| Previous Section | Back to Table of Contents | Lords Hansard Home Page |
Lord Hunt of Kings Heath: Before I deal with the amendments, perhaps I may tell the noble Baroness, Lady Carnegy of Lour, that I have been most interested in the Reith lectures given by the noble Baroness, Lady O'Neill. I have a great deal of sympathy with some of the points that she has made about the potential for over-regulation. The Government have signed up to the importance of professional self-regulation. However, I ought also to point out that the purpose of self-regulation is not for the greater glory of the profession itself; it is to serve better the public interest. The intention behind the Government's proposals is to strengthen self-regulation in the public interest.
As the noble Baroness, Lady Northover, suggested in her opening remarks, we need to go back to the Bristol inquiry report and to the specific endorsements and comments in recommendations 39 and 40 which stated:
- "a council for the regulation of healthcare professionals should be created to bring together those bodies which regulate healthcare professionals . . . in effect, this is the body currently referred to in the NHS Plan as the council of healthcare regulators . . . [it] must ensure that there is an integrated and co-ordinated approach to setting standards, monitoring performance, and inspection and validation. Issues of overlap and of gaps between the various bodies must be addressed and resolved".
We accepted Kennedy's recommendation about the council. We published our more detailed proposals and engaged in a consultation exercise. The results of that consultation exercise supported the establishment of a new, more transparent framework for self-regulation which explicitly puts patients' public interest first and provides for greater integration and co-ordination and sharing of good practice between the regulatory bodies.
The existing regulatory bodies have responded to the need for reform; for example, to improve their fitness-to-practise procedures and to modernise and streamline their governance. The value of the council for the regulation of healthcare professions in this climate will be in keeping up the momentum of change and helping it to happen in a co-ordinated way.
Regulatory bodies and consumer groups have welcomed plans to establish the council. We reached an agreement with the regulators on the new council's proposed powers and that was communicated in the press statement issued on 5th March. That also contained statements from the presidents of the General Medical Council and the General Dental Council expressly stating that the new council would preserve parliamentary accountability and the
important principle of self-regulation. Sir Graeme Catto, President of the General Medical Council, stated:
- "I am delighted that we have been able to reach an agreement with the Government that maintains the line of direct accountability of the GMC, and the other regulatory bodies, to Parliament. The issue of maintaining our independence from Government has been crucial throughout our discussions and I am delighted that the proposed amendment satisfies these concerns."
We have not reached the group of amendments which I shall move which relate specifically to the comments of the president of the General Medical Council. However, in addressing this first group of amendments, it is important to make clear the agreement that has been reached between the Government and the regulatory bodies.
I turn to the group of amendments which are about accountability to Parliament of professional regulatory bodies. Essentially, the core of the amendments would do away with our proposed new council for the regulation of healthcare professionals and propose that many of its functions should be given to a health joint Select Committee if Parliament should so decide to establish such a committee. I shall come to that in a moment. However, I take the opportunity to spell out how the accountability of regulators will work under the Bill. The council will be accountable to Parliament. Schedule 7 of the Bill obliges it to lay a report before Parliament each year. It must also, under the same schedule, provide Parliament with a special report on any matter which Parliament asks it to. It must also lay its accounts before Parliament.
The regulatory bodies have long been accountable to Parliament in the sense that Parliament can ask them to provide evidence to, for example, departmental Select Committees. That has happened on a number of occasions in the past few years. The Bill maintains that accountability to Parliament for the regulatory bodies. What it changes is that in essence it provides Parliament with some assistance in the work of the new council. Reports from the council will allow Parliament to see more readily how the world of regulation is developing, what is going well and, if necessary, what is going less well and requires closer scrutiny.
I say to the noble Baroness, Lady Northover, that the amendments that she specifically puts forward are somewhat unusual. They seek to specify the way in which Parliament could exercise its powers to hold the regulations to account and, in essence, to appoint a joint Select Committee to take on the functions of the proposed council.
Amendments Nos. 165E and 165F appear to be particularly unusual. Their effect would be to turn the tables so that the Secretary of State, the National Assembly for Wales, the Department for Health in Northern Ireland and the Scottish Minister, could ask Parliament for advice; and it would be obliged to comply. That surely cannot be right. The noble Baroness forecast that I would say this, and I shall: it is for Parliament to decide whether it wants a joint health Select Committee. I can have no views about the rights
or wrongs of this particular means of improving accountability. That is a matter for Parliament and not the Government.I am concerned to see that regulators should be more effectively accountable to Parliament. I believe that the proposed council will, as I said earlier, enhance accountability to Parliament by helping it assess the performance of the regulatory bodies.
I do not think that the parallel with the Ecclesiastical Committee helps us. I never thought that I would discuss that committee on health matters. But my understanding is that its role is in the passage of Church of England primary legislation. That is very different from this new council which exists to promote best practice in regulation, overseeing the work of regulated bodies and helping Parliament hold them to account. Unlike the Ecclesiastical Committee, the council and the regulated bodies do not have powers to intervene in the making or amending of primary legislation. I would be happy to write extensively to the noble Baroness about the Ecclesiastical Committee if she would like me to.
Amendment No. 167—and indeed I think that I can now refer to Amendment No. 168 as well as Amendment No. 169—would take away the ability to modify the scope and functions of the council by a Section 60 order. I take the substantive point of concern of both the noble Baroness and the noble Earl about this matter—a feeling that the Government might be allowed to use this power to build up the council's power over time over the regulated bodies. But I would remind Members of the Committee that Section 60 is limited by some stringent safeguards provided in Schedule 3 of the Health Act 1999.
As a result of Schedule 3, as well as a stringent consultation and parliamentary approval process, the Government cannot abolish an existing regulatory body; they cannot impose a lay majority on an existing council; they cannot remove a function conferred on the Privy Council; they cannot remove core functions from existing regulatory bodies, such as keeping the register—I think that this is the answer to the noble Earl, Lord Howe—determining standards of education and training for admission to the profession; and administering procedures relating to misconduct, fitness to practise and similar matters.
It is not as though future changes to the council provided for here could diminish the independence of the regulatory bodies. We have also added a new safeguard in Clause 24(10) that an order about the council may not give the Secretary of State more powers over that council. I think that that preserves the independence of professional self-regulation fairly comprehensively.
Amendments Nos. 167 and 169 stop us modifying the council in any way without a new Bill. We could not clarify some of its functions. We could not remove a regulator from its scope. Although any new regulators set up would automatically come under its responsibilities under Clause 23(3)(j). We could not at some future date decide that the council's field of activity was too wide and remove a subject, say education, from its scope.
Amendment No. 168 removes the power in a future Section 60 order to take a regulatory body which had a mix of regulatory and other functions. The Royal Pharmaceutical Society of Great Britain and the Pharmaceutical Society of Northern Ireland are the current examples. We could not alter the mix of its functions which fell within the council's scope. It is logical to include that flexibility, although at present we have no plans to use it. By way of conclusion, I return to our great debates about Section 60, which was created to allow more flexibility in the workings of professional regulation. So far, we have introduced several orders covering medicine, dentistry, nursing and the allied health professions, all of which have benefited from those provisions. Given all the caveats and safeguards that I have mentioned, it would surely be odd if the council that brings all the professions together were to be the only one over which there could be no such flexibility.
11.15 p.m.
Baroness Northover: I very much regret the fact that we have reached this major part of the Bill for debate at this hour. I thank the noble Baronesses, Lady Carnegy and Lady Finlay, and the noble Earl, Lord Howe—not "the Eark Howe" described on the Marshalled List—for their careful exposition of the issues.
Healthcare professions have self-regulated since at least 1858. Precisely how we move forward to a more transparent and accountable system in the 21st century should not be decided at the tail end of the agenda late at night like this. I understand that the Minister may well feel demob happy as he nears the conclusion of the Bill's consideration in Committee, but I trust that on Report we shall have more thorough consideration of the issues involved. Meanwhile, I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendment No. 159B not moved.]
Next Section
Back to Table of Contents
Lords Hansard Home Page