Introduction

As the place of overseas doctors became politically contentious within and outside of the medical profession, the liminal place of the GMC between the state and the profession made it highly sensitive to political pressure. To be sure, the council possessed regulatory authority. But the effective power of the GMC was minimized by its constitutional subordination to the Privy Council, not to mention the government's legislative mandates. Its capacity for independent action was diluted further by the autonomy of university and nonuniversity licensing bodies, which comprised the majority of the representatives on the council. Nonuniversity licensing bodies, for example, were able to use their own discretion in determining whether the conditions for requalification had been met by overseas candidates, relying on their expertise in assessing candidates’ professional experience.

Furthermore, the virtual absence of supplementary sources of funding curbed the GMC's capacity for pursuing independent initiatives. Until the establishment of the category of temporary registration for overseas doctors, the GMC had maintained a hand-to-mouth existence. To subsidize its operations, the GMC relied on the one-time fee for life paid by domestic medical graduates who were admitted to the register to subsidize its operations. Fees from overseas doctors proved advantageous in the short run but were not a permanent solution to financial stability as hostility against nonwhite Commonwealth immigration grew. Indeed, one unintended consequence of the 1962 Commonwealth Immigration Act, which mandated work vouchers for all Commonwealth immigrants, was the drop in the number of overseas doctors seeking admission to the register. As costs associated with the operation of the GMC continued to climb, this reduction of revenue spurred the council to look to the domestic medical profession for a more reliable source of support.

The development of a more regular source of revenue would produce a trade-off for the GMC: financial security heightened scrutiny from organized medicine. In 1966 the council proposed a new retention fee. Instead of a one-time fee for life, all doctors would now be required to pay an annual fee to remain on the register and continue to be legally entitled to practice medicine.