Draft Medical Profession (Miscellaneous Amendments) Order 2008

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The Chairman: I hope that this is relevant to the order.
Peter Bottomley: It is. Without going into detail, there ought to be a de minimis requirement for people’s revalidation not to be held back, nor disciplinary cases entered in on if it appears that there is no substantial reason. If the Minister is interested, I shall happily tip him off outside the Committee about my concerns, although there may be no need for that yet.
I move on to the question of revalidation when people are developing new fields. Validation in fields that are well established is no problem, but we are all aware of the advance of medicine. For example, 50 or 60 years ago, the person known as “the wizard of Wigan” was the first to try and put in replacement hips. There was no validation procedure then, because there was no hip replacement. What was a rather rare procedure, which took place outside the NHS, has become something that happens commonly—four or five times a day in my constituency, where there are many elderly people. How would validation work on that? I am not suggesting a particular difficulty, but the issue is not just about matching a doctor up to what is known now. Will the validation process keep up with the advances in medicine?
In general, there has been too much hyperactivity in changing structures and in people launching themselves on things that go wrong. I shall not make any more than has been made already about the change in the law in 1995 on the admission to special registers—to lose the grandfather or grandmother clause for many doctors may or may not have been intended. That is not terribly important. Being able to make regulations to put that sort of thing right is part of what Parliament is here for.
What Parliament should also be here for, what Ministers should be alert to and what those advising Ministers should be far clearer about when giving advice, is when things go dramatically wrong, as the modernising medical careers/Medical Training Application Service did. Good doctors told interested MPs, who put the points as clearly as they could to the Department and to Ministers, but the reaction came far too late. As the Minister knows, I think that the same has been happening over the NHS IT system. One day I hope that we have the same kind of debate about that as we have on this.
4.58 pm
In response to the hon. Member for Leeds, North-West, who speaks for the Liberal Democrats, the reason that there is no sunset clause on the licensing pilots is that they are non-statutory and we do not need one. The reference to “pilots” is to do with sharing adverse information. Information that comes to light during a pilot will be publishable in the public interest. Our revalidation support team is currently working out the details of where the pilots should take place, who should be involved and how we shall apply the learning from them. We expect them to start in April 2009 but, as I said, a new statutory instrument will be required to deal with revalidation itself. It will be drafted by the General Medical Council, and it will need approval and debate by us. We will be dealing with the content of revalidation and building on the existing provisions that will be relevant to recertification.
The hon. Member for Worthing, West highlighted an ambiguity in the numbers in the explanatory memorandum. I am advised that all 240,000 will be offered licences, but we expect a smaller number than that to take up the offer. Along with the hon. Member for Leeds, North-West, the hon. Gentleman asked about the consequences of transferring education. As I am sure he knows, it was originally a proposal that came from the GMC and it is one that we support. The GMC proposed establishing three new boards, which will be an appropriate avenue for influence regarding legitimate concerns about education.
The boards will include an undergraduate board, which relates to the hon. Gentleman’s point about the importance of medical students being represented. The other two boards will be a postgraduate board and a continuing professional educational board, which will maintain the involvement of educators in GMC education. In response to a further issue that he raised, it will not be up to us to dictate to the GMC how it organises matters. That will be entirely up to the GMC. If it wants a majority of educators on the bodies that will be making decisions about such matters, that is entirely appropriate, but it is a decision for the council to make.
Peter Bottomley: The Minister disposed of that point very well. To return to the previous matter that he was responding to, will he remind us for how long the licence will last?
Mr. Bradshaw: The revalidation proposal is for every five years, but I will write to the hon. Gentleman and clarify whether the licence is for exactly the same time—unless I am advised by officials before the end of our sitting.
The hon. Member for Eddisbury asked how the British Medical Association will continue to exert influence. The GMC will be able to call on a range of expertise undertaking work on both undergraduate and postgraduate education. It will be expected to represent the interests of all stakeholders, registrants, patients, employees and educators. He also asked about fee increases. As I am sure he appreciates, they are entirely a matter for the GMC. The regulations that are made in respect of fees are not subject to Privy Council approval.
The hon. Gentleman asked about the concerns expressed by the Royal College of Pathologists regarding the wording of the order on the specialist register. Again, the GMC will be consulting on the detailed scheme for managing late entries to the specialist register. He also asked whether we had estimated how many people had been affected by the issue that we want to resolve today. I am advised that there are fewer than 200. The hon. Gentleman asked why there was no detail about the scheme for putting specialist doctors on the register. Again, the GMC will be addressing those issues when it consults on them.
I am also advised that the licence is for life. Revalidation is every five years, but the licence does not have a sunset clause. I hope that I have been helpful to members of the Committee.
Question put and agreed to.
That the Committee has considered the draft Medical Profession (Miscellaneous Amendments) Order 2008.
Committee rose at four minutes past Five o’clock.
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