Abstract

Recently, the system of medical regulation through which doctors are held to account has come under sustained criticism. A series of public inquiries have revealed incompetence, dishonesty, sexual misconduct by individual doctors and, in one case, serial killing, as well as weaknesses in systems that failed to detect deviant behaviour early and then to take action to protect patients. This article looks at the longer-term social and political changes that have brought a shift in the relationship between patients, doctors and the state and a greater concern for predictability in medical competence. It then assesses the evidence for a decline in public trust in doctors as individual practitioners and in the system of professional self-regulation. The concept of trust is discussed and, from the data available, it is suggested that members of the public continue to trust their doctor. However, data on complaints indicate an increasing propensity for people to make complaints about individual doctors and the doctors' regulatory body, the General Medical Council (GMC) has been seen by the public as self-interested. Various state-sponsored inquiries have questioned whether professional self-regulation in its present form can be sustained. The final section of the article looks at the reforms introduced by the GMC and government, and considers whether these are sufficient to restore trust. The discussions have implications for other professions as professional governance systems in the UK have been based on the medical model.