Lord Grimstone of Boscobel Portrait Lord Grimstone of Boscobel (Con)
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My Lords, I thank all noble Lords who have given their careful consideration to the amendments in this group. It was an unusual experience for me standing at the Dispatch Box almost to feel a warm glow as noble Lords welcomed my amendments. The lesson that I learn from that is that the quicker one can amend one’s own Bills, the better, probably, in your Lordships’ House.

As noble Lords will appreciate, the Government have not brought these amendments lightly. As we have heard, they have been informed rightly and properly by careful engagement with healthcare regulators. I thank a number of noble Lords; perhaps I can single out the noble Baroness, Lady Garden of Frognal, for her support and the noble Lord, Lord Fox, for his comments. Without reservation, of course, my door is open to other regulators who wish to speak to me as this Bill continues its passage.

We heard again from the noble Lord, Lord Fox, on his point about consultation with the HSC. I think that group 7, which is about consultation, will be a good place to return to that and I will try to address in detail the points the noble Lords, Lord Fox and Lord Purvis, have made.

My noble friend Lady McIntosh referred back to what, in her view, was clearly the golden age of mutual recognition with the European Union. As I said previously, we would have liked to have maintained that mutual recognition. The phrase I used at Second Reading was:

“We took the horse to water but it refused to drink.”—[Official Report, 25/5/21; col. 975.]


I hope that noble Lords will support my amendments. I believe that they protect the public interest, maintain standards and ensure that regulators have the necessary flexibility and autonomy to regulate appropriately. I thank the noble Lord, Lord Patel, for his comments, echoed by the noble Baroness, Lady Hayter, and I am happy to give a complete reassurance standing at the Dispatch Box on the important points that were made.

In relation to the points made by the noble Baroness, Lady Finlay of Llandaff, about the use of the word “substantially”, we have a later group which is almost entirely devoted to discussing that word. If I may, I will leave comments on that until we get there and, again, I hope to assuage noble Lords’ fears when we reach that point.

On what happens if other regulators pop up in this field, the way the Bill is drafted and, frankly, one of the reasons why we have not included a list of professions—I am sure we will come back to that later as well—is because it is a moving target. Of course, any new profession that ends up being regulated by law will automatically fall within the purview of the Bill by being so regulated, and if it falls within the purview of the Bill, the standards of the Bill and the methods that we have been discussing today in relation to my amendments will also apply to those new professions.

I come to Amendment 11 in the name my noble friend Lord Lansley, who made some interesting points during the discussion which were reinforced by my noble friend Lady Noakes. I always admire my noble friend Lord Lansley’s forensic attention to the detail of the legislation before our House. I think all Front-Bench spokesmen from this side always listen carefully to the points that he makes. I will look at this again, but I hope that he appreciates that the wording of Amendment 10 is intended to provide more flexibility about how regulators make their determination. We believe that they need this flexibility and will find it helpful.

Some regulators—and this is, of course, completely a decision for the regulators—may consider it appropriate to look solely at what is demonstrated by a qualification obtained overseas, others may require an applicant to pass a separate test of knowledge and skills, while others may choose to combine the two. Regulators should have this broad discretion available to them. I believe, and I am advised, that the proposed removal of the word “only” from Amendment 10 could cast doubt on whether the first of those options is available. I will have another look at this to make sure that that is the right reading. Meanwhile, I ask my noble friend not to move his amendment.

I commend Amendments 3, 6 and 10 to the Committee and beg to move Amendment 2.

Lord Faulkner of Worcester Portrait The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
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I call the noble Lord, Lansley, and then I shall call the noble Lord, Lord Purvis, who has requested to speak after the Minister.

Lord Lansley Portrait Lord Lansley (Con)
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My Lords, I am grateful to all noble Lords who have kindly approved of the argument made in Amendment 11 and to my noble friend for saying that he and colleagues will look at it again. I think that what they suggest is not the case. As it stands, Amendment 10 allows regulators to make a determination based on overseas qualifications and experience alone, but it runs the risk, which is a different risk, of preventing them combining that with other factors and assessments and bringing them together in the determination. That is the point. The removal of the word “only” would not, in my view, prevent a regulator making a determination based solely on overseas qualifications and experience.

I am grateful to the noble Baroness, Lady Hayter. If the Minister is willing not to move Amendment 10 today and to look at it again and bring it back on Report, I think that would be the best way to proceed. I think we all know what we want to achieve, which is to give the regulators flexibility. It is purely a drafting issue, and I am sure we will not need to be detained at length on Report if the draftsman, is, in the event, clear that the effect is as the Minister wishes it to be. He has not moved Amendment 10 yet, and I hope he will not move it when we reach it.

Lord Grimstone of Boscobel Portrait Lord Grimstone of Boscobel (Con)
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I think I have in fact moved Amendment 10. I commended amendments to the House and begged to move.

Lord Faulkner of Worcester Portrait The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
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May I explain to the Minister that we are debating Amendment 2, with which other amendments are grouped? The debate that is taking place currently is on Amendment 2 only.

Lord Grimstone of Boscobel Portrait Lord Grimstone of Boscobel (Con)
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My Lords, I am grateful for that clarification. May I consider that point and come back to the House shortly on it?

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Amendment 3 agreed.
Lord Faulkner of Worcester Portrait The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
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We now come to the group beginning with Amendment 4. Anyone wishing to press this or anything else in this group to a Division should make that clear in debate.

Amendment 4

Moved by
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Lord Grimstone of Boscobel Portrait Lord Grimstone of Boscobel (Con)
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My Lords, I thank the noble Baroness, Lady Garden of Frognal, for tabling Amendments 4, 5, 7, 8 and 33, which probe the use of the word “substantially” in Clauses 1 and 4, and I thank the noble Baroness, Lady Randerson, for her comments. The point is that, in the end, it is the individual who must be fit to practise, and the assessments that we make must relate to the individual. It is here where the important matter of regulator autonomy comes in, and why it is that the only people who can safely work out what is the appropriate route for a particular profession and the right mix between the individual, the skills and the qualifications seems quite properly to be the regulator. That is the key safeguard that we want to achieve under the Bill.

I turn to the amendments. As we know, Clause 1 is the “Power to provide for individuals to be treated as having UK qualifications”. If amended as the Government suggest, under Clause 1 an individual would be treated as having UK qualifications if the regulator determined that the individual had substantially the same knowledge and skills to substantially the same standard as are demonstrated by the specified UK qualification or experience. The noble Baroness asked some interesting questions about this approach and whether it undermines the freedom of UK regulators. I reassure noble Lords that the issue has been very carefully considered.

If we removed the word “substantially” from Clause 1, that would change the requirement such that individuals would need the same knowledge and skills to the same standard as demonstrated by the specified UK qualification or experience. That suggests an assumption that it is often the case that skills and knowledge gained in one country for a profession exactly match those gained in another country for that profession. It also suggests an assumption that it is often the case that a profession in one country covers exactly the same set of activities as the equivalent profession in another country. Of course, these assumptions are not necessarily valid. So while it might make it easier for UK regulators to decline applications, removing “substantially” would remove regulators’ flexibility in considering how skills and knowledge developed overseas translate into the UK profession.

In the event that regulations were made under Clause 1 as drafted, regulators would have the discretion—and I believe that is where the discretion should sit—to make appropriate judgments about whether overseas skills and experiences meet their expectations to an acceptable degree. That drives us back to the consideration of whether the individual is fit to practise in substantially the same way as a UK individual would. This does not water down expectations and is not a compromise on quality, because if a regulator felt that the quality had not been maintained then they would not want to approve that person. The individual’s knowledge and skills must be substantially the same.

Lastly, including “substantially” does not restrict the freedom of regulators to make determinations of equivalence in ways that they deem fit. We come back to a point that we discuss regularly in this debate: the importance of regulators’ autonomy in deciding exactly the right approach to take.

On the question of English language proficiency, at Second Reading the noble Baroness raised the need in certain professions for demonstrable English language proficiency in order for an individual to deliver professional services to the standards required in the UK, and for regulators to be able to consider this. The Bill allows regulators to take into account language requirements as part of an assessment of knowledge and skills. Alternatively, under Amendments 2 and 10, regulations could provide that passing a language test was an additional condition in itself.

Amendment 33 examines the definition of “corresponding profession” in relation to authorisation that can be given by the appropriate national authority to enable regulators to enter into regulator recognition agreements. The amendment would change the permitted scope of regulator recognition agreements from those with overseas professions whose activities are

“the same as or substantially correspond to”

the UK profession to those with overseas professions that are “the same as or correspond to” the UK profession. As I have explained, there are differences between professions in different countries, and differences between how they are regulated between jurisdictions. Even under the EU’s prescriptive mutual recognition of professional qualifications directive, there were differences in the qualification requirements between different EU member states. The clause as drafted reflects the reality that professions do not exactly align across different countries’ regulatory systems and standards. Some countries do not make the same distinctions as us in how they define professions—for example, England and Wales distinguish between barristers and solicitors, but that is not the case in many other countries.

The amendment would narrow the circumstances in which a recognition agreement could be made, potentially preventing recognition agreements from being made at all if professions did not directly align with one another. The Government believe this would limit the autonomy of regulators to make decisions about how similar professions are in different countries. Regulators should be free to determine for themselves where it is appropriate to enter into regulator recognition agreements with their counterparts overseas.

Many noble Lords have spoken passionately about the need to ensure that regulators can make decisions that are appropriate to their professions. I hope I have explained why the word “substantially” is an important qualifier that allows for more regulatory autonomy in these clauses, and indeed in the other clauses where it is used, and that, on that basis, the noble Baroness is able to withdraw her amendment.

Lord Faulkner of Worcester Portrait The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
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I call the noble Lord, Lord Fox, who has asked to speak after the Minister.

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Amendments 7 and 8 not moved.
Lord Faulkner of Worcester Portrait The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
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We now come to the group beginning with Amendment 9. Anyone wishing to press this or anything else in the group to a Division must make that clear in the debate.

Amendment 9

Moved by
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Lastly, the noble Lord, Lord Bhatia, asked about the four nations, their abilities and their powers in relation to the regulation of professions. We will cover all matters to do with the devolved Administrations at a later stage in the Bill. With the reassurances that I hope that I have been able to provide, I hope that my noble friend will withdraw her amendment.
Lord Faulkner of Worcester Portrait The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
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I have received a request to speak after the Minister from the noble Baroness, Lady Hayter of Kentish Town.

Baroness Hayter of Kentish Town Portrait Baroness Hayter of Kentish Town (Lab)
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The Minister has not answered my question. She seems to have continued to say that a national authority—that is, the Government or one of the devolved Governments—can decide when a professional is charging high fees. Can she be absolutely clear that she is saying that? I would like to know on what basis that would be and whether they would go to the CMA for advice. Whether it is a farrier or anything else—or an accountant, although I think they are not covered—on what basis is a Minister going to decide that a professional is charging a high fee? Will that be challengeable in court or via the CMA? What would be the mechanism for that decision?

Baroness Bloomfield of Hinton Waldrist Portrait Baroness Bloomfield of Hinton Waldrist (Con)
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I am sorry that I gave that impression, but I do not believe that I did give the impression that the Government would set the fees. There would be a mechanism for oversight, which would be the impact assessment route that I mentioned in my speech.

Lord Faulkner of Worcester Portrait The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
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I have had a request to speak from the noble Lord, Lord Purvis of Tweed.

Lord Purvis of Tweed Portrait Lord Purvis of Tweed (LD)
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Could the Minister repeat what she said at the Dispatch Box? She said that the regulators do not have parliamentary oversight in setting their fees. The Health Department’s consultation at the moment says that four do not but the remaining ones do. They have to secure the approval of the Privy Council and, in some cases, the Scottish Parliament. So which is it, and will any of these regulations have any impact on the relationship with the Privy Council and the Scottish Parliament when it comes to the fact that they have to approve changes of fees?

Baroness Noakes Portrait Baroness Noakes (Con)
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My Lords, I thank all noble Lords who have taken part in this debate for their contributions, an awful lot of which were on my amendment. Some important issues were raised by the noble Lord, Lord Purvis of Tweed, and the noble Baroness, Lady Hayter, none of which have been very satisfactorily dealt with by the Minister.

I turn to my amendment. I thank my noble friend Lord Lansley for his support and accept his challenge to look at the positioning of my amendment if I decide to take it forward at a later stage. The Minister talked as if compensatory measures were just sitting in every regulator’s toolbox to deal with every situation that could possibly arise, but the truth is that compensatory measures will have been designed for the sort of applicants who have already been coming to the UK for assessment, and they are not going to cause any problem. We do not even need this Bill for those applicants.

We are most likely to encounter problems when other forms of overseas applicant arise, with less traditional professional qualifications and/or experience. It is that which is likely to cause the burdens on the individual regulated professions to cope with things that they are not already coping with. The question posed by my amendment was about how we avoid unreasonable burdens being placed on those regulators and, in particular, on existing members of those professional bodies who fund the regulators.

To be honest, I do not think that the Minister answered that question at all. There is a very real problem there. I can see that we are not going to progress it any further today, but I recommend to my Front Bench that all the issues raised in this debate are looked at again before we get to Report because there are some big unanswered questions arising from this debate.

Lord Faulkner of Worcester Portrait The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
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Before inviting the Committee to consider the withdrawal of the amendment, I call the noble Lord, Lord Lansley, who was attempting to come in after the Minister.

Lord Lansley Portrait Lord Lansley (Con)
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I am grateful. I just wanted to make a point after the Minister because I think she made a fundamental error in suggesting that if we were to take out the words

“without unreasonable delays or charges”

from this subsection unreasonable delays or high charges would not be able to be considered as factors in determining whether demand is met. On the contrary, they will be considered with other factors. They would not be excluded.

We will clearly come back to this again on Report because the reply to the debate was not satisfactory, and we will have to write these things out in more detail. Will my noble friend at least just agree that removing those words does not mean that those factors are not taken into account?