NHS Reform and Health Care Professions Bill

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Mr. Heald: I beg to move amendment No. 233, in page 30, line 12, after 'must', insert

    'consult with the profession and'.

The Chairman: With this it will be convenient to take the following amendments: No. 234, in page 30, leave out lines 21 to 23.

No. 235, in page 30, in line 33, leave out from second 'profession' to 'which' in line 34.

No. 236, in page 30, line 34, leave out '(wholly or partly)'.

Mr. Heald: Under clause 24(7), if the Secretary of State asks for advice--this applies also to other authorities that might seek advice--about the health care profession, the council must give such advice. Amendment No. 233 would require the council to consult the profession when that request is made. It also raises the question of the Secretary of State's purpose in seeking advice and what the Minister has in mind. Does the Minister agree that if the Secretary of State, the National Assembly for Wales, Scottish Ministers, and the Ministry of Health, Social Services

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and Public Safety in Northern Ireland asked for advice, consultation would almost inevitably be necessary? The primary purpose of the amendment is to find out what the Minister has in mind for the sort of advice that might be requested.

Section 60 of the Health Act 1999 gives a regulation-making power to the Secretary of State and clause 24(8) adds to that list. Amendment No. 234 would delete a provision in paragraph (e) that allows the Secretary of State to modify

    ''the range of functions of that body in relation to which the Council performs its functions.''

This is a probing amendment to test whether the provision is necessary and the reasons for it. I invite the Minister to explain exactly what he has in mind in subsection (8)(e).

Amendments Nos. 235 and 236 would delete the words in brackets in subsection (11), which states:

    ''In this section, 'health care profession' means a profession (whether or not regulated by or by virtue of any enactment) which is concerned (wholly or partly) with the physical or mental health of individuals.''

Why should it not read, ''In this section, 'health care profession' means a profession which is concerned with the physical or mental health of individuals''? I am sure that the Minister will tell me that there are extremely good reasons for that, but so often in the drafting of clauses there is a great deal of surplusage. I should be grateful if he would explain why that drafting is needed.

5 pm

Mr. Peter Atkinson (Hexham): Clause 24(8)(e) states:

    ''modifying, as respects any such regulatory body, the range of functions of that body in relation to which the Council performs its functions.''

Will the Minister explain that in more detail and give us an example of the sort of change that might lead to the council wanting to modify its existing arrangements?

Mr. Hutton: Amendment No. 233 requires that before the council complies with a ministerial request under clause 24(6) to give

    ''advice on any matter connected with a profession'',

it must consult with that profession. I have several problems with the amendment, although I do not dispute the need for proper consultation. The obvious problem is that it does not describe the consultation process: does it mean a regulatory body or the individual members of a profession?

A practical problem with the amendment is that we envisage the UK council consulting regularly with other regulatory bodies, and, in some cases, the professional membership of those bodies, through consultation proposals, documents, meetings and conferences, which would be a legitimate way for it to go about its business. There is an obvious difficulty in placing on the face of the Bill a requirement to consult with the profession. Ministers might request information from the council and want it at necessarily short notice. They would be aware how these processes work and might require advice quickly about

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professional regulation and self-regulation. If the council had to consult before it could give that advice it would not be an ideal situation for either Ministers or the council, which is something that the hon. Member for North-East Hertfordshire, who is a man of goodwill, will understand.

Amendment No. 234 removes one of the three changes that we proposed the Bill should make to section 60 of the Health Act 1999. Amendments Nos. 235 and 236 seek to change the definition of ''health care profession'' in clause 24. The hon. Member for Hexham (Mr. Atkinson) asked me about that definition, which is not new and relates to section 61(b) of the 1999 Act. I remember sitting through many hours of discussion and debate about the meaning of that term. He did not have that pleasure—perhaps I should send him copies of the bound volumes of Hansard so that he can flick through them at his leisure.

I am not disputing that amendments Nos. 235 and 236 have the ring of common sense. However, if we were to amend clause 24 in the way in which the hon. Member for North-East Hertfordshire has suggested, the clause would not cover professions such as psychology that are only partially concerned with health. Furthermore, the clause would not cover professions such as operating department practitioners, perfusionists or physiological measurement technicians, none of which are currently regulated. Depending on the advice that Ministers receive from the Health Professions Council, we want a situation in which we can extend regulation into those areas. In understand that his amendments are designed to probe the rationale behind these definitions and the reasons why they are drafted in this way. However, the definitions are deliberately drafted to allow for the possibility of an expanded regime of self-regulation in those areas.

Dr. Andrew Murrison (Westbury): I take issue with the Minister, and professionals such as psychologists would also take issue with him, in excluding their work from the definition of health. The World Health Organisation has offered a useful definition of health, and I am sure that he has heard it many times before. It would certainly include professions such as psychology, along with operating theatre technicians and a raft of people who work within the health service. The wording of the clause in relation to physical and mental health seems verbose. Nothing would be lost, indeed a great deal would be gained in terms of clarity, by deleting ''physical and mental'' because ''health'' is all-encompassing. The wording is unnecessarily complex, and most within health care would know what he meant were he to stick to ''health''.

Mr. Hutton: This is one of those occasions on which I must disagree with the hon. Gentleman. The amendments create further doubt as to what is and what is not regarded as a health care profession for these purposes. Including ''wholly or partly'' is designed to ensure that in areas where there is argument and potential doubt, we can ensure that we

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are not inhibited from expanding the range of professional self-regulation. If we were to take the words out it would narrow the definition rather than expand it, and we should have an expansive definition rather than a narrow one.

Dr. Evan Harris (Oxford, West and Abingdon): I agree with the Minister's comments, as I did in 1999, on the need to expand professional self-regulation where appropriate. The danger of taking out the provision that there must be a physical or mental health component to the care given might be taken as a signal that we are opening the door to professional self-regulation to people who deal, as they would see it, purely with the spiritual side of health. As a minimum, we must further debate the primary legislation before giving a signal that we are going down that path.

Mr. Hutton: To be fair to the hon. Member for North-East Hertfordshire, he is not proposing the deletion of ''physical or mental health'' from the definition. He wants to delete:

    ''whether or not regulated by or by virtue of any enactment''.

Amendment No. 235 would confine the work of the council to bodies that are currently regulated, and not allow it to consider those that might be regulated in future. That would be daft because it would limit the efficacy of the council.

Amendment No. 236 would omit the words ''wholly or partly'', which are designed, as the hon. Member for Oxford, West and Abingdon (Dr. Harris) said, to give us the greatest possible scope. We want to avoid rather than encourage arguments about whether professions are covered by the Bill.

Amendment No. 234 raises some different issues. The provision the amendment proposes to delete would give us the power in a future section 60 order to adjust the range of functions that fall within the remit of the council to those bodies that are both the regulatory and professional body for their profession. Currently the only such bodies are the Royal Pharmaceutical Society and the Pharmaceutical Society of Northern Ireland. Because of their unusual status, the council only bites on their regulatory functions, which is absolutely correct. This is a piece of flexibility that it is logical to include now, but we have no plans to use it.

The provisions that we are proposing in relation to section 60 are designed to preserve flexibility. The Bill currently gives us the power to alter the range of functions that fall within the remit of the council of those bodies that are both regulatory and professional. Because of that status, the council should have a competence and jurisdiction in relation to its regulatory functions. That is what the clause seeks to do, and I hope that that clarifies the position for the hon. Member for Hexham.

Mr. Heald: I feel that we have had a ''Titanic'' moment—there was more beneath the surface than I had realised. From what the Minister is saying, some groups or bodies that clause 23(3) proposes could

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become part of the scheme in due course: bodies apart from the General Medical Council and the others on the list.

The Minister mentioned psychology and physiological measurement, but if there are several possible applicant groups that will be joining in the regulation, what will be the route for them to do so? Will the logical way be through the Health Professions Council? Can the Minister give us an idea of which bodies might be included? Are there groups requesting to be part of the Health Professions Council, who are they, and is a process underway to join them up, over a period of time, which I had not fully appreciated?

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