Doctors' leaders have for the first time agreed there must be public scrutiny of the way their profession is policed. Tomorrow they will offer to make their disciplinary body answerable to MPs.

Doctors' leaders have for the first time agreed there must be public scrutiny of the way their profession is policed. Tomorrow they will offer to make their disciplinary body answerable to MPs.

The General Medical Council, criticised for being slow in cracking down on dangerous or incompetent doctors, is also considering making it easier to have bad doctors struck off. It may switch from the criminal test of guilt, requiring evidence "beyond all reasonable doubt" to the civil test of "on a balance of probabilities".

After a series of scandals, the GMC will admit it "shares the concerns of others that its processes are not sufficiently clear and that it has often been too slow to respond to changing needs". The GMC's proposals will be discussed this week and put out to public consultation. A decision is expected in December.

There was an outcry about the GMC failing to discipline Rodney Ledward, a gynaecologist, who for years had left many patients in pain and complaining. He was eventually struck off. And ministers were appalled by the GMC waiting until after the GP Harold Shipman had been found guilty of 15 murders before it struck him off.

The reform proposals are more radical than many patients' groups expected, and have persuaded Alan Milburn, Secretary of State for Health, to shelve a threatened Bill to force through reforms. He has been pressured by Labour MPs to turn the GMC into a more independent body with a majority of lay members, to end the system under which doctors sat in judgement over their colleagues. "If you have a lay majority, you effectively end professional self-regulation," he said yesterday.

"Providing you make it accountable, self-regulation has a lot to commend it Nobody should be in any doubt, because of the problems of public confidence, the profession is drinking in the last-chance saloon. Everybody should realise it is the last chance to get it right."

The GMC will not propose having a lay majority but there will be a new disciplinary board, with a third of lay members.

The Commons select committee on health, chaired by the Labour MP David Hinchliffe, is likely to scrutinise the GMC.

On Tuesday, health ministers will unveil the long-awaited strategy for restoring access to an NHS dentist for all patients. The plans - promised by Tony Blair at Labour's conference last year - will propose offering more salaried NHS posts.

* A surgeon, Dr Pravin Patel, has been arrested on suspicion of manslaughter after 20-year-old Andrew Ryan died during an operation in Co Durham. Dr Patel, 50, of Harrow, north-west London, was given bail.

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