Part of a series on |
Medical law |
---|
Principles |
Medical treatment |
Regulation |
|
Administrative law |
Criminal law |
Tort |
Applications of medicine to law |
Studied by |
Category |
In medical law and medical licensing, fitness to practise is a concept in the regulation of medicine regarding whether a health professional or social worker should be allowed to work. While fitness to practice can include matters of technical competence, including qualifications the concept also contains questions about the implications of the health of professional and their ethics. [1]
Concerns regarding a professional's fitness to practice are often addressed by professional bodies, though sometimes the decision-making process of these bodies is legislated. [1] : 2 The decisions can involve quasi-judicial proceedings, that are constrained in some countries by judicial review on the grounds of procedural fairness.
Some countries maintain a register of people who are allowed to work in a particular healthcare field, and through legislation these titles are "protected" so that individuals not on this register (or removed from this register) cannot use a this title.
A professional deemed to not be fit to practice may no longer be able to practice.
Professional bodies say that they regulate fitness to practice to ensure public trust, protect the public interest, to ensure life-long competence and to improve healthcare outcomes. [2] : 5 Authors who write on the topics are often interested in the quality of care, patient safety, and risk of medical errors, and more generally the social contract between the medical professions and society. [2] : 4
In the United Kingdom, the Health and Care Professions Council, Nursing and Midwifery Council and the General Medical Council have a legislatively mandated role in controlling the behavior of health care professionals. [3] : 2 Social work is regulated by the General Social Care Council. [4] : 311
The General Medical Council's role in regulating fitness to practice is regulated by the 1983 Medical Act. [5]
There are around 1200 hearings each year regarding fitness to practice. [4] : 313 The General Medical Council carries out hearings through the Medical Practitioners Tribunal Service. [3] : 5
A GMC fitness to practice hearing begins with a complaint, the GMC will then investigate the case and decide whether to refer the case a to the MPTS, a case may be dismissed by the GMC. [6] : 2 The GMC investigation involves giving the doctor an opportunity to respond, before obtaining expert evidence and written witness statements for involved parties, as well as carrying out assessments of a doctors competence or health. [6] : 11 The GMC may then choose to suspend the doctor pending a decision at a MPTS trial. [6] : 12 MPTS cases are held in public unless they involve matters of a doctors health. [6] : 19 An appeal to the High Court of Justice can be made if a doctor disagrees with the outcome. [6] : 30 If a doctor is convicted of a criminal offence the GMC will treat the conviction as proof of the offence. [6] : 28
In the United States fitness to practise is regulated by medical boards. These boards generally have medical and non-medical members. [1] : 2 Many states have separate boards for professionals with qualifications from Doctor of Osteopathic Medicine(DO) and Doctor of Medicine (MD) qualifications. [1] : 2
Before the 1970s most regulation was self-regulation but this changed due public pressure. [1] : 3
A physician, medical practitioner, medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis and treatment of disease, injury, and other physical and mental impairments. Physicians may focus their practice on certain disease categories, types of patients, and methods of treatment—known as specialities—or they may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families, and communities—known as general practice. Medical practice properly requires both a detailed knowledge of the academic disciplines, such as anatomy and physiology, underlying diseases and their treatment—the science of medicine—and also a decent competence in its applied practice—the art or craft of medicine.
Optometry is a specialized health care profession that involves examining the eyes and related structures for defects or abnormalities. Optometrists are health care professionals who typically provide comprehensive primary eye care.
A podiatrist is a medical professional devoted to the treatment of disorders of the foot, ankle, and related structures of the leg. The term originated in North America but has now become the accepted term in the English-speaking world for all practitioners of podiatric medicine. The word chiropodist was previously used in the United States, but it is now regarded as antiquated.
A medical license is an occupational license that permits a person to legally practice medicine. In most countries, a person must have a medical license bestowed either by a specified government-approved professional association or a government agency before they can practice medicine. Licenses are not granted automatically to all people with medical degrees. A medical school graduate must receive a license to practice medicine to legally be called a physician. The process typically requires testing by a medical board. The medical license is the documentation of authority to practice medicine within a certain locality. An active license is also required to practice medicine as an assistant physician, a physician assistant or a clinical officer in jurisdictions with authorizing legislation.
The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses and nursing associates eligible to practise within the UK. It sets and reviews standards for their education, training, conduct and performance. The NMC also investigates allegations of impaired fitness to practise.
The College of Physicians and Surgeons of Ontario (CPSO) is the regulatory college for medical doctors in Ontario, Canada.
The General Dental Council (GDC) is an organisation which regulates dental professionals in the United Kingdom. It keeps an up-to-date register of all qualified dentists and other dental care professionals such as: dental hygienists, dental therapists, dental nurses, dental technicians and clinical dental technicians. It was established in 1956 to set and maintain standards in UK dentistry, with the aims of protecting the general public from unqualified dental professionals.
The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by controlling entry to the register, and suspending or removing members when necessary. It also sets the standards for medical schools in the UK. Membership of the register confers substantial privileges under Part VI of the Medical Act 1983. It is a criminal offence to make a false claim of membership. The GMC is supported by fees paid by its members, and it became a registered charity in 2001.
The Victorian Board of the Medical Board of Australia is the state body for Victoria which has powers delegated to it by the Medical Board of Australia, the national body that regulates the medical profession in Australia. The operations of the Board are enabled by the Health Practitioner Regulation National Law (Vic) Act 2009, which also governs authorities for other health professions in Victoria. This Act replaced the Health Professions Registration Act 2005, under which the forerunner Board operated until 1 July 2007, and which was the successor to the Medical Practice Act 1994. The Victorian Board's delegated powers allow it to make individual practitioner registration and notification (complaints) decisions within the state, based on the national policies and standards set by the National Board.
Professional social workers are generally considered those who hold a professional degree in social work. In a number of countries and jurisdictions, registration or licensure of people working as social workers is required and there are mandated qualifications. In other places, the professional association sets academic and experiential requirements for admission to membership.
The Medical Council is the regulator of the medical profession in Ireland. It maintains the register of medical practitioners licensed to practice, and has the power to place restrictions on or revoke such licences, in cases of questions about a doctor's fitness to practise. As of 2022 the president of the council is Dr Suzanne Crowe, and its chief executive officer was Leo Kearns.
In the United Kingdom and Australia, revalidation refers to a mechanism used to "affirm or establish the continuing competence" of health practitioners, whilst strengthening and facilitating ethical and professional "commitment to reducing errors, adhering to best practice and improving quality of care". Medical practitioners, nurses and midwives practicing in the UK are subject to revalidation to prove their skills are up-to-date and they remain fit to practise medicine. It is intended to reassure patients, employers and other professionals, and to contribute to improving patient care and safety. The Medical Board of Australia is currently engaged in a review and trial of revalidation of medical registration in Australia.
Health professional requisites refer to the regulations used by countries to control the quality of health workers practicing in their jurisdictions and to control the size of the health labour market. They include licensure, certification and proof of minimum training for regulated health professions.
Medical regulation ensures that medicine is only practised by qualifed and suitable people and can be used to prevent competition and increase financial compensation. The history of regulating doctors in the UK dates back around 600 years. The earliest licensing procedures were administered by the Church, with professional associations and universities also playing a role. Modern regulation of doctors is carried out by the General Medical Council.
The General Pharmaceutical Council (GPhC) is the body responsible for the independent regulation of the pharmacy profession within England, Scotland and Wales, responsible for the regulation of pharmacists, pharmacy technicians and pharmacy premises. It was created, along with the Royal Pharmaceutical Society, in September 2010 when the previous body responsible for regulation, the Royal Pharmaceutical Society of Great Britain, was split so that representative and regulatory functions of the pharmacy profession could be separated.
The Medical Act 1983 is an Act of the Parliament of the United Kingdom which governs the regulation and credentials of the medical profession, and defines offences in respect of false claims of fitness to practise medicine.
The Professional Standards Authority for Health and Social Care (PSA) oversees the nine statutory bodies that regulate health professionals in the United Kingdom and social care in England. Where occupations are not subject to statutory regulation, it sets standards for those organisations that hold voluntary registers and accredits those that meet them.
The Medical Practitioners Tribunal Service (MPTS) is a tribunal in the United Kingdom that adjudicates on complaints made against doctors, making independent decisions about their fitness to practise. This includes imposing sanctions for decisions about violations of ethical principles.
Sir Donald Hamilton Irvine was a British general practitioner (GP) who was president of the General Medical Council (GMC) between 1995 and 2002, during a time when there were a number of high-profile medical failure cases in the UK, including the Alder Hey organs scandal, the Bristol heart scandal and The Shipman Inquiry. He transformed the culture of the GMC by setting out what patients could expect of doctors and is credited with leading significant changes in the regulation of professional medicine and introducing the policy of professional revalidation in the UK.
The Australian Health Practitioner Regulation Agency (AHPRA), infrequently spelt as the Australian Health Practitioners Regulation Agency is a statutory authority founded in 2010 which is responsible, in collaboration with the Medical Board of Australia, for registration and accreditation of health professionals as set out in the Australian legislation called the National Registration and Accreditation Scheme. As of 2018, approximately 586,000 health professionals were registered with the AHPRA, containing 98,400 medical practitioners (which includes general practitioners, medical specialists and some hospital workers), and 334,000 nurses and midwives. This rose to 825,720 registered health professionals in 2021.
{{cite web}}
: CS1 maint: url-status (link)