Professional Qualifications Bill [HL]

Baroness Fraser of Craigmaddie Excerpts

2nd reading
Tuesday 25th May 2021 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I declare my interests as set out in the register. I sit on the board of OSCR, the Scottish charity regulator. Although it is not concerned with regulating professions, it is still a regulator, and I am aware therefore of the unintended consequences that legislation can have in some areas, and that there are moments when more than one regulator can potentially be involved in service delivery. Also, as chief executive of Cerebral Palsy Scotland, I am involved with the employment of regulated allied health professionals, who are highly specialist in their field and, while not employed by the NHS, are still key. As chair of the Scottish Government’s National Advisory Committee for Neurological Conditions, I have looked at the specific workforce needs for the provision of neurological health and care services in Scotland.

It is vital that we ensure a robust scheme for recognising competent professional qualifications for those from across the world in this country, and vice versa for UK professional qualifications to be reciprocated. I therefore wholeheartedly support the general provisions of the Bill. The regulated professions are indeed a diverse group and the regulatory landscape is far from uniform. Therefore, I welcome the Government’s approach in establishing a framework under which profession-specific provisions can be made. Regulators must be able to set the standards and make autonomous and independent decisions. The Bill is needed and is important, and I look forward to supporting its passage through Parliament.

However, instead of looking at these matters in the context of trade and trade deals, I am looking at the Bill through the lens of health and social care, and as such I am not convinced that the regulation framework will achieve the stated desired results of improving service provision. To ensure public confidence that professionals are appropriately regulated, recognition of professional qualifications from overseas should be based on the equivalence of the standard and content of an overseas qualification rather than solely on reciprocity.

I have three general observations to make at this stage. First, qualification and registration alone are not sufficient. Qualification, whether from within or outside the UK, does not necessarily make an individual proficient to carry out their profession, and the regulatory process must be robust enough to ensure competency as a very minimal standard. What makes an individual truly competent is rigorous supervision from senior and experienced fellow professionals, access to ongoing professional development, and the opportunity for postgraduate and specialist training. We need these to be requirements so that the workforce has the skills to be swift and to adapt to the changing needs of service users. Regulators must make due consideration for experience, supervision and CPD, and see that benchmarks are set and met.

Secondly, we need specialist skills, not just generic skills. There is indeed a skills shortage throughout the health and social care workforce, but we must ensure that we are attracting the right professionals with the right specialist skills. As the noble Baroness, Lady Blake, said, just registering more people will not necessarily resolve vacancy issues. More and more is being expected of individuals who have the bare minimum of skillsets. We see this with health visitors in the expanding early years workload, and in schools, where classroom assistants and teachers are expected to support children with very complex disabilities, with a monitoring visit by a qualified paediatric therapist perhaps only once a term. The identification of “priority professions” in the Bill therefore must recognise that not all registered professionals are the same. In my own charity we employ Bobath-trained therapists—that means that, while being physiotherapists, occupational therapists and speech and language therapists, they have very specific qualifications to support people with cerebral palsy. Improvements in service provision will depend on being able to distinguish between those with the experience and specialisms that we require to develop sustainable services, and the rest.

Thirdly, we cannot rely on professionals from overseas to improve services. Evidence from the regulated allied health professional bodies that I have consulted suggests that professionals who come from overseas perhaps do not stay long, and therefore service provision is not necessarily benefiting. It is perhaps for another time to discuss how we can support and invest in the domestic workforce pipeline, but how can we then support regulation and regulators within this framework to support the retention of qualified professionals?

Notwithstanding these points, there are many aspects to be welcomed in the Bill: the commitment to sharing information across all parts of the UK with, I hope, the public, rather than just professions or employers; recognition that the Bill is not limited to specific professions, but concerns devolved and transferred matters; the establishing of an assistance centre; and the requirement for published information for entering and remaining within a profession. I trust that these requirements may take some heed of my earlier reservations and I look forward to supporting the further progress of the Bill.