I am grateful to my hon. Friend, who is precisely right. The question is whether the sliding scale is geared to perception or reality—until the hearing has happened, one cannot be sure—of professional failings or the consequence of those failings. I would add a third aspect, which is the potential sanction or remedy that is within contemplation. The big question, which I put directly to Lady Justice Smith in the evidence-taking session, is how can one know what evidence will be required to prove matters of fact until and unless one knows the gravity of the matter and the range and gravity of the potential sanctions, penalties or removal of livelihood that might be at the end of the process. That is what is so difficult.

In fairness, Lady Justice Smith said in her oral evidence—one of the great benefits that we have had from that process—that she did not feel that that was something that I should be over-concerned about. She said that there has been some experience, which is part of the body of our common law, and that there is sufficient expertise. However, she linked that to having a legally qualified chair of the panel. That is why it was difficult to argue for the amendments in the order that we have discussed them today, although I understand the procedural reasons for that. In many ways, it will be helpful to go through the discussion on Report, because, as the Minister has quite fairly and properly pointed out, he has it in mind to introduce a measure on a legally qualified chair position.

I am conscious that we may be interrupted, but the issue is sufficiently important that we must ensure that we do not rush it unduly. I have made the point about fairness between hearings and between two different sets of circumstances and individuals. There has also been some question over the fairness within a hearing, particularly in relation to a standard of proof where the bar is raised ever higher as the hearing proceeds. Neither the Government briefing nor our witnesses have clarified that for us, other than the somewhat compelling assurance that Lady Justice Smith was able to command. I would be grateful, therefore, if the Minister were to touch on that specific matter in his response.

Delay is also something with which we must be concerned. It is plausible that hearings will take longer under the civil standard of proof, particularly at the  beginning. Has the Minister looked at the pace at which hearings under the civil standard take place, both in our regulators and other countries, and does he expect either a temporary or permanent increase in the length of time taken? In light of that, what training will be in place for those who sit on fitness to practise panels?

There are a couple of other areas that I want to cover, and I am happy to proceed until I am drawn up short. On quantity, Sir Graeme Catto noted during the GMC’s oral evidence that while he did not think that the move to the civil standard of proof would have “any significant effect” in terms of numbers at the serious end of the spectrum,

“there may be an impact on doctors whose practice has failed to a lesser extent”.

However, he said

“any impact is likely to be small”——[Official Report, Health and Social Care Public Bill Committee, 8 January 2008; c. 51, Q103.]

What increase in the number of fitness to practise hearings does the Minister expect to arise from the move to the civil standard? We have touched on that point before, and an answer would be welcome.

Finally, I would like to touch on defensive medicine. I do not want to be unnecessarily critical—far from it—but I thought that it was slightly unfortunate that Dr. Buckman and the BMA had not gauged more effectively whether it is an issue across the profession. While he did not make the case as effectively as he might have done, there is a justified concern.