Orders of the Day — Medical (Professional Performance) Bill

Part of the debate – in the House of Commons at 5:45 pm on 25 April 1995.

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Photo of Mr Roger Sims Mr Roger Sims , Chislehurst 5:45, 25 April 1995

I listened with interest to the hon. Member for Newcastle upon Tyne, Central (Mr. Cousins) who raised a number of points with which I have some sympathy. Indeed, in the past year, I have had some correspondence and discussions on minimal invasive surgery and the relationship between the General Medical Council and the royal colleges, but I am not sure how far those issues impinge on this relatively narrow Bill. No doubt we will have the opportunity to explore them on another occasion.

Before I go any further, I should declare an interest as a member of the General Medical Council. I thank my right hon. Friend the Secretary of State for her kind remarks earlier in the debate, but I must also declare an interest in the conventional House of Commons sense in that, as is recorded in the Register of Members' Interests, I receive an honorarium from the GMC in recognition of my work as a lay screener, to which I shall refer later.

I suspect that most of our constituents are pretty hazy as to exactly what the GMC is, what it does and what the difference is between the GMC and the British Medical Association. As recently as last Thursday in the privileges debate, a distinguished and senior hon. Member, while floating the idea of professional self-regulation among Members of Parliament, twice referred to the BMA and its control over doctors.

Of course, the BMA is a trade union of professional people, which doctors are free to join or not as they wish. It is not comparable with the GMC, which was, as we have heard, set up by statute. If I may just correct the figures that my hon. Friend the Minister for Health inadvertently gave a few moments ago, I think that I am correct in saying that, of its 102 members, 54 are elected by their fellow doctors, 35 are appointed by the royal colleges and universities and there are 13 nominated lay members.

As we have heard, there are proposals in the pipeline to increase the lay membership. Those lay members include the hon. and learned Member for Montgomery (Mr. Carlile), who was appointed with me to the GMC in 1989. I know that he would have wished to be here today if other commitments had not precluded that. At that time, no Labour Member was appointed, but we were pleased to be joined last autumn by the hon. Member for Gower (Mr. Wardell) who has already intervened in our debate.

The key to understanding the role of the GMC is that the person who in other organisations might be described as general secretary or chief executive bears the title of registrar, for the very good reason that he is responsible for the register. It is he who keeps it, and no doctor can practise unless his name appears on that register.

The General Medical Council lays down the curriculum for medical training and monitors the work of medical schools. It satisfies itself as to the quality of medical education and it accepts on its register only men and women with the appropriate qualifications. It also has other duties. It recognises—or refuses to recognise—medical training in some places overseas and decides whether doctors trained overseas can practise in Britain with or without conditions. Those are matters outside the Bill, but I can assure my hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) that a test known as the PLAB—Professional and Linguistic Assessment Board—test would normally ensure that doctors from overseas have a reasonable command of the English language.

The GMC not only decides the established standards that doctors must reach before practising but is responsible for maintaining those standards. It has to deal with doctors who are brought to the council's attention because it appears that they may have fallen below the standards required.

Cases normally reach the GMC through three routes. First, if a doctor is convicted before the courts, it is virtually automatic that the GMC will be notified, regardless of whether the charge is a fairly simple one of being drunk and disorderly, whether it is shoplifting or a murder. The second route is through the findings of local medical services committees. A doctor who is found not to have kept to the terms of his contract will be reported to the GMC.

It is important to understand the distinction between the relationship between a doctor and his local employing hospital or health authority and the relationship between a doctor and the General Medical Council. A doctor may have been found to have broken the terms of his contract and he will have been dealt with by a local medical services committee. Ultimately, when the decision has been confirmed by the Secretary of State, that doctor may suffer a withholding of his salary—in effect, a fine—but the circumstances in which he has broken his contract may or may not be relevant to his registration with the General Medical Council.