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Lord Clement-Jones: My Lords, I thank the Minister for giving way. I well understand the Minister's argument about the need for flexibility. That is desirable. The purpose of the amendment was to tease out from the Minister whether it might be possible for guidance to be given in the period of 18 months before the funding is no longer available for the implementation officer.
Lord Filkin: My Lords, clearly, when sufficient time has been allowed to make a sober and sound assessment of the effectiveness of low vision committees, the Government will be in a position to act in that way if they feel it appropriate. However, I do not think that we are in that position at this time which is why we believe that the useful experiment should continue and be properly evaluated.
Lord Clement-Jones: My Lords, I thank the Minister for that reply. I believe that there is a germ of satisfaction in there in so far as the Minister seemed to say that, without commitment, the resource could be made available at the end of the implementation period.
Lord Filkin: My Lords, I do not recollect mentioning resources.
Lord Clement-Jones: My Lords, I do not think that the Minister could have said that at the end of the 18 months period there would be an ability to issue guidance or to recommend a way forward unless there were the resources to back that. It would be rather negative to issue guidance without the resources to support it. Perhaps I am reading too much into the Minister's words. Perhaps it is perfectly usual for departments to issue guidance without any resources to support it.
Lord Filkin: My Lords, I am afraid that that has often been known to happen on the part of governments of all parties.
Lord Clement-Jones: My Lords, I am afraid that the Minister issues me with even more of a dud cheque than I thought he had in the first place. I shall take what satisfaction I can from what he had to say. It is a little unfortunate that, despite the arguments about flexibility, we are in a sense in a phase where certain approaches are being explored. Low vision committees are being set up and evaluated. However, the statutory authorities are not in every case being as "come hither" or as pro-active as they might be. That is the key concern of those in the voluntary sector who support the amendment. Even if the Minister cannot be more positive at this stage, perhaps he will take away the proposition that some guidance or some further encouragement to the statutory sector might be appropriate. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 23 [The Council for the Regulation of Health Care Professionals]:
Baroness Northover moved Amendment No. 62:
- Page 29, line 17, leave out subsection (1) and insert—
The noble Baroness said: My Lords, in moving Amendment No. 62, I wish to speak also to Amendments Nos. 63 to 65 and 67 to 72. We are now moving on to consideration of the regulation of the medical professions. This is a major area in the Bill. It is here that we have the proposal of a lay dominated overarching committee with in effect control over the health professions. That is a change which should be made after full consideration of what we are doing, why and whether that is the best way to proceed.
When we considered this matter in Committee, we started at 10.45 p.m. on Thursday 11th April and we concluded our session at 12 minutes past midnight on Friday 12th April. That is not a recipe for careful and considered appraisal of what is a major change in the accountability and arrangements which have been in place for the health professions in some cases for well over a century and a half. I hope that we shall be better placed today to do this subject justice. We are again at the tail end of the Bill as before, but the hour is not quite so late.
The medical profession was the first to professionalise, with others following later. Self-regulation has always been part of that. There are pros and cons to that and I have no problem whatever with the notion that at the beginning of the 21st century we should reappraise that. Professor Kennedy's report on Bristol and his proposals for linking the professions have acted as a catalyst for that and must be seriously addressed. I welcome the fact that the various professions have played a full part in such discussions. Co-ordinating standards, spreading good practice and monitoring performance, as suggested by him, are all worthwhile objectives. It is clearly also vital that the various health professions should be more accountable and more transparent as well as better co-ordinated.
The Kennedy report proposed that an overarching council should report directly both to the Department of Health and to Parliament and should have a broadly-based membership, including representatives of the health professions of the NHS and the general public. It is now up to us to assess whether, with this blueprint, the Government have now come forward with a sensible proposal.
As I mentioned previously, there is a danger that the Government are proposing a quango to second-guess what the regulatory bodies are doing without the depth of knowledge and experience that they have. We are in serious danger of bogging down this council in looking at endless complaints against the profession by jaundiced patients even if the council then rules the complaints not worthy of further consideration.
However, we agree that in addition to co-ordination and a spread of good practice the time has come for greater accountability of the professions to the public and for there to be greater transparency. In that respect we agree with the Government although, conspicuously, the Minister trod very gently around the subject in Committee.
It is not enough for the Minister to argue, as he did in Committee, that Select Committees can call the various regulators before them. We need a more systematic way of ensuring accountability on a regular basis and not simply when things go wrong. We retain serious doubts about making the health profession accountable to yet another quango. The Government's proposal does not make each of the professions answerable to Parliament. As the noble Earl, Lord Howe, said, all is done at one remove via the council. Such accountability should surely be by the shortest route and enable each regulatory body to be cross-examined.
Therefore, we propose that those bodies which regulate the health professions should be accountable directly to Parliament. We propose that the health bodies should report each year to a Joint Select Committee appointed by the House of Commons and House of Lords. They should report in public and that is where they should answer and be scrutinised.
The Minister said that the Government have no power to request the establishment of such a committee. I thank him for the letter he sent me on the matter which unfortunately arrived after the deadline for amendments. However, he had made clear his views in Committee. I submitted the amendments, therefore, in the knowledge of where he stood. The Minister said that he can have no view on the idea of a Select Committee as he cannot dictate what Parliament does or does not do. That is true enough. But, as he knows, that is not the whole story. After all, the Government could bring forward such a proposal to be debated in both Houses which could decide to set up such a Joint Select Committee. Select Committees are set up through the usual channels. We all know what the usual channels are and they do not exist in isolation from the political parties or government. A "usual channel" is sitting on the Front Bench. I served on a Select Committee on stem cell research.
Lord Carter: My Lords, by definition the usual channels are not defined.
Baroness Northover: My Lords, I shall now not see the noble Lord sitting there!
The proposal that the Select Committee on stem cell research should be established was put forward by the noble Lord, Lord Walton of Detchant, and agreed by this House—no doubt not by any "usual channels". The Select Committee was set up. There are ways of doing things. In many ways, what I am laying down is the principle of the kind of arrangement that we should like to see: an arrangement which allows for the direct
We have in the new document, Delivering the NHS Plan, which the Minister must heartily wish had been issued after rather than before the debates on the Bill—
Lord Hunt of Kings Heath: My Lords, I must respond to that. I am delighted that the plan was issued. I believe that it has informed our debates. As we have seen with the decision about the appointment of a chair to the national patient and public involvement commission, we have been able to move the agenda on in the light of that reform.
Baroness Northover: My Lords, I thank the Minister. It has informed our debates. It has been most encouraging to see all the skittles falling as we come to Report stage. I am pleased to see that annual reports to Parliament from bodies are mentioned in the new document. It also refers to high national standards and clear accountability, so perhaps we are moving in the same direction.
In Committee, the Minister said that a balance must always be held between professional self regulation, parliamentary accountability and the public interest. I agree. However, I argue that we achieve that more effectively through our proposals than through the proposed council. I beg to move.
Lord Hunt of Kings Heath: My Lords, the amendments turn on the accountability to Parliament of professional regulatory bodies. In so doing, they would do away with our proposed new council for the regulation of healthcare professionals and propose that many of the functions that we intended for the council should be given to a health Joint Select Committee if Parliament should decide to establish such a committee.
Following the interesting comments of the noble Baroness, perhaps I may take this opportunity to spell out how the accountability regulations would work under the Bill. The council will be accountable to Parliament. Schedule 7 to the Bill obliges it to lay a report before Parliament each year. It is explicitly stated within that schedule that it must also provide Parliament with a special report on any matter which Parliament asks it to. It must also lay its accounts before Parliament.
The noble Baroness raised the issue of direct accountability of individual regulatory bodies. Those bodies themselves have long been accountable to Parliament in the sense that Parliament can ask them to provide evidence, for example, to departmental Select Committees. It has done so on a number of occasions in the past few years. The Bill changes none of that. Regulatory bodies will, I am sure, in their individual capacity, continue to be called before Select Committees and the Government very much welcome that.
The Bill 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.
The amendments are somewhat unusual. Amendments Nos. 71 and 72 seem to turn the tables. In effect, as drafted the amendments provide that the Secretary of State could ask Parliament for advice and Parliament would be obliged to comply, which is an unusual turn of events. Of course, we want proper accountability to Parliament. There is no question but that the new body will have the responsibility of reporting. Parliament must then decide how it will wish to call in such a body. We already have Select Committees. If Parliament decided to create new Select Committees the commission could be called in to give evidence. However, as I have said on a number of occasions, it is not for the Government in the form of a Bill to dictate to Parliament how it should discharge its responsibilities.
"(1) The bodies referred to in subsection (3) shall in each year submit a report to any joint select committee appointed by the House of Commons and House of Lords to perform the functions prescribed in this Part ("health joint select committee")."
7 p.m.
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