Campaigners in the region have worked for years to make the National Health Service safer for patients. Health Editor Barry Nelson reports on Governmant plans to make it harder for rogue doctors to thrive.

LAST night, the Government announced proposals to tighten up the regulation of doctors and improve patient safety.

If the measures contained in a White Paper become law, UK doctors will have to prove their fitness to practice every five years.

The Government also plans to overhaul death certification, in an attempt to prevent a repetition of the mass killings carried out by Britain's worst serial murderer, Dr Harold Shipman.

Shipman, from Hyde, in Greater Manchester, murdered 215 people. He committed suicide in his prison cell.

At the time, the judge who chaired the Shipman Inquiry said the General Medical Council (GMC) - the organisation that regulates doctors - seemed to be more interested in looking after other doctors than protecting patients.

The White Paper is also a response to a series of other medical scandals, including the Richard Neale affair.

It took years for patient campaigners to get Neale struck off for botching operations at the Friarage Hospital, in Northallerton, North Yorkshire.

Campaigners were horrified when it emerged that Neale had already been struck off in Canada and struggled to get their complaints taken seriously.

Patients from the region also suffered at the hands of North Yorkshire psychiatrists William Kerr and Michael Haslam, who were both found guilty of indecency with patients after a long fight for justice.

The Government now wants complaints from patients about doctors to be taken more seriously as well as lowering the standard of proof in cases where doctors are accused of misconduct.

If the proposals are accepted it will mean that doctors will lose the powers to regulate themselves.

The GMC, which for more than a hundred years has been the judge and jury when it comes to investigating allegations of professional misconduct, would lose its power to strike off or suspend doctors.

Instead the GMC's role would be limited to investigating alleged misconduct and the hearing of allegations and adjudication of cases would be handled by an independent body.

Main proposals on medical regulation are:

* Competence tests for doctors every five years;

* The GMC will be stripped of powers to hear misconduct cases but retain its role as investigator;

* Adjudication in misconduct cases will be carried out by an independent body;

l All health regulatory bodies will have to move towards at least a 50:50 split between professional and lay members;

* Medical examiners will be appointed to sign all death certificates submitted by doctors.

Main proposals to safeguard patients are:

* Better support for patients who complain and steps to ensure they are taken seriously;

* Better checks when people are applying for health jobs;

* All primary care trusts must adopt "best practice" when it comes to investigating and acting on complaints;

* Stronger guidance for staff on preventing inappropriate sexual behaviour with patients.

Graham Maloney, advisor to the 300 strong support group set up by victims of Richard Neale, said: "This is a step in the right direction, but I don't think the reforms go far enough. It might make it harder for another Richard Neale to practice, but I don't think it will stop another Shipman."

Kathy Haq, a victim of Dr Kerr, who now lives in Sunderland, said: "I would like to see health workers trained to accept that their colleagues are capable of abuse. I would also like to see everyone in the NHS trained how to handle complaints."

Dr John Canning, a Middlesbrough GP, who speaks for the British Medical Association in the region, welcomed the regular "MoT" checks for doctors, but voiced concerns about more Government-appointed lay people on the GMC.

"Taking the GMC away from being professionally-led is a grave concern," he said.

"I am also concerned that someone could lose their livelihood and professional reputation on the basis of something being likely rather than being proved."