Orders of the Day — MEDICAL BILL [Lords]
Mr Robin Hodgson (Walsall North)
This amendment would delete Clause 3, the purpose of which is to set up branch councils under the General Medical Council for England, Wales, Scotland and Northern Ireland. We seek further elucidation on this matter because we are not entirely satisfied with the proposals. We are not satisfied for four main reasons.
First, there is the question of the increase in bureaucracy that may result. We have had a long and, at times, turbulent debate on the National Health Service this evening. Both sides of the House have commented on the tendency of administrators and bureaucrats within the Health Service to proliferate. I know that we are dealing with the General Medical Council in this clause, and this Bill, but we wonder whether a similar tendency might not take place there as well. On this ground at least, we feel that the clause is too widely drawn.
Secondly, we consider that the clause is not needed. There is no demand for it. England and Wales already have had one branch between them. The council for Scotland has been purely formal and meets once a year. There has been no demand from the membership or from Scottish doctors to increase the number of meetings. The Northern Ireland council will be new. So why go to all this trouble?
Thirdly, we oppose the clause on the ground that it is not effective. I draw attention to the unevenness of the constituencies that will be represented by the councils. Professor Merrison's report points out that there are 63,000 doctors in England, 4,000 in Wales, 10,000 in Scotland and 2,000 in Northern Ireland. That must surely lead to extremely ineffective and uneven branch councils representing hugely different numbers of doctors.
Fourthly and finally, my hon. Friend the Member for Reading, South (Dr. Vaughan) and the hon. Member for Berwick-upon-Tweed (Mr. Beith) mentioned the question of cost. The setting up of the four additional branches potentially will lead to unnecessary expense.
Some of these arguments were made during the Second Reading debate upstairs. The Minister then said:
We are empowering the General Medical Council to set up these councils. They will have to be set up under the Bill, but the GMC will decide, in the light of practical requirements, whether the branch councils will be used. It will decide that in the light of pragmatic experience. If it comes to the conclusion that there is no justifiable need for the branch councils, it need not use them."—[Official Report, 22nd February 1978; Vol. 944, c. 1669.]
The Minister seemed by that to undermine the argument for setting up the branch councils. He was dismissive about my speech in the debate on the NHS earlier this evening. I shall now be dismissive about the logic with which he justifies Clause 3.
Mr David Crouch (Canterbury)
I disagree with my hon. Friend. I have consistently disagreed with my own party on the question of devolution, This is a clause which reflects the views expressed by my friends in the other place, who have shown a wisdom about devolution which has not been reflected on this side of the House during recent debates.
This anticipates the future. It might lead to a little more expense. I am not so much concerned about the expenses of the GMC as I am about doing the right thing. These branch councils will not be so wrong if they represent England, Wales, Scotland and Northern Ireland, notwithstanding the enormous differences between those divisions of Great Britain. The numbers game means nothing at the moment because we are not considering a federal separation of the United Kingdom. We are considering the possibility of its separation into its historical parts, which are mentioned in the clause.
I advance these opinions without having heard the opinions that were expressed in Committee on this matter. I was not there on the day that this matter was considered. Without wishing to express a divisive opinion, I think that there is some wisdom in what is suggested in the clause. It is because of my deeply held views about the future shape of the United Kingdom, about its being kept together in these historical parts, that I believe that the GMC would not do wrong to follow what I am suggesting.
Mr Laurie Pavitt (Brent South)
I do not wish to anticipate the words of my hon. Friend the Minister of State, but I welcome the intervention of the hon. Member for Canterbury (Mr. Crouch). In the GMC a few years ago there was a loss of a good deal of confidence when doctors were threatening to withhold their fees. A wide gap was developing between the registered practitioner and the council that was governing him.
In bridging that gap we must seek all the time to secure greater participation by practitioners. In that sense practitioners must feel that they are part and parcel of the council. They should not feel removed from it and, therefore, the location of branch councils in Belfast and Edinburgh, for example, is preferab1e to the council being tucked away down in London. On that elementary ground, I welcome what was said by the hon. Member for Canterbury.
Mr Roland Moyle (Lewisham East)
I do not want to debate the pros and cons of devolution in a discussion of the Medical Bill. I say only that we do not know what the future of these matters will be. Both the major parties and the Liberal Party are in favour of a devolved Government in Northern Ireland. There will probably be referendums in Scotland and Wales on the future of devolution there. We must therefore provide the medical profession with the opportunity of setting up whatever machinery it feels to be necessary to meet any situation that might arise.
There are three branch councils at the moment, and they are being increased only to four. It seems that the logic of the situation is to accept that we are dealing with a responsible profession and that therefore, we should give it the full powers to react to any constitutional situation it might have to face by setting up branch councils if necessary. We then say that if a different constitutional or administrative situation arises and the GMC does not want to use the branch councils, it will be empowered not to do so.
Since the Government's position, from the point of view of the medical profession, is more flexible than that proposed by the hon. Member for Walsall, North (Mr. Hodgson), I commend our view of the clause to the House.
Mr Robin Hodgson (Walsall North)
I hope that before the GMC sets in train this extension of the number of branch councils it will think carefully about it because of the cost, the bureaucracy and so on. However, in view of the Minister's comments, I beg to ask leave to withdraw the amendment.