Regulating the Medical Profession: From Club Governance to Stakeholder Regulation

The 2008 Health and Social Care Act introduced reforms in the regulation of the medical profession in the United Kingdom which have arguably challenged medical autonomy in the form of the principle of medical self-regulation through introducing performance surveillance and appraisal mechanisms designed to ensure medical practitioners are ‘fit to practice’ in their chosen speciality. This paper outlines these developments, arguing as it does so that there has been a shift in the governance of medical work from the traditional ‘club governance’ model toward one based upon ‘stakeholder regulation’. The consequences of this state of affairs are discussed and possible research avenues highlighted in light of the proposed introduction in 2011 of the performance appraisal process known as revalidation.