Health and Care Bill

Debate between Baroness Thornton and Baroness Pitkeathley

Committee stage
Friday 4th February 2022 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, Clause 142 seeks to amend Section 50 of the Health Act 1999 in relation to making changes to the professional regulatory landscape through secondary legislation. It will simultaneously widen the scope of Section 60 and extend the Secretary of State’s powers. At the moment the Government have powers to bring new professions into regulation or make modifications through secondary legislation but can remove a profession from regulation only through primary legislation. The clause enables the removal of a profession through secondary legislation and makes it clear that a profession would be removed from regulation only when it was no longer required for the purpose of protecting the public.

I went and had a little look at the record. I am sorry the noble Earl is no longer here today, because in 2009 I was in Grand Committee, as the then Health Minister, and we were discussing the regulation of psychologists. I have to tell the Committee that that was not an uncontroversial matter. We had gone through whole series of regulatory reforms that year, as noble Lords who have been following these matters will be aware. I said at the time that

“the reforms set out in this draft order aim to enhance public confidence in the ability of the healthcare regulatory bodies to protect the public and deal with poor professional standards.”—[Official Report, 5/5/09; col. 510.]

The debate we had that day included the noble Earl, Lord Howe, who, at the time, was in my position now, as it were. He also welcomed the fact that the regulatory regime was in existence and, although he rightly had questions about the regulation of psychologists, which was indeed a controversial matter at the time, he did not question the need for public scrutiny of professional regulation.

That is why I have tabled the Motion that clause 142 not stand part. I am left wondering what exactly the yardstick will be, what criteria will be used to determine when there is no longer a need to protect the public and who will decide those criteria. Does professional regulation not also help to facilitate consistent common standards? What is lacking at the moment is any sense of the principles that will be allowed to inform decisions to bring professions into regulation or remove them. Will patients’ organisations, representative bodies or regulators be consulted on any new criteria applied? I can tell the Minister that in 2009 we went through weeks and weeks of discussion and consultation about every single independent regulatory body that this House helped to establish.

I suggest that the system works and there is absolutely no need to change it, though perhaps the Minister can tell me why there is such a need. Moving the power to abolish professions to secondary legislation is not putting scrutiny and transparency at the forefront. I have to say that doing so without putting any indication on the record of which professions are being considered does not instil confidence that this power grab has been considered properly or is in fact needed at all. The implications for the devolved nations, particularly Scotland, are also important but it was clear from discussions in another place that they had not been addressed. Perhaps they have by now, and the Minister would like to tell us what the outcome of that consultation is.

At the risk of repetition, there is a consistent theme in the Bill of seeking greater powers for the Secretary of State without parliamentary oversight, for reasons that are quite unclear. I beg to move.

[Baroness Pitkeathley (Lab)]

My Lords, I declare an interest as a former chair of the Professional Standards Authority. I was happy to go down memory lane with my noble friend on the Front Bench.

When thinking about professional regulation, we always have to bear in mind—I hope the Minister will be able to convince the House that this is what the Government bear in mind—the protection of the public. It is never about the glorification or protection of a profession; it is always about the protection of patients and the public.

The Professional Standards Authority developed the concept of right-touch regulation, whereby you identify the problem before the solution, quantify and qualify the risks, get as close to the problem as possible, focus on the outcome and use regulation only where necessary. I draw the House’s attention to the very successful project of accredited registers, which the Professional Standards Authority has developed in order to have, as it were, regulation at a lesser level than the very tight regulation that is necessary for some professions. You should keep it simple; the system is far too complex at present. You should check—as we always must with legislation, but it seems to me that we do it far too seldom—for unintended consequences. You should also review and respond to change, and the Government are doing just that with the proposals.

However, I must echo the caution of my noble friend on the Front Bench regarding the new powers for the Secretary of State to deregulate as well as regulate professions. We know that the risk profile for different occupations changes over time and a more agile method of responding is sometimes necessary. I hope that is what the Government have in mind. However, I emphasise, and I hope the Minister will reassure me on this, that a commitment to keeping patients safe must guide any decisions made to deregulate professions. There must be a robust and independent process to ensure that decisions are made after a clear assessment of risk—and I emphasise “independent”.

If the Secretary of State has the power to abolish regulators by secondary legislation, will there not be a threat to the independence of the regulators? If they know that the Secretary of State can abolish them at a stroke, as it were, might they become too focused on pleasing—or, rather, on not antagonising— whichever Government are in power, instead of, as I have stressed, working always and solely in the public interest? I hope the Minister will assure the House that that is the Government’s intention.

International Women’s Day

Debate between Baroness Thornton and Baroness Pitkeathley

Thursday 7th March 2013 Lords Chamber

[Baroness Pitkeathley]

My Lords, it is always a huge pleasure to take part in this debate. I, too, am grateful to the Minister. As ever, I am in awe of the amount of experience, passion and expertise which Members of your Lordships’ House bring to the subject. This far down the batting order—we have had quite a few sporting metaphors today—it is difficult to think of anything new to say, but I just want to say a bit about public service.

All my working life has been in public service. I have never worked in the private sector. I have worked for local authorities, for the NHS or in the voluntary sector. Because I know what a hugely fulfilling experience this has been, I am concerned, even appalled, by recent reports about the fact that the number of women in British public life is plummeting; that there are fewer women now in senior positions in the judiciary, the arts, education, finance, the Civil Service and government than 10 years ago. Nearly 40 years after the Sex Discrimination Act and despite a huge influx of women into professions such as law and medicine at the lower end, as we have heard today, the glass ceiling for senior positions remains very firmly uncracked.

I count myself extremely fortunate to be able to sit in a legislature without standing for election, because of the peculiar institution that is the House of Lords. I know that it is ironic that I am saying that we should have more representation of women when I sit in a House that has only 21% women and, although we have many bishops, no women bishops, as the marvellous maiden speech of the right reverend Prelate has reminded us. It is of concern to me, and should be to all women, that we are 51% of the population, but only 22% of the House of Commons and a bit over 21% here.

A high point came in 2008 when Gordon Brown appointed Jacqui Smith as the first female Home Secretary. Before the Labour Government in 1997, only 40 female MPs had ever held ministerial office. By the time that Government ended, that had risen to 80; indeed, at that time women held a third of all ministerial posts. Currently, I am sad to say, many departments have no women Ministers at all, in spite of the ambition of the Prime Minister, which we have heard about several times.

Of course, many of the institutions that have promoted women have been abolished: the Equalities Office, the Women’s National Commission, to name two; and of course the Equalities and Human Rights Commission has been amalgamated with other institutions.

It bothers me greatly, as I know it does other noble Lords, that there is a perception that the battle for equality was won a while ago—by my generation, perhaps—but it is simply not true. Some people might say that it does not matter but I contend that having an 80/20 split rather than a 50/50 split has a damaging effect on our political life and on our social and cultural life as well.

Why do we find ourselves going backwards? One reason might be lack of leadership from the top. We still have a female Home Secretary, and other women do very well in some branches of industry, but the fact that there are so few sends a message to other women. Is the treatment by the media of women in public life harsher than it is for men? I contend that it is and that may also put women off.

The hours here and in the other place are not family-friendly, as we know. They are better than they were, especially in the House of Commons. The House of Lords is notorious for starting a debate on family-friendly hours at 10.30 pm. In fact, I think that the noble Baroness, Lady Thornton, was due to make her maiden speech in that debate.

[Baroness Thornton]

So did I!

[Baroness Pitkeathley]

We do a little better than that now, but perhaps not all that much better. Perhaps the image that politics is an inherently sexist arena—recent events may have reinforced that image—is also not welcoming to women.

We have also heard that it is hard to give up power. Power largely resides in the hands of men, who understandably want to retain it. Inadequate childcare is certainly a factor. A recent survey shows that two out of three local authorities are failing to fulfil their statutory obligation to provide childcare, despite the progress that the Minister mentioned. If the lack of support in the childcare area is a factor, how much more this is true of women who have caring responsibilities for older or disabled relatives.

It is in all our interests to enable those women, many of them over 50, to remain in the workforce. We need them to provide care but also to be able to continue to combine caring with paid employment. Their contribution to the economy is vital in both roles but we must also ensure that the caring role does not of itself lead them to live in poverty or build up poverty for the future because of a lack of pension contributions or savings. I am pleased to say that, yesterday, Carers UK launched an inquiry into caring and family finances, examining the costs of caring and the impact that caring has on the ability to work, with the aim of influencing policy in this area.

So far as public service goes, we must ask: what can we do about it? We can get better leadership from the top. We can stop rubbishing the idea of public service. Too often we hear that civil servants are interested only in bureaucracy. We must talk up public service.

We must have parity on interview panels, because we tend to appoint or choose people in our own image. Having appointed dozens, probably hundreds, of people in my time, I know that men tend to oversell themselves while women go the other way and undersell themselves. In that regard, increasing the self-confidence of women is all-important. Those of us who have been reasonably successful in public life owe a duty to our daughters and granddaughters to build that confidence so that the whole of society can benefit.