Question: The GMC is currently going through a major reform process. Why is that and will this be good for patients?

Professor Catto:Yes it will be good for patients.

Our primary purpose is to promote, protect and maintain the health and safety of the population by maintaining proper standards in the practice of medicine. So we're really there for the protection of the patients.

The reform programme has three main parts to it.

The first is making sure that doctors are up to date and fit to practise - this is our revalidation programme. By 2005, every doctor will be expected to have a licence to practise. Doctors will have to show us that they have been practising medicine in line with the seven principles set out in our guidance booklet Good Medical Practice. My name is on the medical register because I qualified in 1969, but since then I have not had to prove on a regular basis my fitness to practise. This is what revalidation is about - it is a positive emphasis on doctors being up to date and fit to practise.

The second is to make sure that the processes for identifying poorly performing doctors are speedy, efficient and fair. We will be able to consider a doctor's fitness to practise in the round rather than deciding early on in the process whether it is a health, conduct or performance matter.

The third is making the Council itself more streamlined and much more businesslike. We have increased lay membership to 40%, to reflect the principle of professionally-led regulation in partnership with the public.

Question: You were talking of making it more streamlined, but how will the reforms assist the reaction times to complaints?

Professor Catto:We have been criticised in the past for being terribly slow and allowing complaints to build up.

The processes are not inherently ours - they're governed by legislation and it is a slow process to get this changed.

Instead of having an enormously complex system, we're going to have two committees. One will deal with investigations and determining if there is a case to answer.

The second adjudication committee will determine the outcome and decide which sanctions the guilty doctor should face.

This system will streamline the complaints process, ensuring that complaints are progressed promptly as is consistent with achieving fairness.

Question: You have recently called for a new 'gateway' to filter patient complaints. Why is this necessary?

Professor Catto:Our complainants tell us that it is extremely confusing for patients who have a concern about their doctor to know how to raise it. Some 50 per cent of complaints to the GMC would have been better directed elsewhere. No doubt there are complaints going to the NHS which really ought to come straight to the GMC.

The aim will be to try and make sure that patients are given guidance on how best to make their concerns known and also to have in place a mechanism ensuring their complaints are properly addressed.

The whole of the healthcare world is so complex that you can't expect individual members of the public to understand how best to approach this monster.

It is not in the interests of patients, the NHS or other healthcare or regulatory organisations, including the GMC, that this confusion should persist. It causes delay and frustration for patients, and may have more serious consequences if complaints are not being properly directed and investigated.

Question:Why hasn't this sort of reform happened before now?

Professor Catto:I suppose partly the reason is that the NHS complaints procedure itself is a complex beast and when you add all the other bodies that have been created in recent years as well as longstanding regulators such as the GMC, there is now a very complex system.

People now need some kind of guidance on how best they can find their way around it.

Question:What are your comments on the Health and Social Care Bill?

Professor Catto:We do have reservations on one part of the Health and Social Care Bill. I guess from a political point of view it's one of the minor parts.

The new Commission for Health, Audit and Inspection will have new powers to look at individual patient records and we think that that Commission should only be allowed to see anonymised records or a record that has been amalgamated in some way.

If there is a real need to see individual patient records then the patient should be asked for their permission before that happens.

Confidentiality is really at the heart of medicine. If patients feel what they say to a doctor might be transmitted elsewhere, they would be very much less likely to give the truth, so their health and safety might be compromised and also that of the community.

It's not just the GMC against this. Our views are supported by patient groups, the Nursing and Midwifery Council and a number of other groups.

Question: How hopeful are you of the government coming round to your point of view?

Professor Catto:I hope it will be changed. The patient groups and the other regulators are all together on this. I will be contacting the Commission myself over the next few days to see if we can get a meeting in order to take this forward constructively.

Movement of patients and doctors through the EU is on the increase. What challenge does this pose to the GMC?

Britain is a net importer of doctors so we've got to welcome them from both inside and outside the EU.

The problem with the draft directive is that it is aimed at all professions - not just the healthcare professions - and it allows individual practitioners to come and practise in another country for up to 16 weeks per year without any kind of registration or understanding of what it is they are doing.

All the healthcare regulators and the Department of Health feel this potentially puts patients at risk.

I suspect it's because the directive covers professions well beyond healthcare and you can see that there are, in trade terms, potential advantages to having free mobility of labour.

It's really in this sector alone where there are potential problems. Patient safety must come first.

Question:So what are you doing about this? Are you lobbying Brussels?

Professor Catto:We have an alliance of all the nine UK healthcare regulators. We've got amendments into the Commission and the European Parliament and we're beginning to make some progress.

I'm hopeful that that directive will be changed.

We also need to work to have standards which are identifiable and agreed across Europe. We need to know the standards to which foreign doctors work if they were to ever come to work in Britain.

Question:How have you found this government's record on healthcare?

Professor Catto:Obviously there has been controversy on whether or not you should have targets.

This hasn't really impinged on the regulators, I think as far as this government is concerned, all the reform programmes we have wanted, they have put through parliament. We enjoy a positive relationship.