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Baroness Jay of Paddington: My Lords, I rise briefly to support the noble Lord, Lord Walton of Detchant, on this amendment. The case has been eloquently made by him. It is clearly to everybody's benefit that these doctors from overseas should play a temporary role and have their education enhanced by visiting this country.
Sometimes we on these Benches are accused of undermining the NHS by the concerns which we express about it; let me say that I believe it would be of
enormous benefit to any overseas doctor trying to establish or conduct a proper primary care service in his or her own country to observe how well it is done here.
Baroness Cumberlege: My Lords, we agree with both the noble Lord, Lord Walton, and the noble Baroness, Lady Jay, that international exchanges of the nature described by the noble Lord are of enormous value. Indeed the Joint Committee for Postgraduate Training in General Practice already has the power to issue certificates allowing overseas doctors to enter general practice in this country as a principal, but only where it considers their experience to be equivalent to that required of domestic GPs.
We do not believe that it would be in the interests of patients to allow exchange doctors entry on the strength of a lesser requirement. That would undermine the single standard of entry to UK and EC general practice necessary to maintain the quality of service to patients. Permanent supervision of the doctors concerned could not be guaranteed, with the result that patients could find themselves being treated by a GP whose qualifications did not meet the required standards.
I can assure the noble Lord that we have put forward to the professions proposals which would enable exchanges to take place within existing primary legislation and which would not fall foul of the principle I have just set out. With that reassurance, I hope that the noble Lord will not press his amendment.
Lord Walton of Detchant: My Lords, I thank the Minister for that reply. I would only say that there have been occasions in the past when the Joint Committee for Postgraduate Training in General Practice has refused to offer certificates of equivalence or appropriate certificates to doctors of great distinction with extensive experience of general practice overseas solely on the grounds that those individuals have no experience of working in this country within the National Health Service. If the Minister can give me the assurance that discussions with that body and the profession have overcome that difficulty and that it will be possible for such doctors to come here on exchanges and work in general practice, providing the concerns that their experience and qualifications are of an appropriate standard are satisfied, I believe that that should be sufficient reassurance and I will beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 27 [Medical lists and vacancies: England and Wales.]:
Baroness Miller of Hendon moved Amendment No. 48:
The noble Baroness said: My Lords, I beg to move Amendment No. 48 and with it I should like to speak to Amendments Nos. 50, 52, 53, 54, 55, 56, 57, 58, 59, 70, 72, 77 and 88. This group of amendments is concerned with some matters of detail relating to our proposals on GP appointments contained in Clauses 27 and 28. Amendment No. 50 will enable a health authority to
I commend these amendments to the House. I beg to move.
On Question, amendment agreed to.
Baroness Cumberlege moved Amendment No. 50:
The noble Baroness said: My Lords, I have already spoken to this amendment. I beg to move.
On Question, amendment agreed to.
Baroness Jay of Paddington moved Amendment No. 51:
The noble Baroness said: My Lords, this amendment deals with another concern about the independence of the Medical Practices Committee. Its purpose is to delete the increased power which the Secretary of State seems to be giving to himself to vary or revoke decisions which at the moment are made within the law by the Medical Practices Committee. As we discussed on earlier amendments, we understand that the Government will meet next week with the Medical Practices Committee on this and other concerns.
With that in mind, given the reply that I expect to hear from the noble Baroness--I hope this will be the subject of those discussions--at this point I would simply like to register our concern on this additional matter about the Medical Practices Committee, to which we may have to return at Third Reading. I beg to move.
Baroness Miller of Hendon: My Lords, Amendment No. 51 is concerned with the appeals process as it relates to the filling of vacancies. We find it rather baffling. Our intention in Clause 27(3)(b) is to provide a regulatory power for decisions taken by health authorities on filling vacancies to be reconsidered by the Secretary of State through an agreed appeals process. The amendment as tabled removes this power and effectively would mean that there would be no right of appeal to the Secretary of State over non-selection by a health authority to a medical
Baroness Jay of Paddington: My Lords, I shall certainly withdraw the amendment this afternoon, on the understanding that I had when I moved it. This subject obviously lacks some clarity--certainly, views have been given to me expressing concern about the nature of the wording of this particular part of the Bill and its effect on the independence of the Medical Practices Committee. As I said in moving the amendment, I trust that it will be subject to the discussions which we understand will take place next Tuesday. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Baroness Cumberlege moved Amendments Nos. 52 to 54:
The noble Baroness said: My Lords, I have already spoken to these amendments. I beg to move them en bloc.
On Question, amendments agreed to.
Clause 28 [Medical lists and vacancies: Scotland]:
Baroness Cumberlege moved Amendments Nos. 55 to 59:
The noble Baroness said: My Lords, I have already spoken to these amendments. I beg to move them en bloc.
On Question, amendments agreed to.
Clause 29 [Sale of medical practices]:
Page 23, line 21, after ("relates") insert ("(whether wholly or in part)").
Page 24, line 4, after ("is") insert (", or will be,").
6.30 p.m.
Page 24, line 23, leave out from beginning to ("or") in line 24.
Page 24, line 25, leave out from ("vacancies") to end of line 26 and insert ("relating to the area of one Health Authority which also relate to the area of another Health Authority or a Health Board,").
Page 24, line 28, at end insert--
("(3A) Regulations which make provision about vacancies which relate partly to the area of a Health Board may, in particular, provide that section 29A(2)(b) is to have effect in prescribed circumstances as if the reference to regulations under this section were a reference to regulations under section 19B of the National Health Service (Scotland) Act 1978.").
Page 24, line 37, at end insert--
(""Health Board" has the same meaning as in the National Health Service (Scotland) Act 1978;").
Page 25, line 16, after ("relates") insert ("(whether wholly or in part)").
Page 25, line 46, after ("is") insert (", or will be,").
Page 26, line 20, leave out from ("vacancies") to end of line 21 and insert ("relating to the area of one Health Board which also relate to the area of another Health Board or a Health Authority,").
Page 26, line 23, at end insert--
("(3A) Regulations which make provision about vacancies which relate partly to the area of a Health Authority may, in particular, provide that section 19A(2)(b) is to have effect in prescribed circumstances as if the reference to regulations under this section were a reference to regulations under section 29B of the National Health Service Act 1977.").
Page 26, line 32, at end insert--
(""Health Authority" has the same meaning as in the National Health Service Act 1977;").
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