on the introduction of the performance surveillance and appraisal tool revalidation to monitor medical practitioners’ clinical practice, as well as made changes to the hearing of fitness to practice cases by the GMC when a doctor is accused of medical malpractice.

The paper outlines how these changes have challenged several orthodoxies surrounding medical governance pertaining to, firstly, the role of the public and other health and social care professions in the regulation of doctors, and secondly, how social scientists have traditionally conceptualised contemporary trends in the relationship between the medical profession, the public and the state.

The paper argues that it is important for social scientists interested in the study of medical regulation to remember that current developments in the governance of doctors must be analysed within the broader socio-economic-political context. For recent reforms in medical governance are to no small measure bound up with a broader shift in how ‘good governance’ is conceptualised and operationalized under neo-liberal mentalities of rule as the state seeks to promote ‘at a distance’ a certain type of citizen-subject congruent with the enterprise form within the risk saturated conditions associated with high modernity.

The paper concludes by arguing that we currently sit at the apex of far-reaching changes in medical regulation, the full affects of which will not be known for at least another generation, and it is therefore vitally important to investigate contemporary reforms in medical governance while bearing in mind the need to challenge current conceptual orthodoxies within both professional practice and the academic literature.