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  • Author or Editor: John Martyn Chamberlain x
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This chapter provides a commentary on, and introduces, the collection of papers in this volume. It begins by outlining how professional forms of health care expertise have become increasingly subject over the last four decades to third-party scrutiny, as well as how we have witnessed greater public involvement in the monitoring and quality assurance of healthcare work, particularly in Western neo-liberal societies. It then discusses how these changes have led the ‘social closure’ model of professional work to become revised, and in doing so how this raises concerns regarding academic engagement with members of the public as part of a broader patient advocacy and policy reform agenda focused on the promotion of the public interest. This discussion helps set the scene for subsequent chapters, which together seek to unpack the complex relationships that exist between health care practitioners, civil society, the state and professional groups in a variety of different international borders and regulatory jurisdictions. In doing so, each author seeks to explore critically how calls for increased efficiency and cost effectiveness in healthcare are balanced with the need to promote the public interest through providing citizens with essential health services.

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The chapter provides a historical policy account of the introduction of medical revalidation in the UK and outlines the limiting structural and cultural factors at play and how these might well hinder its ability to identify poorly performing doctors.

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This chapter outlines the aims and objectives of the book and its focus on regulatory reform of the General Medical Council and how it investigates complaints against a doctor’s fitness to practise alongside the introduction of medical revalidation to periodically test professional competence. To set the scene to this analysis in subsequent chapters, the emergence of risk-based approaches to professional regulation are outlined as well as how these have transformed traditional ‘doctors only’ approaches to medical governance.

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In light of previous chapters, the final chapter outlines how recent developments in the regulation of doctors are a result of the fluctuating social conditions associated with the emergence of the risk society. It discusses the possible future of risk-based forms of medical regulation and sets out a conceptual and policy-focused research agenda for ascertaining the impact of regulatory reform on both the public and the medical profession.

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This chapter outlines recent developments in the fitness to practice hearings where complaints are made against doctors. It traces the introduction of the medical practitioner tribunal service as a separate arm of the general medical council. It outlines how the tribunal service works and discusses its performance over the last decade. As a result, it questions whether recent reforms made have secured the public interest.

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A Critical Introduction

Medical sociology has long been concerned with the role played by specialist forms of expertise in enabling the governance of ‘troublesome’ social groups – including those who are unwell, ‘deviant’ and criminally insane. However, only recently has it begun to explore how the state ensures the public is protected from acts of medical malpractice, negligence and criminality. Against the background of a series of high-profile scandals, including the case of Dr Harold Shipman who murdered over 200 of his patients, this topical and authoritative book examines how the regulation of doctors has been modernised by reforms to the Medical Practitioners Tribunal Service and the introduction of the quality assurance process of medical revalidation. In doing so, it questions whether there is evidence to support the argument that revalidation serves the public interest by ensuring that individual doctors are fit to practise.

Highlighting areas of good practice and areas for further research and development, the book is ideal for academics and postgraduates interested in medical sociology, socio-legal studies, medical law, medical education, health policy and related subjects

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International perspectives

There are significant variations in how healthcare systems and health professionals are regulated globally. One feature that they increasingly have in common is an emphasis on the value of including members of the public in quality assurance processes. While many argue that this will help better serve the public interest, others question how far the changing regulatory reform agenda is still dominated by medical interests.

Bringing together leading academics worldwide, this collection compares and critically examines the ways in which different countries are regulating healthcare in general, and health professions in particular, in the interest of users and the wider public. It is the first book in the Sociology of Health Professions series.

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