Restratification and Revalidation: United Kingdom and International Perspectives

Abstract

This chapter explores the impact of the process of restratification on professional practice and medical regulation by looking at the implementation of revalidation. In doing so, this chapter acts as a necessary introduction to the exploration of the handling of fitness to practice cases in Chap. 7. Chapter 5 ended by noting that in addition to state intervention to reform medical regulation and re-establish the General Medical Council as an independent regulatory body, over the last decade, medical elites themselves have increasingly acted to strengthen peer review and appraisal mechanisms as they have sought to maintain professional self-regulatory privileges within the broader transformative context that is the emergence of the new neo-liberal governing conditions associated with the risk society. It was highlighted that the esoteric nature of medical expertise means that regardless of calls for greater consumer and inter-professional input into medical regulation, some semblance of medical control will be retained as peer appraisal remains the key mechanism by which the quality of medical work can be judged and its quality assurance assured. This chapter explores the consequences of this for the development of revalidation. This is the process by which the competence of medical practitioners will be quality assured in the United Kingdom. This chapter outlines how revalidation will operate when it is implemented sometime after late 2012. For comparative purposes, this chapter also outlines recent international trends in the quality assurance of medical practitioner’s continued competence. In doing so, this chapter highlights how a move towards increased professional accountability seems to characterise medical governance frameworks internationally. This provides some empirical support for the restratification thesis. Yet this chapter also points out that it is important to note that the situation internationally is more complex than the restratification thesis allows. The need to empirically explore this point further is taken up in Chap. 8. End-of-chapter self-study tasks are provided so the reader can engage in further study in relation to chapter contents.