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
Mr.
Bradshaw: The hon. Member for Eddisbury asked whether the
provisions in the statutory instrument would prevent another Shipman. I
shall not over-claim for them; as I indicated, they are a very small
part of the Government’s overall response to the inquiries of
Dame Janet Smith. Some of the response was dealt with in
more depth and length during the passage of the Health and Social Care
Bill, and more will be dealt with in other legislation, governing
coroners, for example. The order is a small, technical and less
significant bit of what we debated earlier in the summer. In that
sense, it is part of the framework, but we are not discussing
revalidation here. That will come later. When we have had the pilots,
there will be a separate regulation, which we will have to bring before
a Committee such as this, in a statutory instrument. We will debate the
issue of revalidation and all those issues in full then. What we are
specifically discussing here is the licensing provision, which is a
preparatory provision for the eventual revalidation
system. 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. Resolved, 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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