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Lord Skelmersdale: My Lords, I would add to that the public at large because there are all sorts of naturally invasive procedures conducted by professions allied to medicine which are currently not regulated or, indeed, are insufficiently regulated. That is a very wide concern.
The whole point of Clause 47 is to change the statutory regime whereby these professions are regulated by Act of Parliament into professions regulated by order. I go along with that to a great extent. However, it is important that the same sort of controls, the same sort of inspections and the same sort of registration as are currently conducted under an Act of Parliament should continue to be conducted under regulation. That is something I would very much like the Minister to confirm this evening.
Baroness Hayman: My Lords, I am grateful to my noble friend for introducing his amendments. I shall certainly do my best to be reassuring. I hope that he will understand that if I cannot give firm commitments on
matters of detail it is because of the stage in the legislative process at which we currently find ourselves, rather than any lack of concern regarding the fact that these are important matters that we need to address.As ever, my noble friend has put a powerful case for respecting the contribution to healthcare given by chiropodists and podiatrists; and, indeed, by members of other professions supplementary to medicine. As the noble Lord, Lord Skelmersdale, rightly said, they can have a crucial role to play in the health of patients and we all have an interest in ensuring that they have effective self-regulation.
I should point out to the noble Lord, Lord Skelmersdale, that the reason I shall not give him an assurance that it will be the same sort of regulation that will replace the current Professions Supplementary to Medicine Act is because I believe that that framework is too weak. We are looking to provide stronger professional self-regulation. I shall quibble with the noble Lord on the semantics and say that it is not that we wish to take any functions away from any successor body, but that the many criticisms which the chiropodists and the podiatrists have made of the current regulatory structure--indeed, other professions supplementary to medicine have grave concerns about the weaknesses that are there--are one of the main reasons for seeking an order-making power to enable progress to be made on establishing a more effective regulatory structure for these professions.
The Bill makes clear our intention to repeal and replace the Professions Supplementary to Medicine Act under which the chiropodists and podiatrists are currently regulated. A review of the Act was published in 1996, following extensive consultation with the professions concerned, education providers, employers, consumer representatives and those who wished to be accredited under the Act. The review made important recommendations for new legislation to cover the professions allied to medicine, the broad thrust of which was accepted by the Government.
Given that the review was published almost three years ago, I understand the impatience of the professions to get into the detail of the replacement legislation. But perhaps I should remind the House that the Bill before this House does not contain any specific proposals other than that the 1960 Act be repealed. This is precisely because the proposed order-making power is an enabling measure, which is subject to the checks and balances and the limitations on the scope of orders that we have already debated. I believe that all Members of your Lordships' House agree that they are necessary, given that we are changing from a situation of primary legislation to one of secondary legislation.
During the passage of the Bill we have rightly debated what use the scope of the order-making power should have and the procedures for using it. Indeed, we shall do a little more of that later on. However, this is not the time to debate the detailed proposals of a future order. There will be plenty of opportunities for such a debate in the future as set out in the Bill. We are committed to full consultation on any proposals for replacement legislation. Once a draft order has been
developed the Bill provides for the publication of it; for consultation, including with the professions concerned; reporting the responses to the consultation to Parliament; and, finally, affirmative resolution procedures. It is our intention to work closely with all the professions concerned in creating an appropriate legislative framework for the professional self-regulation of the professions allied to medicine.Although I cannot go into detail as regards what the outcome of that process would be, perhaps I may repeat that our aim is not to diminish but to strengthen the regulation of chiropodists, podiatrists and all the other professions allied to medicine. I explained in Committee that we want to take action to ensure the proper protection of title. I was grateful for the welcome that my noble friend gave to that proposal. I have also explained, and am happy to repeat, our intentions in relation to the Privy Council; namely, that we will consult on the basis of retaining accountability to the council, not just for the chiropodists and podiatrists alone. I believe that that is what my noble friend was suggesting. We will be consulting for all the professions which will be regulated under the successor legislation.
Lord Morris of Manchester: My Lords, it was not my intention to exclude any other profession. As I believe I explained, I was speaking as president of the Society of Chiropodists and Podiatrists. Thus, naturally my concern was to obtain for them the assurance that my noble friend is now giving. I know from my very close contacts with other professions allied to medicine that they will also be extremely glad that this important link with the Privy Council is to be maintained.
Baroness Hayman: My Lords, I completely understand why my noble friend used that particular example. I was only drawing attention to the breadth of my reply because the way that he phrased his introduction did relate to chiropodists and podiatrists. It is important to understand that it is accountability to the Privy Council for the successor body dealing with all the professions supplementary to medicine.
Perhaps it might be helpful at this stage to explain that one of the most fundamental recommendations of the review report was a move away from parent uni-disciplinary boards towards a federal council with a much stronger strategic role. Within this structure it envisaged that input on matters specific to individual professions would be secured through extensive advisory networks and provision for "peer review" in fitness to practise cases. The review recommended the establishment of a strong cross-professional council in order to strengthen the overall effectiveness of the regulation of the professions supplementary to medicine, as there is a great deal to gain from more collaborative working, both for the professions concerned and for patients.
As I have said, I understand and share the concern of chiropodists that the distinctive contribution of each profession within a joint regulatory framework should be properly acknowledged. Areas such as the content of education and training syllabuses and fitness to practise cases are matters where uni-professional input will be essential.
Your Lordships will, however, understand that many fitness to practise cases deal with issues not directly related to the practice of the profession itself but with the conduct of the registrant, for example, in cases of abuse of patients or criminal convictions. This is an area on which the professions could usefully share and develop common values and standards for the better protection of patients. I do not think it is in the interests of patients for there to be a variety of standards of protection according to the individual profession concerned. However, fitness to practise cases on matters of clinical competence are obviously an area where uni-professional input must be properly secured. Getting the system right will be a delicate balancing act.
But, equally, the health professions have many aims and values in common, and we see great merit in strengthening the collaboration between them so as to promote genuinely patient-focused team-working of the kind to which my noble friend referred. It is worth noting that nurses, midwives and health visitors are jointly regulated, and that the recent review of the Nurses, Midwives and Health Visitors Act recommended that this arrangement continue, although there too we have to ensure that the right uni-professional input exists on appropriate matters.
It is therefore our intention to work closely with all the professions concerned to ensure that the new arrangements strike the right balance. It is useful to remember that there are nine other professions within the CPSM and three more hoping to join, all of whose views will need to be taken into account. What we all share is a desire to see a stronger and more effective successor body to the CPSM.
I hope my noble friend will understand that I have given as much detail as I can at this stage on our proposals. But I can certainly give an undertaking to ensure that, in working closely with the professions to develop proposals for replacement legislation, I will ensure that this very important issue of securing proper individual contributions from each of the professions concerned is paid the closest of attention, as indeed must be the case with nurses, midwives and health visitors. I hope that, given my assurances about how the next stage in the process will be tackled and that we will have proper regard to the concerns my noble friend has raised today, he will feel able to withdraw his amendments.
9 p.m.
Lord Morris of Manchester: My Lords, I am grateful for the kindliness of the remarks of my good friend Lord Walton this evening. I know that the Society of Chiropodists and Podiatrists will also be most appreciative of what he said about our exchanges in Committee. He is a friend and colleague for whom I have the highest regard.
I am grateful also to my noble friend Lady Hayman for her reply which I shall discuss with the Society of Chiropodists and Podiatrists before the Bill's Third Reading. I know that it will carefully consider all that my noble friend has said and that its starting point will be the hope that agreement can be reached with the
Government in pursuit of shared objectives. It is on that basis that I withdraw the amendment at this stage. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
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