Clause 25 - Supplementary lists
Health and Social Care Bill
4:00 pm
Mr John Denham (Minister of State, Department of Health; Southampton, Itchen, Labour)
This clause is about the regulation of practitioners who assist in the provision of primary care services, such as deputies, assistants and locums. They are an essential and sometimes unrecognised part of the primary care work force. It is estimated, for example, that they undertake 20 million consultations each year in general practice. They cover temporary vacancies arising from, for example, sickness, holidays or study leave. However, despite their crucial role, they are largely unsupported and unregulated. A locum can lead an isolated professional life. We want to attend to that gap by integrating them into the range of developing NHS support mechanisms. The list system will enable that.
I do not want to repeat earlier debates about the list system. Many of the same points that were covered earlier with respect to changes to the main list of GP principals apply also to the present topic. However, I need to make a few quick points. The list, together with provisions for the accreditation of out-of hours-providers, will ensure that GP co-operatives and deputising services, as well as mainstream practices, as it were, will have to employ doctors who are on health authority lists. It may interest the Committee to know that any general practice qualified doctor who works as a locum will be granted access to the NHS pension scheme on admission to the appropriate health authority list. It is our intention, subject to parliamentary approval of the regulations, to backdate the entry to the pension scheme to April 2001. We are discussing with the British Medical Association how that might be done.
Amendments Nos. 99, 110, 112 and 160 would provide for a new power of the Secretary of State to make regulations to prevent a person from withdrawing from a health authority principal, supplementary or services list during any period in which he or she was under investigation that might result in removal or suspension from the list. Some unnecessary provisions are also being removed. When considering an application to join a list, the health authority would be obliged to consider the facts underlying any previous decisions by other health authorities to remove the individual from a list. The fact of a previous incident would not, as we have discussed, automatically disqualify a person from admission to a list—unless a national disqualification had been imposed—but the health authority would be entitled to consider it as sufficient grounds for refusing an application.
Of course it would sometimes be advantageous for individuals voluntarily to withdraw from a list if they were under investigation or suspension, or had received notice of an intention to remove them—to avoid a health authority-imposed removal, which could rightly disadvantage them in attempts to gain a place on another list. Avoidance of enforced removal would mean that the individual would have nothing to declare to another health authority. That would be an unsatisfactory and inconsistent state of affairs.
Amendments Nos. 98, 109 and 111 deal with the fact that in the interests of limiting bureaucracy we do not want to force people who are on a health authority supplementary list to reapply periodically. If there are circumstances that warrant a removal based on elapsed time, for example, because a doctor has not worked as a deputy or assistant for a significant period, they can be prescribed in the regulations that will define the circumstances in which a health authority may remove a person from the list. The provisions are, therefore, unnecessary. I hope that that provides an adequate explanation of the amendment and a brief introduction to the purpose of the clause.