Doctors will lose their right to police themselves under proposals to be announced by the Government today, The Times has learnt.

As part of reforms aimed at preventing another Harold Shipman tragedy, ministers are expected to curtail the role of the General Medical Council by stripping its powers to discipline and prevent doctors from practising.

The GMC, the regulatory body for the medical profession, is also set to lose its medical majority, putting an end to the professionally led regulation that has been enshrined for nearly 150 years since its foundation in 1858. Ministers will announce the changes to Parliament in a White Paper.

The British Medical Association said last night that eliminating the principle of self-regulation would not be in the best interests of patients.

The White Paper is expected to contain plans to test doctors with “MoTs” every five years to ensure that they are fit to practise. Doctors will also lose the right to sign off death certificates on their own, without further scrutiny. All deaths will have to be certified by at least two doctors, as is currently the case for cremations but not for other funerals. Patricia Hewitt, the Health Secretary, is proposing that all death certificates should be completed by the certifying doctor but then scrutinised by a “medical examiner”, attached to a local NHS hospital or trust, who will have full access to medical records. The reforms are designed to catch dangerously incompetent practitioners or rogue doctors acting in the manner of Shipman, Britain’s biggest serial killer, who falsified details on death certificates that allowed him to murder up to 250 of his patients.

The proposals come after recommendations by Sir Liam Donaldson, the Chief Medical Officer, made in a broad review of medical regulation after the Shipman inquiry and other recent investigations into doctors’ conduct and standards.

In a move that will further undermine the role of the GMC, the Government is expected to recommend that fitness-to-practise cases be judged on a sliding scale of proof, where the evidence required is determined by the severity of the misdemeanour.

Critics said last night that switching the current criminal standard of proof, beyond reasonable doubt — required to strike a doctor off the GMC register — to the lesser civil standard, the balance of probabilities, could result in miscarriages of justice for doctors.

The GMC declined to comment on the White Paper last night before its official release, but it is understood that its adjudicatory role was one of the powers it had hoped to retain.

It is unclear who will take on that role, but Sir Liam’s original report, Good Doctors, Safer Patients, suggested that the GMC could be responsible for investigating and assessing serious cases of fitness-to-practise, while independent panels comprising legal, medical and lay representatives conducted the actual adjudication hearings.

Another option would be to pass that responsibility to the Council for Healthcare Regulatory Excellence, an overarching quango that was granted the right to appeal against GMC rulings in 2004.

A BMA spokeswoman said last night: “If the GMC was to lose the adjudication process and there was no longer a medical majority of elected doctors on its council, that would drive a nail in the coffin of professionally led regulation for doctors.

“There would be concern that with many doctors working in the state-owned NHS, for a monopoly employer and regulated by a body controlled by Government, the clinical independence of doctors could be threatened.”

The BMA said that it would be opposed to abandoning the criminal standard of proof in fit-ness-to-practise hearings: “When a person’s livelihood is at stake it cannot be just to rely on a balance of probabilities.”

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