Schedule 7 - The Council for the Regulation of Health Care Professionals
NHS Reform and Health Care Professions Bill
11:30 am
Dr Evan Harris (Oxford West and Abingdon, Liberal Democrat)
The hon. Gentleman asks you, Miss Widdecombe, how you would calibrate it. I think that you would find it very difficult. I am seeking to accept some of the Government's arguments that representation on this new council cannot be according to health care profession. First, the new council would be large and unwieldy; and secondly, it would still not be proportionate to membership. Of course, I accept that. This is a probing amendment to find out where the Government want to go with regard to the future structure of these councils and whether they recognise that this is a consequence, albeit an unfortunate one, of the fact that one health care profession has a separate council, whereas another regulatory council covers a wide range of organisations.
In an earlier debate the Minister implied that because the proposed council will represent the regulatory functions of the councils that look after all these professions, there is no reason that representation will be any different in its quality or its stress, whether it represents a physiotherapist, a clinical scientist or a podiatrist. Many of those covered by the CPSM have argued that there is a different culture in those professions and that regulation is effectively a compromise between them. That is why there has been such a strong call for uni-professional bodies dealing with education and training.
The Minister will have to accept that because of the structures and the constraints that we are under, something may well be lost and he may need to offer some reassurance that the council will be looking mainly at issues that are unlikely to be affected by the profession of the representative on it. Indeed, the Government might argue that some issues involving best practice will be so clear and obvious that they could be adequately represented by lay members nominated to the council from the regulated councils. I am not saying that an issue need to be simple so that lay members can understand—I hope that I am not misunderstood on that point—but that something that is core to the regulation does not require professional input.
Another question that this debate raises is that when new professions are brought in, they will be under some incentive to have their own council, rather than join the health professions council, as it is soon to be, because they feel that their professional interest, which is already diluted on the council—chiropodists certainly see it that way—will be further diluted on the new council. That may cause difficulty in the speed with which we would want to ensure that there is adequate protection of title, and therefore public protection by regulating the new professions.
Through this amendment, I want the Government to accept that there is no perfect way of doing this given the asymmetry of the current councils. The councils regulate issues such as education and training, which are different in the various professions in the CPSM, on which they take advice from professional advisory committees. Those professions should not be subject to direction or suggestion from the council without wider consultation with the health care professions. The specific issues associated with physiotherapy and chiropody are different from those associated with the clinical sciences. I hope that the Minister has understood my point.
If it meets the Committee's wishes, it may be appropriate to discuss the other amendments. I have appended my name to amendment No. 188, which was tabled by the hon. Member for North-East Hertfordshire and his colleagues. They may feel that the issue has been tackled by Government amendment No. 203. If that is the case, it shows that the Committee can be of some use, which is something that I welcome.
Amendments Nos. 189 and 256 seek to probe the Government on the balance between council members, who are members of the council nominated by the regulatory councils, and the number of Government appointees, albeit that if Government amendment No. 203 is passed Government appointees will be mediated through the NHS Appointments Commission. Government amendment No. 203 provides reassurance for those who are worried that an automatic Government majority, if one includes those appointed by the devolved powers, goes too far in undermining the independence of the regulation of health care professions given the wide directional powers in clause 25.
In earlier sittings, I asked the Government whether they were certain that the protection of patients and the public could better be provided by professional self-regulation than by Government regulation, and the Minister indicated that that was the case. Although I understand that the idea of the council is to identify best practice and to promote the interests of patients and the public, it is still unclear whether that cannot be done with a council the majority of whose members are appointed by the councils. The members may not all be professionals but the councils should appoint the majority. For the council to be effective, it must have the confidence not only of the public and Parliament, but of the professions. If the status quo ante is a professional majority, or at least a majority appointed by the councils regulating the professions, the Government must show a need for that to change to a minority appointed by the councils. I hope that the Government will set out why they feel that that must be the case.
Amendment No. 226 seeks to ensure that some regulations that the Secretary of State may lay to provide for various functions are subject to positive resolution procedure. In earlier sittings I suggested to the hon. Member for North-East Hertfordshire that there were some regulations that it would not be appropriate to die in the ditch over. This type of amendment allows Opposition Members to make a stand because it is in these sensitive areas that positive scrutiny by both Houses of Parliament would be most useful.
Government amendment No. 205 and amendment No. 187, which has become a quasi-Government amendment, seek to reduce the Secretary of State's powers to give directions to employees. I suspect that those amendments will be widely welcomed, and I certainly welcome them.