J Health Organ Manag. 2010;24(6):540-55. doi: 10.1108/14777261011088647.
This paper aims to outline and comment on the changes to medical regulation in the UK that provide the background to a special issue of the Journal of Health Organization and Management on regulating doctors.
DESIGN/METHODOLOGY/APPROACH: This paper takes the form of a review.
Although the UK medical profession enjoyed a remarkably stable regulatory structure for most of the first 150 years of its existence, it has undergone a striking transformation in the last decade. Its regulatory form has mutated from one of state-sanctioned collegial self-regulation to one of state-directed bureaucratic regulation. The erosion of medical self-regulation can be attributed to: the pressures of market liberalisation and new public management reforms; changing ideologies and public attitudes towards expertise and risk; and high profile public failures involving doctors. The "new" UK medical regulation converts the General Medical Council into a modern regulator charged with implementing policy, and alters the mechanisms for controlling and directing the conduct and performance of doctors. It establishes a new set of relationships between the medical profession and the state (including its agencies), the public, and patients.
ORIGINALITY/VALUE: This paper adds to the literature by identifying the main features of the reforms affecting the medical profession and offering an analysis of why they have taken place.
本文旨在概述和评论英国医疗监管的变化，为《卫生组织与管理杂志》关于规范医生的特刊提供背景。
设计/方法/途径：本文采用综述的形式。
尽管英国医学界在其存在的头 150 年中的大部分时间里都享有一个非常稳定的监管结构，但在过去十年中，它经历了惊人的变革。其监管形式已经从国家认可的同行自律形式转变为国家指导的官僚监管形式。医学自我监管的侵蚀可以归因于：市场自由化和新公共管理改革的压力；对专业知识和风险的观念和公众态度的变化；以及涉及医生的高知名度公共失败。“新”的英国医疗监管将医学委员会转变为一个负责执行政策的现代监管机构，并改变了控制和指导医生行为和表现的机制。它在医学专业人士和国家（包括其机构）、公众和患者之间建立了一套新的关系。
原创性/价值：本文通过确定影响医学专业的改革的主要特征，并分析它们为何发生，为相关文献做出了贡献。
