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The noble Baroness, Lady Barker, is completely correct that this does not necessarily mean a deprivation of liberty. It might be one of a range of circumstances, as she said, which are about safeguarding people’s interests. Best interests assessors can be social workers under Regulation 5(2)(b) as long as they are not already involved in the person’s care, which is to ensure independence and ECHR compliance. The noble
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I will return to the issue of independence. I looked at the code of practice to reassure myself that it was comprehensive. I will not take the House’s time by reading paragraph 4.13, but it has a very comprehensive list that is there to ensure that assessors are indeed independent and will give an independent view.
I hope that I have covered most of the points, but if I have not, I promise that I shall write to noble Lords. As I said in my opening speech, these safeguards provide important protection for some of the most vulnerable people in our society. By setting out the requirements relating to the assessment process and assessors, the information required for standard authorisations and arrangements for authorisation where ordinary residence disputes take place, these regulations will help to ensure that supervisory bodies and managing authorities have the information that they need to implement the safeguards in a safe and effective way.
On Question, Motion agreed to.
Health Care and Associated Professions (Miscellaneous Amendments) Order 2008
2.10 pm
Baroness Thornton rose to move, That the draft order laid before the House on 4 June be approved.
The noble Baroness said: My Lords, this draft order is the second in a series of affirmative resolution orders. These form part of the Government’s reform and modernisation of the regulation of the healthcare professions. Noble Lords will be familiar with this and may recall that we debated similar reforms in respect of the Nursing and Midwifery Council early last month.
The aim of the reforms is to enhance public confidence in the ability of the healthcare regulatory bodies to protect the public interest and to deal with poor performance and professional standards. Public concerns and doubts based on perceived partiality of the regulators have threatened to undermine patient, public and professional trust in the system of professional regulation. These concerns have been highlighted by a number of high-profile inquiries, with which, by now, the House will be familiar.
The order is part of the process of implementing the recommendations of those inquiries. It makes various amendments to the framework legislation for the regulation of doctors, opticians, osteopaths and chiropractors. The main changes relate to the governance arrangements of the General Medical Council, the General Optical Council, the General Osteopathic Council and the General Chiropractic Council. Those changes include: moving each of those bodies from a partially elected to a fully appointed council, in response to the recommendation from Dame Janet Smith that professional interests should not unduly influence council members; members to be appointed by the independent Appointments Commission against specified skills and competences; provision for a separate constitution order to specify the numbers of lay and professional
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The order makes a number of other miscellaneous amendments. I will outline those most worth noting. For the first time, each council’s annual report will have to include a description of the arrangements that the council has put in place to ensure that it adheres to good practice in relation to equality and diversity. Each regulatory body will be able to strike off registrants who are barred from working with children or vulnerable adults when the new independent barring board is established. Finally, the GMC will be able to register anyone whom it considers suitably experienced as a doctor—such as recently retired doctors—in an emergency such as pandemic flu.
There are special arrangements for the registration of osteopaths and chiropractors with older UK qualifications that are not recognised under current legislation. This change is made at the request of the two regulators concerned and will enable them to make rules to deal with some practitioners who did not benefit from the original transitional provisions that enabled such people to register at the time their registers were first opened. All these measures are supported by each of the regulatory bodies covered by the order and I commend them to the House. I beg to move.
Moved, That the draft order laid before the House on 4 June be approved. 21st Report from the Joint Committee on Statutory Instruments.—(Baroness Thornton.)
Earl Howe: My Lords, I thank the Minister for introducing this order, which for us on these Benches is not a matter of controversy, as its content has been the subject of extensive consultation and debate outside this Chamber as well as within it. As the Minister has helpfully explained, the order covers four or five main subject areas, as well as a number of subsidiary ones, which I will not repeat.
I welcome in particular the changes to the powers of the GMC in relation to medical education. This is not something that we have debated previously. Up to now, the Medical Act has contained a list of bodies entitled to hold qualifying examinations. Any changes to that list have needed an amendment to the Act, which is extremely cumbersome, as well as approval by the Privy Council. The order removes the list from the Act and gives responsibility to the GMC to maintain and publish the list of recognised institutions. I welcome that change. We should, of course, note that it will not in any way affect the standards that medical schools are required to meet or indeed the standing of the education committee of the GMC. I do not personally
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2.15 pm
Perhaps I could conclude briefly with some questions. The order provides for the GMC to keep an emergency powers doctors list, which will allow for suitably experienced people to help as doctors during an emergency. It would be helpful to hear from the Minister what “suitably qualified” means here and whether it has been defined in any detail. I understand that this provision is part of a package of measures that would enable the Government to respond flexibly in an emergency, but I wonder whether the Minister could say something about the safeguards governing the use of such powers.
The order also proposes the reconstitution of the GMC, the General Osteopathic Council, the General Optical Council and the General Chiropractic Council as fully appointed bodies, with all councils having parity of membership between lay and professional members. Can the Minister say how the Appointments Commission will be advised about the professionals who are to be appointed? How exactly will that nomination process work and to what extent will the GMC be able to set the criteria on which potential appointees are chosen?
Finally, when will the order be reviewed to establish whether it is having the desired effects? It is quite important that such a review should take place after a suitable interval, although I do not doubt that any problems with the order’s implementation will come to the surface naturally. However, we need to assess in a formal way the costs and benefits of implementing it. Some of the provisions are likely to show a welcome saving in terms of costs, but others may result in the opposite, and we need to take stock of those.
Baroness Barker: My Lords, like the noble Earl, Lord Howe, I do not wish to repeat debates that have been held in this House extensively over the past two years in the light of Dame Janet Smith’s major report. It is worth noting that these orders reflect a high degree of consensus among the professions about how they need and wish to change to ensure that the standards of practitioners within their different professions are not only maintained but extended.
I agree with most of what the noble Earl, Lord Howe, has said. I do not wish to repeat it. I simply wanted to ask three questions. First, under the GMC’s powers to approve doctors, who will be able to practise in times of emergency? Will there be a fitness-to-practise process through which they will have to pass to be on a list in advance of an emergency? Secondly, will those powers deal with qualified doctors who are asylum seekers in this country—an issue that has been raised in your Lordships’ House on different occasions—and with whether they would be allowed to practise in a time of emergency? I very much welcome the requirement of the councils to reflect diversity in their make-up.
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Finally, I echo a point made by the noble Earl, Lord Howe. We are going through a major change in the regulation of professionals. Welcome though that is, the momentum behind it was a terrible scandal, in which hundreds of people died. The process of review is important. We never again want to be in a position where a scandal of that magnitude is required to make revisions that are deemed necessary. It is also the case that, whenever there is major change, there will be unintended consequences. The enthusiasm of the professions may wane when these orders are enacted. Can the Minister be a bit more definite than she was on the last order about the timescale of a review? It would be advisable to have a review within three years of these arrangements.
Lord Colwyn: My Lords, I am feeling rather left out of this order. I am probably the only person in the Chamber who does not know the answer, but can the Minister tell me why the Dentists Act is not involved at this stage? I had a useful conversation with the Department of Health about 10 minutes ago and I gather that similar changes are subject to another Section 60 order, which will be laid at a later date. It is something to do with the Scottish Parliament and the devolution settlement. Can the Minister tell me when that is likely to happen and why amendments to the Dentists Act are different?
Baroness Thornton: My Lords, I thank the noble Earl and the noble Baroness for their welcome for this order and their constructive comments. I hope that I can answer some of their questions more definitively than on the previous order. Who will be on the panel making the new appointments is a matter for the Appointments Commission and the regulatory body to determine. The usual practice will be for a panel of three members, although in some circumstances there may be more—for example, when they are appointing a chair. The panel will consist of the Appointments Commission, an independent assessor and someone nominated by the regulatory body. It will make appointments in consultation with the regulatory body.
In 2011, there will be a review of the governance arrangements of all these regulators. The noble Baroness, Lady Barker, was quite correct in her remarks.
The temporary registration of suitably experienced doctors in an emergency is an issue that we will take forward with a protocol. It will be developed by the GMC and there will be no statutory definition. In relation to asylum seekers, it has not yet been decided who will be registered under these provisions, although recently retired doctors are the most obvious candidates. It has not been decided to rule out doctors from overseas who have not yet been through the registration process, but neither has it been decided to rule them in. That is still a matter for discussion.
A variety of other questions is also being discussed, including whether the GMC will be looking at part of the protocol and how it will develop this in terms of gaining EU practices to operate elsewhere. All those things still have to be discussed as part of that protocol.
There will be a separate order covering the General Dental Council, the Health Professions Council and
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On Question, Motion agreed to.
Education and Skills Bill
2.25 pm
The Parliamentary Under-Secretary of State, Department for Children, Schools and Families (Lord Adonis): My Lords, I beg to move that the House do now again resolve itself into Committee on this Bill.
Moved accordingly, and, on Question, Motion agreed to.
House in Committee accordingly.
[The DEPUTY CHAIRMAN OF COMMITTEES (Viscount Simon) in the Chair.]
Clause 11 [Educational institutions: promotion of good attendance]:
Baroness Sharp of Guildford moved Amendment No. 62:
The noble Baroness said: In Committee on Tuesday, we discussed Clause 10, which places a duty on local authorities to make sure that young people who have a duty to participate in education and training between 16 and 18, as mentioned in Clause 2, fulfil their duties. Clause 11 puts a duty to promote good attendance on schools within the local authority remit. It will never be enough just to put the duty on young people to attend education and training. Someone—the local authority—has to keep an eye on what they are doing and encourage them to attend. The purpose of these amendments is to extend the duty from what is mentioned in Clause 11(2)—community, foundation and voluntary schools, community or foundation special schools, pupil referral units and institutions within the further education sector—to city technology colleges, city colleges of technology of the arts, academies and independent special schools under Section 342 of the Education Act. If young people choose to carry out their duty to participate in any of these establishments, it is not unreasonable to put a counterduty on the schools to promote their attendance. If state-maintained community schools, PRUs and colleges, as well as foundation schools, have to do it, then why not others? They are all subject to inspection, so why should they escape this duty? It is inconsistent that they should do so. Therefore, Amendment No. 62 places educational institutions in the private sector within Clause 11, Amendment No. 63 places this duty on independent special schools, and Amendment No. 64 puts the duty on academies.
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In reference to Amendment No. 63, the Minister in another place suggested to my honourable friend Mr David Laws that the Government would consider including this duty in relation to special Section 342 schools, but nothing has been tabled. With regard to Amendment No. 64, can the noble Lord tell us the situation with regard to academies? I suspect that he will say that the matter will be addressed in their funding agreements. However, as he will know very well, those agreements are available only when they have been finalised, are not open to consultation and are not easily changed. I cannot see how such a duty would curtail the freedoms that the Government are so keen to give those schools, so that cannot be the logic behind their exemption. In Clause 12, academies and city technology colleges are included, so what is the logic behind this exemption? In a previous answer, the Minister said that he felt that we could leave the CTCs and CCTAs to their own devices.
It is not normally the Government’s practice to leave to chance the implementation of one of their flagship measures, so how can the Minister be so confident? Indeed, why employ an army of civil servants to rewrite the funding agreements of academies and city technology colleges when it would be much simpler to add those sorts of schools to primary legislation? I beg to move.
2.30 pm
Baroness Morris of Bolton: As the noble Baroness, Lady Sharp of Guildford, explained, the amendment expands the list, including special schools, of institutions that are expected to promote good attendance. There seems to be no good reason for leaving them out of the Bill, but I shall listen to the Minister with interest to hear why he thinks that it is not necessary, especially for special schools.
Lord Adonis: First, Amendment No. 62 would add “proprietor” to what Clause 11 refers to as,
I can tell the noble Baroness, Lady Sharp, that the amendment is unnecessary because the institutions listed in Clause 11 are in the maintained sector, so the governing body is in fact the proprietor. On Amendment No. 63, which would include non-maintained special schools under the clause, we considered that question, as we said in another place that we would, and we agree that it is important for non-maintained special schools to be subject to that duty. Having considered how that can best be done, we have concluded that the policy aim would be better achieved by enacting regulations under Section 342(2) of the Education Act 1996. I can confirm to the Committee that we will do that, so we will meet the point raised by the noble Baroness.
In respect of Amendment No. 64 concerning city technology colleges, the one city college for the technology of the arts and city academies, academies are required through their funding agreements to have regard to the same guidance as maintained schools on improving behaviour and attendance. The handful of remaining city technology colleges and the one city college for
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Lord Elton: I hope that the Minister will forgive my ignorance, but I am a little surprised by subsections (2)(a), (b) and (c), because I would have thought that those bodies would already be under a statutory duty to, as far as possible, encourage attendance at their place of work. Am I wrong? If I am, should that duty not be extended downwards to below the age of 16?
Lord Adonis: The duty does extend downwards, but it is covered by different legislation; I believe that that is the answer to the noble Lord’s point.
Lord Elton: But if these bodies are under a duty to get their students to attend up to the age of 16, does the legislation specifically have a cut-off—I suppose because that is the end of compulsory education? I may be delaying the Committee unnecessarily, so if I am right, the noble Lord need not reply; if I am wrong, he can write to me.
Lord Adonis: I believe that that is precisely the case.
Baroness Sharp of Guildford: I think that the clause creates some anomalies. It is slightly odd that in supplying information under Clause 13, “Notification of non-compliance with duty imposed by section 2”, subsection (5) lists city technology colleges, city colleges for the technology of the arts and academies. I agree with the noble Lord, Lord Elton, that if the duty is already there on schools it is otiose to have this extra clause, but if we are to have it, those institutions should be required to supply the information.
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