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Lord Higgins My Lords, as the Question specifically refers to the operation of the welfare state, is it not the case that there have been considerable problems as a result of break-downs and deficiencies in computer systems, for example, in the payment of deferred pensions? Can the Minister bring us up to date on that? On the point raised by my noble friend Lord Attlee, is there not a case for carrying out a survey on the particular problem to which he has drawn the attention of the House?

Baroness Hollis of Heigham: My Lords, on the second question, I shall certainly ask my colleague in the DETR whether he can give further information on the number of women beggars. I shall write to the noble Earl, Lord Attlee, and put a copy in the Library, when we have further information.

The noble Lord, Lord Higgins, also asked about computers, particularly the NIRS2 computer. The latest information that I have on contributory benefits, as opposed to income-related benefits, is that something like 95 per cent of all benefits have now been paid and that the backlog, if it has not already been cleared, will be cleared by the end of this month. Where appropriate, compensation has been paid.

Baroness Greengross: My Lords, perhaps I may put two points.

Noble Lords: Questions!

Baroness Greengross: My Lords, I apologise. I should like to put two questions to the Minister. First, as regards homeless people and beggars, research published a while ago showed that a high proportion of elderly people are homeless in and around London. Does the Minister agree that we should set up an investigation into the current situation? Secondly, as regards "Do not resuscitate" orders, that is one example of discrimination in the NHS and I am

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grateful for the Minister's comment that this will not be tolerated. However, in this area also we do not know all the facts. Does the Minister further agree that it would be better to hold an inquiry to examine all aspects of discrimination in the NHS so that we can eliminate it on the basis of full information?

Baroness Hollis of Heigham: My Lords, noble Lords, including my noble friend Lord Hunt, have heard the points made by the noble Baroness. Obviously my noble friend will reflect on whether it makes good sense to conduct an inquiry. However, what is needed is to ensure that this does not continue to take place in the future. The best way of ensuring that is to establish a National Service Framework for Older People. That is being developed and will apply to all local authorities. I hope that, in a year or two, the noble Baroness--who has worked so wonderfully for Age Concern--will no longer consider this to be a problem.

Baroness Gardner of Parkes: My Lords, in the light of so many questions on health being raised today, can the Minister say whether they typify the problem of lack of cohesion between the social services and health sectors? When does she think that this gap in communication will be bridged?

Baroness Hollis of Heigham: My Lords, as my noble friend said, I do not believe that this is so much a matter of lack of joined-up government as a lack of joined-up Questions. In all seriousness, I recognise that the major concerns affecting the elderly, which range from pensions, health, housing, fuel poverty, social exclusion and so forth, need to be addressed by all government departments. That is precisely why the Prime Minister has set up an inter-ministerial group on ageing and the care of the elderly. That group will range across all the fronts of government. Furthermore, that is why my right honourable friend the Secretary of State for Social Security has become the champion of older people in that respect.

Professions Supplementary to Medicine

3.13 p.m.

Lord Clement-Jones asked Her Majesty's Government:

    What prior consultations were carried out in relation to circular HSC 2000/006 Professions supplementary to medicine: employment of practitioners in the NHS and social services departments, issued on 13th March, particularly in relation to "Acquired Rights".

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, this circular was subject to consultation, in draft, with the professional bodies representing the nine professions then regulated by the Council for Professions Supplementary to Medicine (CPSM) and

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with NHS trusts, health authorities, the NHS Confederation, local authorities and social services directors.

Lord Clement-Jones: My Lords, I thank the Minister for that reply. However, it is quite clear that this circular was imposed on the professions involved rather than being the subject of consultation. All the organisations related to the professions allied to medicine are unanimously of the view that these arrangements and methods of dealing properly with non-fully qualified professionals will have an adverse effect on the quality of NHS treatment and also bode extremely badly for the way in which the new health professional council will be set up. Can the Minister give an assurance that arrangements related to the entry of non-qualified professionals for the other professions allied to medicine will be dealt with in a different manner? Furthermore, will there be proper consultation in the future?

Lord Hunt of Kings Heath: My Lords, this is a matter of regulation and it is entirely appropriate that the CPSM forwarded to the Government comments as regards acquired rights, which we have taken forward. It is of course for the CPSM itself to engage in discussions with its constituent boards as to how this is to be taken forward. However, I can assure the noble Lord, Lord Clement-Jones, and all noble Lords that in terms of acquired rights, this would apply to a relatively small number of people. Agreement would be given only after a rigorous process in which the individual board concerned with the individual profession will have a say.

Lord Peyton of Yeovil: My Lords, I must apologise because I have not read every word of the circular referred to in the Question. However, I am curious about the phrase, "professions supplementary to medicine". Does that phrase embrace accountants, who nowadays seem far to outnumber the medical profession, whose business it is to make people feel better? No accountant has ever done anything of that kind.

Lord Hunt of Kings Heath: My Lords, that is an extraordinarily interesting reflection. Sadly, the number of professions that can be regulated under the heading "professions supplementary to medicine" is 12. We have now reached that figure and so I am afraid that there is no room for accountants.

Earl Howe: My Lords, if it is the Government's aim to improve public protection, how can it be right to create a new regulatory body in which the majority of members will have no relevant qualifications and no first-hand knowledge of the professions in question but whose function it will be to decide whether a particular individual is fit to practise? How can that possibly be appropriate?

Lord Hunt of Kings Heath: My Lords, the new health professions council, which is to be established,

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will ensure that the public interest is brought to the fore. That is why we wish to increase the number of lay persons on the council. They will help to give strategic direction, to protect the public and to ensure that the interests of the public are given primary concern. However, I can assure the noble Earl that, as regards specific issues relating to specific professions and also to disciplinary procedures, there will be opportunities for those individual professions to be involved and consulted. At the end of the day, the new health professions council will work well with a strong, public lay involvement along with the stewardship of the relevant professions.

Baroness Gardner of Parkes: My Lords, is the Minister aware that acquired rights applied in dentistry in 1921? Anyone who had been practising as a dentist could be registered. However, it was never accepted that those who were registered as a result of acquired rights had the same skills. The circular states that there are two ways in which such rights can be acquired: first, by "grandfathering"--which means that a practitioner has been in the field for long enough; and, secondly, by acquired rights applied to employees who possess neither qualifications nor the relevant education, training and experience. As the noble Lord, Lord Clement-Jones, said, it appears that many of these people will not be adequately qualified. Does the Minister accept that there is a danger here and can he assure the House that something will be done to check on this?

Lord Hunt of Kings Heath: My Lords, the noble Baroness is right to refer to the specific classification on the use of acquired rights which will apply to practitioners who do not qualify for automatic registration but are none the less regarded as practising safely as prosthetists, orthotists or arts therapists, but not necessarily--as the noble Baroness inferred--across the full range of the practice of their particular profession. Each case will be considered on an individual basis. The board, as well as the CPSM, will have to give its approval. I can assure the noble Baroness that I suspect that there will be very few cases indeed where any problems occur. Finally, the public interest will be paramount in any decision taken.

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