Professional Qualifications Bill [HL]

Baroness Finlay of Llandaff Excerpts

2nd reading
Tuesday 25th May 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, other noble Lords have spoken of concerns over the Bill, recognising the need for it while expressing a wide range of concerns. I will focus my remarks principally on the risks to medical registration and declare that I am registered with the General Medical Council.

For some years now, the GMC has been keen to speed up its processes and be more flexible, particularly in how it assesses the competence of international doctors when registering them. The current Department of Health and Social Care consultation, Regulating Healthcare Professionals, Protecting the Public, has wide-ranging proposals to reform professional regulation and include the regulation of physician associates and anaesthesia associates. However, the proposals in the Bill risk undermining the principles behind those reforms, so can the Minister explain how the two departments are working together? He may wish to write to me to clarify whether the proposals in the DHSC plans can be implemented via secondary legislation using Section 60 of the Health Act 1999 to modify professional regulation in the Medical Act 1983 via an Order in Council.

In the Bill, regulators will be obliged to establish a framework to recognise professional qualifications from around the world, with international agreements to ensure greater transparency of information. Yet the GMC and other health professional regulators already have powers and many years’ experience in overseas recognition and registration, making the Bill unnecessary for the health professional regulators—as the noble Lord, Lord Ribeiro, and my noble friend Lord Patel have explained.

I am relieved to hear that the Government will bring forward amendments to Clause 1. Without amendment, Clause 1(4) would inadvertently compromise patient safety and decrease workforce supply. Time spent formally assessing thousands of qualifications in great detail will not meet the policy objective of maintaining existing levels of public and consumer protection. Take the example of a trauma surgeon with 25 years’ experience in the field. The surgeon’s original medical school curriculum, surgical exams and grades provide no indication of current competence and skills. It is an up-to-date skills assessment that is crucial to safe practice, and in which the GMC has a wealth of experience.

Without the Government’s heralded amendment, Clause 1(2) would prevent the GMC from interpreting “qualifications or experience” in a way that enables using written and clinical tests of knowledge and skills to continue. Its well-established processes currently register over 10,000 doctors annually. The Bill needs amending to explicitly support assessment of appropriate knowledge and skills over and above the original qualification.

The safe registration of healthcare professionals is more complex than simplistically focusing on baseline qualifications. Every international medical graduate must have an acceptable overseas qualification and demonstrate that they have the knowledge, skills and experience to practise in the UK, usually through a test of competence with evidence of relevant clinical experience. This is far more meaningful than trying to see whether each international qualification is “substantially the same” as UK qualifications.

I hope that the Minister, in responding, will explain the policy intent behind these proposals that cover over 160 professions, and how the Bill will be amended to avoid unintended compromise of current processes that work well and will allow flexibility in the future. I know he referred to it in his opening remarks, but we are seeking more clarity.

Finally, I declare that I am president of the Chartered Society of Physiotherapy and ask the Minister to confirm that the competencies assessment will continue to apply to allow reciprocity because, for example, respiratory physiotherapy is a core skill in the UK but not taught in some other countries. Currently, the society supports physiotherapists going through the Health and Care Professions Council registration processes. Overall, can the Minister confirm that where processes are well refined they will not be compromised, as the current proposals in the Bill will increase regulators’ workload without evidence of improvement? Can he also confirm that healthcare professional regulators will not have to establish a new stage in their application procedures for international professionals to individually assess each qualification presented by an applicant, but that they can instead undertake this assessment through their existing procedures, such as tests of competence?