NHS Reform and Health Care Professions Bill

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Mr. Heald: The Minister says that nothing would happen if a report were to be laid before Parliament, but that is not the health service commissioner's experience. I am told that it is widely accepted in the health community that that is a powerful tool. Is the Minister seriously suggesting that if a report was laid about one of the health professions' councils, the Council for the Regulation of Health Care Professionals would not act? Is he really saying that if a report were laid about the GMC, the council would not take that extremely seriously? When those bodies are subject to public criticism they take it seriously; why would they not do so if a report were laid before Parliament?

The Chairman: Order. The hon. Gentleman's intervention is too long.

Mr. Hutton: I had rather forgotten the point.

Mr. Heald: There are obvious reactions.

Mr. Hutton: The hon. Gentleman is not comparing like with like. His analogy is in relation to the arbitration of particular disputes and the behaviour of, for example, local authorities. In the context of our discussions, it is difficult to see what the end result would be of laying before Parliament a report that drew attention to a dispute between the UK council and the regulatory body because there would be no requirement to act. I cannot see how the process that the hon. Gentleman described would result in the rule change that the UK council is seeking. That, ultimately, is where we part company.

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There has been great play about the word ''desirable'' and the council coming to decisions that the hon. Gentleman would query were necessary or desirable to protect the public. However, we should not underestimate the important presence and the role on the UK council of the nine representatives of the regulatory bodies. Under the Bill, there will be 10 lay members, but in the context of the serious decisions that the council may make they will have the benefit and advice of the nine representatives of the regulatory bodies on the council. I am sure that they will have a positive influence on the council's decisions.

There is probably nothing more I can say about the amendment that has not been said two or three times. I am absolutely satisfied about the integrity of the provision and the need for it, supported by the amendments that we have tabled. I disagree with the regulatory bodies about the provision and I have heard nothing today to make me change my mind about the wording of the clause or the procedures outlined in the Bill.

6.30 pm

Mr. Heald: Needless to say, we are not satisfied. The Minister will not even narrow the language. He is not prepared to take account of the fact that these views are strongly held by a wide range of bodies and groups in the health world. He is putting forward the view that he is being constructive in his two amendments, but they do not change the position. We are dug in and we do not agree, so I shall ask for a vote on amendment No. 186. However, following the Minister's assurance, I beg to ask leave to withdraw amendment No. 238.

Amendment, by leave, withdrawn.

Amendment proposed: No. 186, in page 30, line 39, leave out subsection (2) and insert—

    '(2)If, after consulting the regulatory body concerned, the Council concludes that—

    (a) it is necessary for the protection of members of the public for a regulatory body to make or amend a rule (under any power the body has to do so); and

    (b) the regulatory body has not made or amended the rule and will not do so the Council may if it thinks fit lay a special report before each House of Parliament.'.--[Mr. Heald.]

    Question put, That the amendment be made:--

    The Committee divided: Ayes 7, Noes 9.

    Division No. 13]

    Atkinson, Mr. Peter
    Baron, Mr. John
    Burns, Mr. Simon
    Harris, Dr. Evan
    Heald, Mr. Oliver
    Murrison, Dr. Andrew
    Taylor, Dr. Richard

    Blears, Ms Hazel
    Challen, Mr. Colin
    Fitzpatrick, Jim
    Hall, Mr. Mike
    Havard, Mr. Dai
    Hutton, Mr. John
    Thomas, Gareth
    Touhig, Mr. Don
    Ward, Ms Claire

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Question accordingly negatived.

Amendments made: No. 247, in page 31, line 5, leave out 'may' and insert 'shall'.

No. 248, in page 31, line 6, at end insert—

    '( ) The regulations must, in particular, make provision requiring the Council to consult a regulatory body before giving it directions under subsection (2).'.--[Mr. Hutton.]

Mr. Heald: On a point of order, Mr. Hurst. If you will allow me, I want to ask the Minister to explain subsection (5). I do not seek a wider debate.

Question proposed, That the clause, as amended, stand part of the Bill.

Mr. Heald: Clause 25(5) provides that a regulatory body is not to be taken to have failed to comply with directions merely because a court determines that the rules made pursuant to the directions have been construed in a different way from that intended when the rules were changed. Will the Minister explain, first, the ambit of that and the discretion within it, and how it would work in practice? Secondly, what is the sanction if the council asks a regulatory body to change the rules and the Privy Council agrees, but for some reason the change is inadequate, or the regulatory body refuses to change them? Do the Government have a sanction that can be imposed?

Mr. Hutton: We have discussed the last point exhaustively on subsection (2) and, with respect to the hon. Gentleman, the issue covered by subsection (5) is clear. It covers a case in which the courts interpret the rule in a different way so that it does not have the effect originally intended. Without subsection (5), there would be a risk that the UK council or the regulatory body might be perceived to be in default under subsection (2).

I prefaced my comments on subsection (2) by saying that I would be disappointed if the provision were ever used, but in the extremely serious situation in which it might be invoked but a regulatory body refused to make a proposed rule change or submit it to the Privy Council, the Bill would provide a legal procedure to require compliance with the rule change and require it to be submitted to the Privy Council. That is my understanding of the provision. There will be a follow-through, but that is the worst possible scenario that any of us could contemplate.

For some of the reasons suggested by the hon. Gentleman, who imagined the cathartic effect of a report before Parliament to which a regulatory body would almost invariably respond, it is unbelievable that a regulatory body would not comply with the proper procedures followed by the UK council and meet its requirement to submit a rule change to the Privy Council. I do not believe that the situation is likely to arise, but subsection (5) is a declaration to avoid the possibility of such a default situation arising because a court makes a different interpretation of a rule change following a direction under subsection (2).

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Mr. Heald: So, the Minister is saying that the sanction is an injunction or a judicial review requiring the regulatory body to propose the rules to the Privy Council.

Mr. Hutton: Yes, that is my understanding.

Question put and agreed to.

Clause 25, as amended, ordered to stand part of the Bill.

Clause 26

Complaints about regulatory bodies

Mr. Heald: I beg to move amendment No. 239, in page 31, line 15, leave out paragraph (a).

The Chairman: With this it will be convenient to take the following amendments: No. 240, in page 31, line 16, leave out 'must (or need not),' and insert 'may'.

No. 241, in page 31, line 18, leave out paragraph (c).

No. 242, in page 31, line 19, leave out paragraph (d).

No. 243, in page 31, line 20, leave out paragraph (e).

No. 244, in page 31, line 27, leave out paragraph (i).

No. 245, in page 31, line 40, at end add—

    '(5)The Council may adopt such procedure as it thinks fit to follow in investigating complaints.'.

No. 246, in page 31, line 40, at end add—

    '(6)The power to make regulations in this section shall be exercisable by statutory instrument.

    (7) A statutory instrument containing regulations under this section shall not be made unless a draft has been laid and approved by a resolution of each House of Parliament.'.

Mr. Heald: Amendment No. 239 would delete clause 26(2)(a). The clause deals with complaints about regulatory bodies and provides that the Secretary of State can make regulations about the council's investigation of the complaints that it receives about the way in which a regulatory body has exercised any of its functions. As the Minister said, it is about enabling the council to investigate maladministration, not a means of overturning the decisions of fitness to practise committees.

Mr. Burns: Does my hon. Friend agree that notwithstanding subsections (2) and (3), this is a classic example of where it would have been helpful to the Committee if the Government had prepared draft regulations in advance?

Mr. Heald: Yes. It is certainly my recollection that that is what we all thought was going to happen, but I have not had time to check the record to find the passage at the beginning of our proceedings in which the Minister promised to be thus helpful. It would be useful to know what the Government have in mind in respect of regulations.

The various bodies that have written to us are keen that the council should be able to manage itself independently of the Government. It is disappointing that clause 26, with its plethora of matters that can be regulated, does not give the council more freedom to manage its own affairs. That is the theme that runs through the amendments.

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Clause 26(2)(a) says that regulations may deal with

    ''who (or what description of person) is entitled to complain''

to the council about maladministration. Why cannot anyone make a complaint? I can understand why it might be desirable to specify the nature of the complaints that the council may consider, but why restrict the kinds of people who can make them?

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