Standing Committee A
Tuesday 11 December 2001
[MISS ANN WIDDECOMBE in the Chair]
the council for the regulation of health care professionals
The Chairman: I understand that the Opposition want a stand part debate on clause 23, so I ask the Committee—indeed, I insist—that the three groups of amendments be debated according to the narrow way in which they have been drawn.
Mr. Oliver Heald (North-East Hertfordshire): I beg to move amendment No. 224, in page 28, line 31, leave out from 'bodies' to end of line 33.
This is a probing amendment concerned with the functions of the Council for the Regulation of Health Care Professionals as described in clause 23(2)(d). Under the clause, the council will promote co-operation between the eight regulatory bodies to which it refers, and I am happy for that principle to be extended to the further body that the Minister is seeking to add to the list through a later amendment. However, if the amendment were accepted the council would not promote wider
''co-operation between regulatory bodies; and between them, or any of them, and other bodies performing corresponding functions.''
It is worth bearing in mind that some of the bodies listed in subsection (3) contain more than one profession. For example, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting contains three professions, and the Council for Professions Supplementary to Medicine contains 12. In total, clause 23(3) lists about 20 bodies that will have a duty to work together, and between which the council will have a duty to promote co-operation.
Why is it necessary for a wider group of bodies to co-operate with such health bodies? If subsection (3) listed just one or two bodies, it might be reasonable to argue that such co-operation is necessary to ensure that matters are dealt with consistently across a range of professions. However, subsection (3) lists some 20 bodies, so why is it necessary to expand the list yet further? Moreover, what sort of bodies does the Minister have in mind? Although the Department of Health is responsible for the Bill's progress, I believe that the bodies listed in subsection (3) are the responsibility of the Privy Council Office. Bodies such as chartered institutes and bankers are also the responsibility of the Privy Council Office. With that in mind, what would be the point of trying to promote co-operation with, say, architects?
Will the professional regulatory bodies that we are discussing be required to co-operate with, and promote co-operation between, bodies that embrace a wide range of professions? I believe that a UK professional council exists that covers such a range. Will the Minister flesh out what he has in mind in terms of promoting co-operation? Will he also confirm that there is some point to the provision, and that it is not just a bureaucratic exercise involving people spending a lot of time discussing parameters and broad agreements to little effect?
The Minister of State, Department of Health (Mr. John Hutton): I am grateful to the hon. Member for North-East Hertfordshire (Mr. Heald) for giving me the opportunity to explain the matters that he raised.
We do not envisage the UK council having any role in relation to the qualification of architects, bankers and chartered accountants. It is a council for the regulation of health care professionals, and all its functions must be seen and exercised in that context. The bodies with which it should be able to discuss matters are the quality standard-setting bodies that have an impact on the delivery of health care and health care services, not those that deal with bankers, architects or accountants. Those are all worthy professions, and I have nothing against them, but they will not fall within the remit of the council. The Bill has been constructed to ensure that that does not happen.
The hon. Gentleman asked why we wanted the council to have a wider remit. In essence, the answer lies in the Kennedy report. Professor Kennedy saw it as part of the council's rationale that it should be able to work closely with other quality-related bodies. As I understand it, that is the reasoning behind new clause 2, which we will debate later.
The amendment would make it harder for the council to promote co-operation between, for example, a regulatory body and the Quality Assurance Agency for Higher Education about the fitness of purpose of educational courses and qualifications in relation to health care professionals. It would make it harder for the General Medical Council and the specialist training authority or the joint committee on the post-graduate training of GPs or its planned successor, the medical education standards body, to have discussions and closer co-operation on the admission of doctors to the specialist register. It would make it harder for there to be discussions between the regulatory bodies and the General Social Care Council, or between the GMC, the General Dental Council and the national clinical assessment authority about the thresholds at which poor performance by a doctor or dentist could lead to referral to their regulatory body.
We regard this provision, as did Professor Kennedy, as a necessary adjunct to the proper discharge by the council of its new functions. It is not designed to extend its remit into professions that have nothing directly to do with health care professionals and their regulatory and educational requirements. As Professor Kennedy said, the overarching body that is established by clause 23 needs to have a broad co-ordinating function between the regulatory bodies and the bodies that are responsible for setting quality standards on education and training in relation to the relevant professional organisations.
This is not a back-door route to bringing within the remit of the council a whole range of professional organisations that have nothing to do with the regulation of health care professionals. It is a sensible measure that will ensure, as Professor Kennedy argued, that the council can do its job properly.
Mr. Heald: Just so that we are clear about this, is the Minister ruling out the promotion of co-operation with regulatory bodies for architects, bankers and so on, and limiting it purely to the health context?
Mr. Hutton: Yes, that is my understanding of the Bill.
Mr. Simon Burns (West Chelmsford): As my hon. Friend the Member for North-East Hertfordshire said, this is a probing amendment, and I want to probe the Minister a little further.
Subsection (2) lays down the general functions of the council, which include:
''to promote the interests of patients and other members of the public . . . to promote best practice in the performance of those functions . . . to formulate principles relating to good professional self-regulation . . . to promote co-operation between regulatory bodies''.
Those are all eminently sensible. However, given the importance of education, professional development and training, to which the Minister referred, why does the Bill include nothing specific about them in relation to the functions of the council? I am sure that the Minister would agree that all three of those areas are critically important, and unless there were good reasons to the contrary, they should be included in the functions under subsection (2).
Mr. Hutton: As I understand it, the hon. for West Chelmsford (Mr. Burns) is arguing for the UK council to have some jurisdiction in relation to setting educational training standards for a variety of health care professions. It is an interesting argument, but I do not think that we want the UK council to discharge that role. We may come to this discussion when we look at some of the amendments about the composition of the council.
As we envisage it, the body will have a lay majority, and some perfectly reasonable concerns would be expressed about a body with a lay majority setting professional standards for doctors' qualifications and so on, and that would not be a sensible path to go down. I know that the amendments would equalise the balance, but even then I am not sure that that would be a sensible thing to do. Existing bodies have responsibilities in these areas, including the royal colleges. We intend to establish, I hope later next year, the medical education standards board to provide oversight and an overview of the work done by the Special Training Authority and the joint committee in relation to the education and training of GPs. It is important that they are professionally-led responsibilities. We certainly envisage that continuing in the future.
The UK council's role is different. We are setting it up partly in response to what Professor Kennedy said, and the reasoning in his report, which I am sure we will come to in the debate on stand part. We are also setting it up for reasons that we set out in the NHS plan last year. In both cases, certainly in the NHS plan, we tried to explain why we wanted to set up a council and why professional education training issues should be dealt with elsewhere.
The hon. Gentleman has an interesting point to make, but, in relation to some of the points that I have tried to address, it is better for the educational issues to be dealt with elsewhere, within professionally-led organisations, rather than within an organisation with a lay majority.
Mr. Heald: Having heard the Minister give a clear assurance that the promotion and co-operation is between regulatory bodies and other bodies within the health sphere, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Mr. Hutton: I beg to move amendment No. 198, in page 28, line 41, at end insert—
'( ) subject to section 24(5A), the Pharmaceutical Society of Northern Ireland,'.
The Chairman: With this it will be convenient to take Government amendments Nos. 199, 201 and 202.