The GMC wants the change, and ministers will back a private member's Bill if an MP can be persuaded to take the issue on; failing that, health ministers themselves are expected to introduce legislation as part of the attempt to heal the rift between Government and the medical profession.
The move towards rapprochement was illustrated yesterday when the Department of Health instantly disowned claims by Roy Lilley, a controversial NHS trust chairman, that doctors' first duty was to their employers, not their patients.
Mr Lilley, chairman of the Homewood Trust in Chertsey, Surrey, was ``speaking of his own volition, not for the Secretary of State'', a spokesman for the department said as the British Medical Association attacked his remarks as ``outrageous'' and senior health authority figures disowned him.
The legislation on incompetent doctors will not be in the Queen's Speech on Thursday, but Whitehall sources said that following last week's Cabinet meeting on legislation for the coming session of Parliament it is now ``in the right column'' and time will be found for it.
The GMC, the doctors' self-regulating disciplinary and educational body, has been pressing for the legislation for two years, arguing that without new powers it cannot answer criticisms of doctors' failure to put their own house in order.
At present the GMC has only two procedures available. One is a charge of ``serious professional misconduct'' - such as sexual misdemeanours, fraud or failure to visit a patient. It also has a less formal procedure for dealing with sick doctors. It cannot do anything about doctors who commit no single outrageous act, or whose overall performance is not up to scratch.
The new procedure will embrace poor professional knowledge, poor skills and unacceptable attitudes towards patients and colleagues. Incompetence could be judged from a string of bad decisions in one case or a number of seperate incidents.
Under the new system, complaints would be screened and assessed, with incompetent doctors being required to undergo counselling, retraining or whatever other remedy felt necessary. While that was under way, conditions could be attached to their practice, such as agreeing not to undertake certain types of operation. If a doctor refuses to co-operate, or if remedial measures produce no improvement, he or she could, in the last resort, be struck off. The procedure, which mirrors the way the GMC now deals with sick doctors, is intended to be remedial rather than confrontational.
It is expected to win cross-party support in the Commons. But there may be criticisms that the GMC will still be able to act only in cases of ``serious'' poor performance, such as would raise questions about whether conditions should be attached to a doctor's registration, or if he or she should be barred from practice.
Lilley row, page 2