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Baroness Carnegy of Lour: My Lords, for the benefit of my noble friend, and to save time, perhaps I may put on record my gratitude to the Scottish Office Minister for clarifying the point to which my noble friend has referred. I have had several letters from him and have asked further questions. I quote from his last letter, which puts the matter very clearly:
- "The Scottish Parliament will ... have no legislative powers whatsoever in this area [of regulation] either over existing bodies or any self-regulatory bodies which might be set up after 1 July 1999".
The noble Lord goes on to explain that that does not rule out the possibility that the Scots Parliament could have an interest in professional self-regulation when it touches on matters to be devolved, but that in those circumstances there would have to be close consultation between the Scots Parliament and the Westminster Parliament. I have satisfied myself and those with whom I have discussed the matter that there is no question of any regulation or alteration to regulation being devolved; it is all in Schedule 5 to the Scotland Act and will be done at Westminster.
Lord Walton of Detchant: My Lords, at Second Reading and in Committee I expressed some concern about the provisions of the Bill relating to the regulation of various professions, the regulation of which at present is enshrined in individual Acts, such as the Medical Act, the Dentists Act and many more. I am happy to say that the amendments which have now been tabled by the noble Baroness on behalf of the Government have met the concerns of those professional bodies. It seems to me and the organisations that I have consulted that by these amendments the Government have walked that important and difficult tightrope between, on the one hand, enabling order-making powers to be used to modify in some respects a few of the functions of these regulating authorities and, on the other hand, leaving their basic structures and functions intact. The evidence from each of these organisations, not least the General Medical Council and the General Dental Council, is that they are very satisfied with these amendments and commend them.
I comment briefly on the points made by the noble Lord, Lord Skelmersdale. I had the privilege of sponsoring the Osteopaths Bill and the Chiropractors Bill in this House. I did so following the reports of the King's Fund upon these particular professions. Like the King's Fund and the inquiry that it sponsored, I was satisfied that those professions had developed a formal training programme of adequate length and content such that those with the protected title of chiropractor and osteopath had been sufficiently well trained for the protection of the public.
The noble Lord, Lord Skelmersdale, is absolutely right. There are many other professions in the field of complementary medicine that would welcome the opportunity of self-regulation. But as yet relatively few of them have achieved the standing and recognition in training and other matters that is sufficient in my view
at least--I speak as a member of the Council of the Foundation for Integrated Medicine established by the Prince of Wales--to seek self-regulation. I believe that that time will come. It may well be that under order-making powers it is proper for them to be included in the body that will subsequently succeed the Professions Supplementary to Medicine Act. But in the meantime I commend these amendments which I believe answer the anxieties of the existing regulatory bodies. I congratulate the Government upon the skill with which they have tabled these amendments.9.30 p.m.
Lord Skelmersdale: My Lords, before the noble Lord, Lord Walton, sits down perhaps I may put one question. Does he believe that the alternative therapies that are in the queue, albeit, as he said, a very long way off, can be happily regulated by order as opposed to Act of Parliament?
Lord Walton of Detchant: My Lords, that is certainly my belief.
Baroness Fookes: My Lords, the Minister always presents her case so reasonably and with such charm. Clearly, she has taken a great deal of trouble over these amendments and therefore it seems positively churlish even to raise a slight query. Nevertheless, I do so. I fear that I shall join that select group of parliamentary moaning minnies to which my noble friend belongs. Is it not true that, even though these powers are now hedged about in a way that they were not before, a determined Secretary of State still has considerable powers to bring forward changes that it is hoped will be agreed with the professions concerned, but may not be? Does she agree that when we are faced with an order that must be accepted by both Houses or rejected entirely the Secretary of State is still left with a considerable amount of power? That is the purpose of my rising to speak now. Quite a number of powers remain, do they not?
Baroness Emerton: My Lords, I too thank the Minister for the way in which she introduced this set of amendments. I join my noble friend Lord Walton in saying that the nursing profession is very pleased by the way in which these amendments together answer its queries on the order-making powers.
As to Amendment No. 79C, the profession is concerned about one matter in particular and asks the Minister to clarify it. It concerns the functions set out in the schedule. Standards for professional conduct could be set out. At present there is reference to administering procedures. Amendment No. 79C gives a wide scope. Therefore the profession is anxious that the standards for professional conduct could be better provided for than by using the word "administering". I ask the Minister to clarify that point which was raised during Second Reading. I was not present, unfortunately, at Second Reading but have read the debate in Hansard.
I congratulate the Minister on achieving the balance between flexibility and safeguards which is extremely difficult in such legislation.
Lord Monkswell: My Lords, I, too, wish to join the noble Lord, Lord Walton of Detchant, in thanking my noble friend and the department for producing what appears to be an extremely satisfactory regime. It may be my inadequacy, but I wish to ask my noble friend two minor questions and one of more significance.
Am I right to believe that Amendment No. 96 is a transition facility or arrangement enabling the current regime to continue while the new regulatory system is formulated and brought into play? Am I also right to think that the middle paragraph of Amendment No. 94 applies to midwives? As my noble friend said in Committee, a committee consisting of a majority of registered midwives could deal with the self-regulatory aspects of midwifery.
The more substantial question relates to Amendment No. 87 which will result in the repeal of the Nurses, Midwives and Health Visitors Act 1997. Section 16 of that Act states that:
- "A person other than a registered midwife or a registered medical practitioner shall not attend a woman in childbirth".
I have two questions. First, under this Bill will the Government have the power to enshrine in law the Section 16 provision of that Act? Secondly, and almost inconsequentially but hoping for a positive reply, is it the Government's intention to enshrine in law such a provision if they have the ability?
Lord Clement-Jones: My Lords, I add the appreciation of these Benches for the fact that the Minister has brought forward the amendments and responded so comprehensively to the concerns of the professions and their regulatory bodies. As the noble Baroness, Lady Fookes, reminded us, there are still considerable powers under the Bill for the Secretary of State. We on these Benches believe that the amendments go a long way towards mitigating those powers. We welcome them.
However, there are still some concerns by the profession about the way in which the safeguards will work. The Minister went some way towards answering them, but perhaps I may replay one or two in order to make sure that we on these Benches have understood her reply. The noble Lord, Lord Morris of Manchester, raised the issues of importance to the chiropodists. Others in the professions allied to medicine also have concerns about not being too narrowly confined, in terms of uni-professional majority to fitness to practice, but also involved is the whole issue of education standards, the validation of courses and entry to the profession. Those professions will appreciate the Minister's assurance about securing proper individual
contributions from those professions in the debate as we go forward. One cannot anticipate the result of those consultations.A further question for the professions allied to medicine relates to the role of the Privy Council. I understood the Minister to say that she will be consulting on the basis of the retention of that Privy Council role. That will be much appreciated.
A further question surrounds the combination of the effect of Amendments Nos. 95 and 97. The wording is difficult and confusing, but I understood the Minister to say that, although in the first instance one must jump over the hurdle of those Acts, successor bodies will be protected. Therefore, it will not be possible to have their functions transferred by order, even though it will be possible for the UKCC and the CPSM.
Furthermore, there is the issue of devolution and the regulation of professions. Although the noble Baroness, Lady Carnegy, was clear in her understanding, I am not sure that my own understanding is quite so clear. It is important that the Minister confirms to the more confused of us that, despite the repeal of the 1960 and 1970 Acts, the professions currently covered by them will continue to be regulated on a UK-wide basis.
Another concern is that if the healthcare assistants are brought into a regulatory scheme, that is not reserved. Therefore, there would have to be agreement by the Scottish Parliament to any joint UK regulation of that set of staff in the health service.
The noble Baroness answered the question about the timing of the repeals. I understand that one can have a different appointed day for elements of a particular subsection. It would be helpful to have confirmation of that.
Finally, I make a cognate point to that raised by the noble Lord, Lord Monkswell, about the committee of a newly constituted UKCC or successor body. It would be helpful for the noble Baroness to reconfirm her understanding of the state of play so far. For instance, will it be an equally balanced body between nurses and midwives? If so, it may well be unnecessary for there to be a committee. If it is not balanced, a committee, that uni-professional majority which deals with issues such as entry to the profession, will be necessary. It would be helpful if the Minister, even at this late hour, were able to throw a little more light on that aspect.
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