Health and Social Care (Safety and Quality) Bill: Legislative Consent Motion

Executive Committee Business – in the Northern Ireland Assembly at 12:30 pm on 2nd March 2015.

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Photo of Jim Wells Jim Wells DUP 12:30 pm, 2nd March 2015

I beg to move

That this Assembly endorses the principle of the extension to Northern Ireland of the provisions of the Health and Social Care (Safety and Quality) Bill, as introduced in the House of Commons on 2 July 2014, contained in clause 5 and paragraphs 1 to 6 of the schedule dealing with the objectives of regulators of health and social care professionals.

In July of last year, the Secretary of State for Health, Jeremy Hunt MP, wrote to former Minister Poots seeking his agreement to a legislative consent motion (LCM) on provisions contained in a private Member's Bill that was introduced in Westminster in that same month by Jeremy Lefroy, the MP for Stafford. The full title of the Bill is the Health and Social Care (Safety and Quality) Bill, and it has a wide patient-safety theme following on from the events at the Mid Staffordshire NHS Foundation Trust.

At the outset, it is important to say that the vast majority of the provisions in the Bill apply to England only. Members will be aware that any Westminster Bill that seeks to introduce changes that relate to a devolved matter must be agreed by the Assembly by means of a legislative consent motion. One provision in the Bill relates to the regulation of health-care professionals, which is a devolved matter for Northern Ireland. A legislative consent motion is therefore required for the provision. It is that provision to which I now want to draw Members' attention.

The provision seeks to introduce an overarching public-protection objective for health-care professional regulators — for example, the Nursing and Midwifery Council and the General Dental Council — and the Professional Standards Authority for Health and Social Care, which oversees the work of the health-care regulators. It is intended that the provision will apply on a UK-wide basis. That is because, with the exception of pharmacy, the jurisdiction of the health-care professional regulators is UK-wide, as is the jurisdiction of the Professional Standards Authority.

The clause introduces an overarching objective of public protection, with further objectives relating to public safety, public confidence in the professions and proper professional standards, each of which are of equal importance. There is well-established case law setting out the expectation that regulators and their fitness-to-practise panels will consider those objectives. However, the Bill seeks to establish those explicitly and consistently in statute. In practice, that will give regulators a clear and consistent legal basis on which to act with confidence to ensure the protection of the public.

The approach of having an overarching public-protection objective, together with the three related objectives, secures the focus on public protection that regulators were keen to emphasise, while also ensuring that regulatory bodies are able to act, where appropriate, in the absence of any explicit patient-safety issue; for example, where a registrant has engaged in behaviour that might undermine public confidence in the profession to such a degree that it would make the public reluctant to seek that individual's help but where the issue is not related to professional competence or patient safety. The Bill also requires the regulators' panels and committees dealing with fitness-to-practise issues to have regard to the objectives. That will help contribute to ensuring ongoing public confidence in the professional regulatory system.

The Department of Health in England has confirmed that the Professional Standards Authority and the regulators affected are content with the regulatory provisions in the Bill. However, those bodies' general position is that the private Member's Bill does not go far enough, as the legal framework governing regulation of health-care professionals requires more significant reform.

Members will be aware that the United Kingdom law commissions, including the Northern Ireland Law Commission, jointly undertook a review of the regulation of health-care professionals. They published their final report, together with a draft Bill, in April 2014, and a copy of that Bill was laid before the Assembly. The aim of the work was to make recommendations for a clear, modern and effective legal framework for now and for the future. In fact, the regulatory provisions in the private Member's Bill are derived from two of the commissions' key recommendations. The regulators and the Professional Standards Authority are eager for the commissions' reforms to be implemented as a priority.

On 29 January 2015, the UK Government issued a joint response to the commissions' report on behalf of the four United Kingdom Health Ministers. In the response, the Government accepted the large majority of the recommendations whilst acknowledging that further work will be required in some other areas. Government officials, including those from my Department, will continue to work constructively with the Department of Health in England, the other devolved Administrations and the bodies affected to progress those issues.

The response highlighted again that the UK Government remain committed to legislate in this important area when parliamentary time allows. In the interim, a number of pieces of secondary legislation have been introduced UK-wide to improve the regulatory bodies’ processes in order to enhance patient safety and improve public confidence. The regulatory measure included in the private Member's Bill seeks to build on that.

Members should note that the private Member's Bill will not introduce the overarching public protection objective for either the General Medical Council, which regulates doctors on a UK-wide basis, or the Pharmaceutical Society of Northern Ireland, which regulates pharmacists in Northern Ireland only. With regard to the Pharmaceutical Society, the Department of Health in England identified issues with applying the overarching public protection objective provision to the society. Whilst legislative amendments in 2012 enabled an enhanced role in public protection and regulatory activity for the society, its current objectives, set out in the Pharmacy (Northern Ireland) Order 1976, are more reflective of a leadership and membership organisation rather than one focused on public protection. Therefore, introduction of the new proposed public protection objective would represent a fundamental change to the society’s statutory basis.

I agree with the position taken by my ministerial colleague in England, and the Bill is not an appropriate vehicle to introduce such a change to the arrangements for regulation for the pharmacy profession in Northern Ireland. I also understand that the society has not raised any objections to its exclusion from the Bill.

I can also advise Members that I have asked departmental officials to begin preparatory work to explore options for the future arrangements for the regulation of the pharmacy profession in Northern Ireland. That will include consideration of the existing professional leadership role of the Pharmaceutical Society. I will continue to keep the Assembly and the Health Committee updated on that as work develops.

In relation to the General Medical Council, the overarching public protection objective will be introduced through a different UK-wide legislative order, which is being taken forward.

In conclusion, the UK Governments, including my Department, support the Bill as it relates to the regulation of health-care professionals. As this is a devolved matter, a legislative consent motion is required. It is important that the provisions extend to Northern Ireland to ensure that we retain parity with the rest of the United Kingdom in that regard so that the public in Northern Ireland can be assured that they are safeguarded in the same way and afforded the same protections as other UK citizens.

On that basis, I ask the Assembly to support the motion.

Photo of Kieran McCarthy Kieran McCarthy Alliance 12:45 pm, 2nd March 2015

I take this opportunity to thank Minister Wells for bringing the LCM to the Assembly today. Speaking on behalf of the Alliance Party, I support the legislative consent motion. It is a somewhat unusual LCM, in that we are lending our support to a private Member's Bill progressing through Westminster. However, given that the UK Government are supporting the Bill and notwithstanding the reality that health care, including the role of health-care workers, is devolved, there is an understanding of maintaining a common framework for regulation across different jurisdictions, especially in the context of greater mobility between jurisdictions and even mobility by patients and those in care. It is important that we do what we can to enhance protection of those who are most vulnerable, maintain public confidence and uphold standards.

With those few words on this important issue, I am happy to relay the Alliance Party's agreement to the LCM.

Photo of Mitchel McLaughlin Mitchel McLaughlin Speaker

With those few words, it is back to the Minister.

Photo of Jim Wells Jim Wells DUP

I was expecting many more contributions. Maybe they have all been won over by my oratory; I do not know.

I welcome MLA McCarthy's comments. He makes a very valid observation that, more and more within the United Kingdom, patients and medical staff are moving back and forward across the borders of the four jurisdictions. Therefore, it is very important that we have parity and that members of the public in Northern Ireland feel that they have exactly the same regulatory framework as those in England, Scotland and Wales. I am glad to say that the standard of medical care in Northern Ireland is extremely high and the number of referrals to any regulatory body is a very small proportion of the number of engagements with patients. However, we all still need to have the confidence that, if things do go wrong, there is a very effective and rigorous framework in which to deal with it. I welcome the fact that the Member who contributed is supporting the Department in this.

As I said, the Bill will introduce a consistent overarching objective for the Professional Standards Authority and the regulators of the affected groups of health-care professionals, including dentists, nurses, midwives and opticians, and will ensure that public protection is at the heart of what the Professional Standards Authority and these professional regulators do. The Bill will contribute to public protection, by providing clarity and consistency across the roles of the PSA and these regulators, and will increase public confidence in the professional regulatory system.

It is important that Northern Ireland continues to retain parity with the rest of the UK in relation to the regulation of health-care professionals. Therefore, I commend the motion to the House. The legislative consent motion came before the Health Committee for scrutiny, and the Committee was broadly supportive of it. I welcome that. I suspect that the fact that the Committee has done much of the scrutiny work already is why this particular legislative consent motion has not attracted a great deal of debate.

Question put and agreed to. Resolved:

That this Assembly endorses the principle of the extension to Northern Ireland of the provisions of the Health and Social Care (Safety and Quality) Bill, as introduced in the House of Commons on 2 July 2014, contained in clause 5 and paragraphs 1 to 6 of the schedule dealing with the objectives of regulators of health and social care professionals.