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Lord Hunt of Kings Heath: My Lords, I am glad to respond to a number of points that have been raised in relation to this group of amendments. I make it clear that Clause 26 is modelled on the powers which the ombudsmen have today. The regulatory bodies are not subject to any of the ombudsmen and, as they are not government bodies, it would not be right for that to be the case. But we look to regulators, as they reform themselves, to create effective ways of handling complaints. These provisions ensure that, only if it were necessary, the new council would be able to underpin that by taking its own action.
I was interested to hear the statistics that the noble Baroness, Lady Finlay, quoted concerning the number of complaints being heard by the GMC. There is no doubt that there has been a problem with a backlog of those complaints. We also have experience of complainants being left with very little idea of what is going on. While some delays have been unavoidable, they have often continued unexplained.
Therefore, a complaints system of the kind envisaged by the Bill would give members of the public an opportunity to press for an explanation in such situations. We envisage that it would cover such problems as advice which is misleading or inadequate, the refusal to answer reasonable questions, and avoidable delays. This is an area where the regulatory bodies, not just in health but also in other areas, have not always come up to scratch in creating a credible complaints system in which the public believe.
Amendment No. 83 would render such a complaints system toothless, but if we were to accept Amendments Nos. 75 to 81, in effect we would be saying that in relation to some areas of substantial importance the council should decide, rather than leaving such matters to regulations that Parliament can scrutinise. It is worth making the point that as part of the delicate balance, under this clause
regulations would be brought to Parliament under the affirmative resolution procedure. Ironically, the amendment, in seeking to take away some of the headings in the clause, would provide for less effective parliamentary scrutiny. I understand where the noble Baroness is coming from, but the affirmative resolution procedure is part of the balance we are trying to achieve between the individual regulatory bodies and the council itself.The noble Baroness asks me why we would want to specify in regulations who is entitled to complain and with what kind of complaints the council should deal. It is important not to open the gates to complaints by every person whose complaint against a practitioner is rejected by a regulator. I remember my noble friend Lord Turnberg warning against a system that simply provides an opportunity for every complaint, where the complainant is dissatisfied, automatically to come to the council.
We do not want to leave the council unable to filter the complaints it receives. However, we may want to be able to require the council to consider certain types of complaints. Amendments Nos. 78 and 79 deal with the procedures to be followed by those making a complaint and by the council in its investigation. It is proper to make regulations for those points. Parliament should have an opportunity to decide what aspects of procedure should be for the council and what should be for the regulations.
Amendment No. 80 seeks to exclude the Secretary of State from making regulations about confidentiality or disclosure of any information supplied to the council or acquired by it in connection with an investigation. Amendment No. 81 seeks to exclude the Secretary of State from making regulations about payments in relation to investigations.
We believe that it is more appropriate to have regulations that Parliament can scrutinise under the affirmative resolution procedure. The point that the noble Baroness, Lady Noakes, made about sensitive issues around confidentiality and ensuring value for money from payments suggests to me that they are better scrutinised by Parliament.
Overall, I recognise the points raised by both noble Baronesses and I recognise that there is a considerable amount of detail in Clause 26. At the end of the day, it leads to a proper balance between the individual role of regulated bodies, the role of the council and the role of Parliament in scrutinising this part of the Bill. Any complaints system that is appropriate, proportionate and sensible will be enhanced by greater parliamentary scrutiny.
Baroness Noakes: My Lords, I thank the Minister for his reply. He has portrayed a balance being struck between the council and Parliament. While there is the affirmative procedure, the Secretary of State in the first instance will decide what is to be done, after which Parliament will have a say. I am not entirely convinced that that is the right approach to this difficult and
sensitive issue, particularly in relation to confidentiality. I shall reflect further on what the Minister said. I beg leave to withdraw the amendment.Amendment, by leave, withdrawn.
[Amendments Nos. 76 to 83 not moved.]
7.45 p.m.
Baroness Finlay of Llandaff moved Amendment No. 84:
- After Clause 34, insert the following new clause—
The noble Baroness said: My Lords, in moving Amendment No. 84 I shall speak also to Amendment No. 93. This Bill covers England and Wales and many of the clauses concerning Wales are enabling clauses for the National Assembly for Wales. It is difficult to disaggregate the English and Welsh components in the Bill and even the contents page at the front of the Bill is not very helpful. My amendments do nothing at all to alter the law itself; they simply make the interpretation of the paperwork easier.
If we are to have openness in the legislative processes and procedures it is important that any student of law, healthcare, healthcare management or an interested member of the public can track the changes as they go from Parliament through to the National Assembly for Wales. In the future students of law may be pleased to have a table that allows them simply to track various parts of the Bill and match them up to legislation that passes through the National Assembly for Wales.
In Schedule 9 there is a table relating to legislation amended by this Bill and the table that I have proposed in Amendment No. 93 mirrors that in layout. I hope it will be equally helpful. It seeks to clarify for Wales what is pertinent to Wales. I hope that these amendments will allow for the documentation of the history of healthcare services as they evolve in Wales under the direction of the National Assembly for Wales. I beg to move.
Baroness Farrington of Ribbleton: My Lords, I am extremely grateful to the noble Baroness, Lady Finlay, for raising this important issue. I can happily give her my assurance that a summary of the effects of the Act in relation to Wales will be included within the accompanying Explanatory Notes. Since 2000 the Government have produced Explanatory Notes to accompany new Acts.
The laudable aim of Amendments Nos. 84 and 93 is to provide a clear indication of those sections of the Act that will have effect in Wales but, as the noble Baroness recognised, they have no legislative effect. Therefore, under normal parliamentary practice it would be inappropriate to include them on the face of the Bill. The schedule is informative of new law made
We accept the reasoning behind the amendment but believe that the insertion of such a new clause and schedule is not the most appropriate way to meet the wishes that lie behind these two amendments. Of course, we shall provide information within the Explanatory Notes.
For the record—this is an example of why it is less appropriate to include such a provision on the face of the Bill—the reference to Section 8 is incorrect and the amendment made by Clause 2 of the Bill to Section 16A of the 1977 Act unfortunately has the effect of repealing the PCT legislation in Wales. It is quite difficult to achieve what the noble Baroness seeks on the face of the legislation. However, we fully accept the points that lie behind her amendments and I am hopeful that she will recognise that we have met her concerns in full.
Baroness Finlay of Llandaff: My Lords, I am extremely grateful and absolutely delighted to have that reassurance from the noble Baroness, Lady Farrington. I fully understand why the table that I have outlined will be more helpful in the Explanatory Notes. I am delighted and I thank the Ministers for having considered and for having incorporated the spirit of my amendment. I beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendments Nos. 85 to 90 not moved.]
Baroness Northover moved Amendment No. 91:
The noble Baroness said: My Lords, I moved a similar amendment in Committee, arguing that historical accident had dictated to the balance of numbers representing the different professions on the council. The Minister in effect acknowledged that that was the case and agreed that it was a minefield. I fully accept the difficulty, but I point out that not all the regulatory bodies are happy with the resolution, which may well lead to problems down the track.
My solution is to expand a part of the council, but I fully recognise the difficulties that the Minister faces. I simply seek a reassurance that the matter will be kept under review. I beg to move.
"SUMMARY OF THE EFFECTS OF THIS ACT IN RELATION TO WALES
The effects of this Act in relation to Wales are set out in Schedule 7A."
Page 88, line 34, leave out "regulatory body" and insert "of the regulatory bodies referred to in section 23(3)(a) to (h)(i), and three members appointed by the regulatory body referred to in section 23(h)(ii) or the successor regulatory body (within the meaning of Schedule 3 to the Health Act 1999 (c. 8)) to the Council for Professions Supplementary to Medicine (the Health Professions Council) established by order in Council under section 60 of that Act"
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