EU: UK Isolation

Lord Kakkar Excerpts

Monday 22nd April 2013 Grand Committee

[Lord Kakkar]

My Lords, I, too, join other noble Lords in congratulating the noble Lord, Lord Dykes, on securing this important debate. I wish to confine my comments to an area where there have been unintended consequences of European legislation—in the delivery of healthcare here in our own country. This is a vital issue. As we move forward, there may be an opportunity for British people to become isolated because they feel that there is an impact on the delivery of healthcare that was unintended and is having a detrimental effect. Before doing so, I declare my own interest as Professor of Surgery at University College London, and as a member of the General Medical Council.

A number of issues have been raised with regard to European legislation and directives that relate specifically to healthcare. They relate to the area of professional qualifications and the free movement of labour within the European Union. There has been important progress with the issue of language testing. The General Medical Council, it is proposed, will now be allowed to test the language skills of all doctors who wish to be registered by the council in the future, including those who come from the European Union. That is an important achievement.

However, there is still concern about the ability to test professional qualifications and the nature and structure of the postgraduate training that has been delivered to healthcare professionals throughout the Union. This is an important issue because doctors coming from other parts of the world are subject to that kind of rigorous testing before they are allowed to join the register.

The issue that I would like to focus on is the European working time regulation. In 2010, when the coalition Government was formed, the then Health Secretary committed to begin negotiations with the European Union on ensuring that working time regulations could be applied in a more flexible fashion with regard to working in our hospitals to reflect the fact that the nature of the delivery of healthcare—the structure of our hospitals and broader healthcare environments—is somewhat different from other European countries, and a degree of flexibility would be important. I recall that the then Health Secretary and the Business Secretary were to commence discussions in January 2011 on this matter, but all seems to have gone quiet because of the broader review of competences that is currently taking place.

We need to be very sensitive to this issue. Recently we have started to see coroners’ narrative verdicts starting to cite European working time regulations as a contributory factor in patient death. We have seen in the Francis report into the problems that were experienced at Mid Staffordshire hospital that the working time regulation was identified as a potential contributor to an inability to provide continuity of care within the hospital system. These kinds of descriptions in coroners’ verdicts and in important reports, such as the Francis report, can cause unnecessary anxiety.

With increasing pressure in the healthcare system, we need to be sensitive to problems identified by, for instance, the Royal College of Surgeons, which estimates that 400,000 surgical hours a month are lost from the healthcare system as a result of the application of the working time regulation to surgical rotas and that some £750 million a year is now spent on locums to ensure that locum doctors can fill gaps in those rotas. Equally, the Royal College of Physicians has identified this whole area as a major issue for the delivery of healthcare.

Therefore, I should like to ask the Minister what progress is being made with regard to the discussion about the working time regulation. This was identified as important on the basis of patient safety and the need to ensure continuity of training to a high standard for our trainees, who will lead the healthcare system in the future. It seems to have become mixed up in the broader question of competences and of bringing them back from Europe. If this issue is not addressed, there could be major problems in the future that will be attributed to it and this could have a detrimental impact on the public perception of Europe, because health was never an issue of competence and this matter is specific to the delivery of healthcare in the United Kingdom. Is the Minister able to guarantee that this important discussion, which started long before, will be continued in a timely fashion?