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Lord Hunt of Kings Heath moved Amendment No. 62:
On Question, amendment agreed to.
Schedule 1 [Primary Care Trusts]:
Lord Hunt of Kings Heath moved Amendments Nos. 63 and 64:
The noble Lord said: My Lords, with the leave of the House I shall move Amendments Nos. 63 and 64 en bloc. I beg to move.
On Question, amendments agreed to.
Schedule 2 [The Commission for Health Improvement]:
Lord Hunt of Kings Heath moved Amendments Nos. 65 and 66:
The noble Lord said: My Lords, with the leave of the House I shall move Amendments Nos. 65 and 66 en bloc.
On Question, amendments agreed to.
Schedule 3 [Regulation of health care and associated professions]:
Baroness Hayman moved Amendment No. 67:
The noble Baroness said: My Lords, this is another issue with which we dealt at both Committee and Report stages. I am pleased to be able to bring forward an amendment which I hope meets the wishes of the House.
We discussed at previous stages the need, in bringing forward an order on professional self-regulation, for proper consultation before the order-making power is used. As I explained, it has always been our intention that consultation on any proposals to use the order-making power should be wide. The views of a number of interests will need to be taken into account, including the professions, the NHS, patients, service users and the wider public. This amendment reflects that intention by broadening the Secretary of State's duty to consult about the draft. At this late stage in our deliberations I would not wish to create a precedent by involving the imposition of a list of those to be consulted on the face of the Bill. We have discussed at length the dangers of that. But we want to make quite clear that the Secretary of State's consultation must not just be with the profession affected by the proposed order.
We have all agreed that the primary purpose of professional self-regulation is the protection of the public and it is right that the responsibility towards consultation with the public, patients and carers should be on the face of the Bill. The Secretary of State will want to consult representatives of the interests of patients and other service users, as well as other interested parties such as the Scottish Parliament and the Welsh and Northern Ireland Assemblies.
Although this amendment varies in drafting terms from those tabled by the noble Baroness, Lady Wilcox, who I know had to go abroad and is therefore not able to be in your Lordships' House today, I hope noble Lords will agree that this amendment meets the objectives she had in mind when arguing on previous amendments before the House. I beg to move.
Lord Morris of Manchester: My Lords, I intervene only briefly. This is an important amendment that I welcome. It provides an opportunity to emphasise again today how essential it is for Ministers to ensure that the profession to be regulated is fully and meaningfully consulted. The amendment also enables those of us who have debated Schedule 3 with her to thank my noble friend, both for her stamina and her abiding readiness to listen.
The Committee and Report stages of the Bill led to positive developments that include commitments from the Government on the protection of title, on continuing the role of the Privy Council in relation to the professions, and on additional safeguards covering future use of order-making powers. There was some progress also in relation to protecting professional self-regulation.
I hope very much that in the spirit of this amendment the Government will go on listening to the professions, especially where demonstrably their principal concern is for high professional standards and protecting the public interest. As the Minister knows, I speak as President of the Society of Chiropodists and Podiatrists and I spelt out their concerns. But the more I speak to representatives of other professions, the clearer it becomes that our concerns are very widely shared.
My noble friend told your Lordships' House that she was sure that her objectives would soon be shown to be the same as those of the society. She also made it clear that she would welcome further dialogue with us and the society looks forward very much to a further meeting with her. Meanwhile, I hope her amendment will be quickly approved.
Baroness McFarlane of Llandaff: My Lords, I, too, add my thanks to those of my noble friend Lord Walton of Detchant and the noble Lord, Lord Morris of Manchester, for the great care that the Minister has shown in meeting our concerns about professional self-regulation and building in so many safeguards for both the public and the professions. I know that the Royal College of Nursing and the UKCC are now happy with the Bill and this schedule as it stands printed. I am delighted to support this amendment.
Lord Clement-Jones: My Lords, I rise briefly to add my thanks to the Minister for her flexibility in the course of the passage of the Bill in this particular respect, and to make one short point on behalf of some of the professions allied to medicine.
The Minister made it clear throughout the course of the Bill what the process of consultation going forward now is in terms of the new council. Many of those professions have been reassured by the safeguards now in place. But there is still some concern about the elements that will be brought within a uni-professional majority and the noble Lord, Lord Morris, expressed some of those concerns on behalf of the Society of Chiropodists and Podiatrists. Others, such as the physiotherapists, have similar concerns, and are concerned about whether it is possible--they believe it is not--to split the fitness to practise aspects between different types of case. That seemed to be the implication of some of the responses by the Minister at Report stage.
Clearly these consultations will be carried forward, but I urge the Minister, in the course of those consultations, to be aware that a number of the professions wish to see education, training and fitness to practise all brought within that uni-professional majority.
Baroness Hayman: My Lords, I am most grateful to noble Lords for the generosity of their response. I believe that we have actually improved the Bill as regards Schedule 3 and that we have managed to meet the legitimate concerns of the professions that there
I have suggested to the House that it would be inappropriate to talk about the detailed content of proposals upon which we will be consulting at a future date in terms of this Bill. The Bill allows us to have those debates and I fully take on board those points made by my noble friend Lord Morris and the noble Lord, Lord Clement-Jones. I understand the concerns regarding the need to have very detailed consultation to ensure that we get it right in terms of improving professional self-regulation for all the professions, but obviously the professions allied to medicine have particular concerns in this respect. I look forward to conducting those debates with the hope and expectation that we will be able to effect change thanks to the provisions of this Bill.
On Question, amendment agreed to.
Baroness Hayman moved Amendments Nos. 68 to 71:
On Question, amendments agreed to.
Schedule 4 [Amendments of enactments]:
Baroness Hayman moved Amendments Nos. 72 to 84:
On Question, amendments agreed to.
Schedule 5 [Repeals]:
Page 56, line 23, at end insert--
(""the 1978 Act" means the National Health Service (Scotland) Act 1978,").
Page 61, line 32, leave out from beginning to ("to") in line 33 and insert ("Provision must be made by regulations requiring Primary Care Trusts").
Page 61, line 39, at end insert--
("by taking such steps as may be specified in the regulations.").
Page 67, line 1, leave out sub-paragraph (3).
Page 67, line 3, leave out (", together with copies of the auditors' report,").
Page 69, leave out lines 26 and 27 and insert--
("(b) invite representations to be made to him about the draft by persons appearing to him appropriate to represent the profession to be regulated, persons appearing to him appropriate to represent those provided with services by the profession and any other persons appearing to him appropriate to consult about the draft.").
6 p.m.
Page 70, line 11, leave out ("references") and insert ("the reference").
Page 70, line 12, leave out ("include") and insert ("includes").
Page 70, line 12, leave out ("references") and insert ("the reference").
Page 70, line 13, leave out ("include") and insert ("includes").
Page 71, line 8, at end insert--
(". In section 12 (supplementary provisions for sections 8 and 11), subsection (1) is omitted.").
Page 71, line 15, at end insert--
(". After section 16B (exercise of functions by Primary Care Trusts) there is inserted--
"Advice for Health Authorities and Primary Care Trusts.
16C.--(1) Every Health Authority shall make arrangements with a view to securing that they receive advice appropriate for enabling them effectively to exercise the functions exercisable by them from persons with professional expertise relating to the physical or mental health of individuals.
(2) This section applies to Primary Care Trusts as it applies to Health Authorities." ").
Page 72, line 6, at end insert--
(". In section 28C(4) (personal medical or dental services), for "13" there is substituted "16D".").
Page 73, line 39, leave out from ("Tribunal") to ("they") in line 40 and insert ("make a national disqualification,").
Page 73, line 48, leave out from ("substituted") to ("and") in line 49 and insert (""national disqualification"").
Page 75, line 42, at end insert--
("( ) In subsection (4), after "to make such" there is inserted "transitional, saving".").
Page 76, line 5, leave out ("in") and insert ("by").
Page 76, line 27, leave out ("16C(1)") and insert ("16D(1)").
Page 77, line 37, at end insert--
(". In section 19A(3)(b) (medical lists), for the words from first "disqualified" to "29" there is substituted "disqualified for inclusion in the list by, or by virtue of a direction of, the NHS Tribunal".
. Section 31 (disqualification provisions in England and Wales or Northern Ireland) is renumbered as subsection (1) of that section and--
(a) in paragraph (a), for the words from "services" to "29(1)" there is substituted "any of the services mentioned in one of the paragraphs of section 29(5)";
(b) in paragraph (b), at the beginning, there is inserted "in relation to the services in question" and for the words from "a list" to the end there is substituted "any list and (if also the subject of such a declaration under those provisions corresponding to a declaration of unfitness) be treated as if a declaration of unfitness had been made in respect of him";
(c) after that subsection there is inserted--
"(2) Where under the conditional disqualification provisions in England and Wales or Northern Ireland--
(a) any conditions are imposed in relation to the provision by any person of any of the services mentioned in section 29(5); or
(b) any conditions so imposed are varied,
the Secretary of State may, by a notice in writing given to each Health Board and to the person in question, impose those conditions in relation to the provision by that person of those services under this Part.
(3) A notice under subsection (2) may make such modifications of the conditions as the Secretary of State considers necessary for them to have the like effect in relation to Scotland as they have in relation to England and Wales or (as the case may be) Northern Ireland, but only if the Secretary of State has previously given the person concerned written notice of the proposed modifications and an opportunity (in accordance with such requirements, if any, as may be prescribed) to make representations about them.
(4) Conditions imposed by a notice under subsection (2) shall cease to have effect if the Secretary of State withdraws the notice by giving written notice to the person concerned.
(5) In this section, "the conditional disqualification provisions in England and Wales or Northern Ireland" means any provisions in force in England and Wales or Northern Ireland corresponding to sections 29C and (so far as relating to conditional disqualifications) 30."
. Section 32 (regulations as to sections 29 to 31) is renumbered as subsection (1) of that section and--
(a) in paragraph (c) after "disqualification" in both places where it occurs there is inserted "or condition";
(b) after that subsection there is inserted--
"(2) Regulations under subsection (1)(a) above may in particular provide that, where (apart from the regulations) it would be the duty of the Tribunal to inquire into both an efficiency case and a fraud case in respect of the same person, they may inquire into one case before inquiring into the other and, after proceedings in the first case are finally disposed of, may if they think it appropriate adjourn the other case indefinitely."
. In section 32A (applications for interim suspension)--
(a) after subsection (1) there is inserted--
"(1A) A Health Board may, if they have requested a review of a conditional disqualification on the ground mentioned in section 30(3)(b) or (c), at any time before the review is concluded apply to the Tribunal for a direction to be made under subsection (2) in relation to the person to whom the review relates.";
(b) in subsection (2), for the words from "it" to "patients" there is substituted "either of the conditions for doing so is satisfied" and after "in question" there is inserted "or the case to which the review in question";
(c) after that subsection there is inserted--
"(2A) The conditions for giving such a direction are--
(a) that it is necessary to do so in order to protect persons who are, or may be, provided with services under this Part to which the case in question, or the case to which the review in question, relates;
(b) in, or in the case of a review relating to, a fraud case, that unless they do so there is a significant risk that--
(i) an act or omission within section 29(4C)(a) will occur; or
(ii) the investigation of the case or the review will be prejudiced";
(d) in subsection (3)(c), for the words from "under" to "engaged in" there is substituted "of unfitness in relation to";
(e) in subsection (4), after "case" there is inserted "or review";
(f) subsection (5) is omitted;
(g) in subsection (6)(a), "prepared under this Part of this Act" is omitted.
. In section 32B (continuation of suspension pending appeal)--
(a) for subsection (1) and the preceding sidenote there is substituted--
"Suspension pending appeal.
32B.--(1) Where, on disposing of a case under section 29B, the Tribunal make a national disqualification, they may, if they consider that either of the conditions mentioned in section 32A(2A) is satisfied, direct that section 32A(3) shall apply or, if a direction has been given under section 32A(2), shall continue to apply to him as respects services of the kind to which the disqualification relates.";
(b) in subsection (2), in paragraph (a), for "direction under section 29(2)(b)" there is substituted "national disqualification" and, in paragraph (b), for "that direction" there is substituted "the disqualification";
(c) in subsection (3), for the words from "direction" to "section 29(3)(c)" there is substituted "disqualification which is not coupled with a declaration of unfitness";
(d) subsection (4) is omitted.
. In section 32D (suspension provisions in England and Wales or Northern Ireland), for "29(1)" there is substituted "29(5)".").
Page 78, line 43, at end insert--
(". In Schedule 8 (the Tribunal), in paragraph 8--
(a) in sub-paragraph (2)(a), for "section 29" there is substituted "sections 29 to 29C";
(b) in sub-paragraph (2)(b), after "disqualification" there is inserted "conditional disqualification or declaration of unfitness";
(c) in sub-paragraph (2)(d), for the words from "the application" to the end there is substituted "section 32A(3) may be made to apply or continue to apply".").
Page 80, line 25, leave out (""16C"") and insert (""16D"").
Page 83, line 7, after ("Act)") insert--
("(a) in subsection (1), for "13" there is substituted "16D" and").
Page 83, line 8, at end insert--
("(b) in subsection (2)(b), for "13" there is substituted "16D".").
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