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It is not the Governments job to take sides in a dispute such as this, nor should it be. Given the length, depth and rancour of the disagreements that have plagued the NMCs leadership, that would be impossible.
Tom Brake: I hear what the Minister says about not intervening, but he will be aware of the correspondence that he has signed off to the chief executive, the president and the vice-president, which is a clear and forceful Government intervention in the matter.
We have not passed judgment on the performance of any of the individuals concerned, and we will not do so. When my hon. Friend the Member for Livingston and others initially raised their concerns, we urged the NMC to try to address them. However, by the time he secured his previous Adjournment debate on the subject, in March, it was clear to both him and me that the NMC was not capable of resolving its difficulties itself. In light of that, I asked the Council for Healthcare Regulatory Excellencethe regulator of regulatorsto expedite its routine annual report on the NMC and to address specifically whether the NMC was performing its statutory functions. We also alerted the Charity Commission to our concerns about the NMC. At the time, my hon. Friend welcomed those courses of action.
The CHRE subsequently spent considerable time and resources looking into the NMC. Its work was led by its highly respected chief executive, Harry Cayton, who has had a long and distinguished career in the public service and representing patients interests. At the end of that process, the CHRE published its report on 16 June. It was devastating. Without seeking to apportion blame to any particular individual, it stated that the leadership of the NMC had failed to carry out its statutory duties to the standard that the public had a right to expect and that it had lost the confidence of some of its stakeholders. It further stated that there was little evidence that the council had the leadership to extract itself from its current difficulties.
After I had discussed the investigation and the report with the chief executive and chair of the CHRE, the chief nursing officer, Unison, the Royal College of Nursing and the Royal College of Midwifery, it was clear to me that the NMC would not be in a position to recover unless its chief executive, president and vice-president all stepped down. That is the background to the letters I sent to those three people. I made it clear that we did not have the power to remove them or force their resignation, but that we believed that it would be in the best interests of both the NMC and themselves if they stepped down from their positions. I said that if Ministers were questioned on the matter in Parliament, we would have to answer accordingly. We welcome the leadership shown by all three in deciding to step down.
As for the NMC itself, it will now be important for it to demonstrate how it plans to address the recommendations made in the CHRE report. For its part, my Department considers that the NMC should put in place an action plan to implement all the recommendations.
Mr. Bradshaw: The vice-president has gone, although there was no requirement on her to leave the council altogether, and the president has indicated that she will depart her position in August. The chief executive has also indicated her intention to resign, but I imagine that as an employee, she will have some contractual arrangements to discuss.
The NMC might wish to consider seeking independent support to help it look afresh at its fitness-to-practise procedures. I note that today, the RCM, RCN, Unison and Unite have jointly offered to help the NMC and urged it to give serious consideration to making an external appointment. They also made a number of other sensible recommendations.
The Government believe that the existing system, whereby professional members are elected to the council, has contributed to the difficulties faced by the NMC. We are changing its governance, and that of all the other health care regulatory bodies, so that in future all members will be appointed. We believe that should help to resolve the councils underlying problems.
As a result of the CHRE report, we are also accelerating the planned reforms to the governance of the NMC. The Nursing and Midwifery (Amendment) Order 2008 has now received Royal Assent, and we are already consulting on a new constitution order for the NMC. We intend that the new council will be appointed through the Appointments Commission against set criteria of skills and competencies, which will ensure that all members of the council are competent board members. We propose to include in the constitution order provisions to allow both council members and employees to notify the Privy Council if they have concerns about a council member and consider that the member should be removed. We are on track to have a new, wholly appointed council in place by 2009.
The CHRE report makes it clear that these problems are of long standing and have not been addressed with the speed that they should have been...We commend the actions of the President and Chief Executive in putting the interests of the organisation first and we would urge the vice president to do so also.
My hon. Friend asked me when I first heard of the problems to which he has referred. It was when he intervened during the Report stage of the Health and Social Care Bill on 18 February. After that, we agreed to have a private meeting. He then secured his Adjournment debate, which took over from that private meeting. Ever since then, we have been in close contact, as I have been with other hon. Members.
My hon. Friend asked about the allegation that the CHRE report findings contradict its own performance assessment made in March. Of course, that is a matter for the CHRE, and I understand that it has said that that is not the case. He is welcome to take the matter up with the CHRE, and I understand that he has had a number of conversations with its chief executive in recent weeks. I am sure that the chief executive will be happy to speak to him about the matter.
Many difficult issues have been raised in the debate. However, we believe that it is important that the Government remain focused on what matters most, which is ensuring public and patient safety. That requires a robust system of professional regulation, with adequate checks to monitor the performance of regulatory bodies and detect problems before patient safety is compromised.
My hon. Friend asked about the David Britten case. The CHREs performance review of the NMC, although it covered a period later than that of the David Britten case, raised significant concerns about the NMCs fitness-to-practise procedures and highlighted delays in investigating cases on occasion. As I have said, it is important for the NMC to put in place plans to address the concerns raised in both the CHRE report and the report on the David Britten case.
There will always be a balance to strike to ensure that the bodies regulating health professionals are independent
of Government as well as of the professions that they regulate. The performance review process undertaken by the CHRE is an important component of the regulatory system and helps to ensure that the right checks and balances are in place. This is clearly a difficult time for the NMC, and I am sure that everyone in the Chamber supports the council in addressing the issues raised in the report. I hope that it will soon be in a position to provide reassurance about how it plans to proceed, and that we will then be able to draw a line under what has happened and look to the future and a fresh start for the NMC.