Professional Qualifications Bill [HL]

Lord Hunt of Kings Heath Excerpts

2nd reading
Tuesday 25th May 2021 Lords Chamber

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I thank the Minister. I declare an interest as a member of the GMC board, although I will be speaking in a personal capacity on the Bill. I welcome my noble friend Lady Blake to the Front Bench and congratulate her on an excellent opening speech.

There are three points that I want to make about the Bill. First, I want to ask the Minister about its core purpose. We have been told that the Bill

“creates a new framework for the recognition of professional qualifications and experience gained overseas and takes steps to reform regulators’ practice. It will revoke and replace the interim system for professional qualifications that derives from the UK’s membership of the EU.”

We have also been told that the Bill

“is part of the Government’s plans to exercise the UK’s new regulatory flexibility”.

What is less clear is how is it to be done. We are in the dark, as my noble friend Lady Blake said.

The Minister also said that we need to remove outdated legislation. Is it the Government’s intention to streamline the approval process for professional qualifications? How does this fit with immigration law and the remit of the Home Office? The noble Lord, Lord Purvis, made some very interesting points about this and the perversity of Her Majesty’s Government’s position in relation to skill shortages.

The Bill aims to ensure the safety of service provision, provide consumer confidence and help maintain professional standards, but if they are to be maintained in the post-EU world is there a trade-off between these different objectives? In the closing remarks of his introduction to the Bill, the Minister referred to the determination of the Government to allow the autonomy of regulators to continue. That is very welcome, but how does that stand beside the Government’s wish to reform regulators’ practice? Will the Minister clear up that point?

My second point concerns the use of secondary legislation in the Bill. This is a very small Bill of 14 pages and 19 clauses, and it is littered with regulation-making powers. The core of the Bill is contained in Clauses 1 3, 4, 5 and 6, which relate to the “Power to provide for individuals to be treated as having UK qualifications”, the “Implementation of international recognition agreements”, the “Authorisation to enter into regulator recognition agreements” and the “Revocation of general EU system of recognition of overseas qualifications”. All these clauses are subject to a series of regulation-making powers. Then there is Clause 13, which is a Henry VIII clause par excellence. It essentially gives Ministers power to modify through regulations any piece of primary legislation. This has not been justified by the Government. All we have been told is that it is necessary because

“Changes would need to be integrated into the existing legislative scheme for given profession because a single approach covering all affected professions would not be ‘practicable’.”


That is not good enough.

I refer the Minister to the recent report of the Secondary Legislation Scrutiny Committee, which during the course of the past year has become increasingly concerned about the growing tendency of the Government to introduce skeleton Bills in which broad delegated powers are sought in lieu of policy detail. As a result, in September, the Secondary Legislation Scrutiny Committee, the Constitution Committee and the Delegated Powers and Regulatory Reform Committee wrote to Michael Gove and Mr Rees-Mogg raising their concerns. The committees said that, even taking into account the exceptional circumstances of withdrawal from the EU and the pandemic,

“the bills which have been introduced into Parliament in response to them have been extraordinary in terms of the extent to which they have permitted a shift of power from the legislature to the executive. … It is a constitutionally fundamental issue, not only in terms of the relationship between Parliament and the executive but also more widely in terms of the relationship of trust between government and the public at large. Without substantive provision on the face of the Bill, Parliament is being asked to pass legislation without knowing how the powers conferred may be exercised by ministers and so without knowing what impact the legislation may have on members of the public affected by it.”

Mr Rees-Mogg acknowledged that, “as these are exceptional times”, such Bills,

“do not necessarily provide a model example of how Parliament would like to see legislation brought forward”

and that

“Bills with substantial powers, though sometimes essential, should not be a tool to cover imperfect policy development.”

The implication of the use of skeleton legislation is that the instruments made under it may contain substantial policy changes which would be more appropriately subject to the greater scrutiny afforded to primary legislation.

Reflecting the conclusions of its correspondence with Mr Rees-Mogg, the scrutiny committee urged the Government

“ ‘to bring forward bills that contain clear policy intention instead of broad delegated powers’ and to ensure that ‘Departments do not use the exceptional powers given to them by Parliament as an expedient in the context of the pandemic as a cloak for effecting longer term, post-pandemic changes which would more properly be included in primary legislation.’ ”

Quite. It will be interesting to see what the Delegated Powers and Regulatory Reform Committee has to say about the Bill when it reports shortly. In advance of its forthcoming report, I suggest to the Minister that either the Government flesh out the policy details in the Bill or the case for a sunset clause becomes very clear. I support my noble friend Lady Blake’s argument for draft statutory instruments to be published before Report.

I now turn to my third point, which is of specific concern to the GMC and other health regulators. Clause 1 gives power to the appropriate national authority—in this case, the Secretary of State for Health and Social Care—to draft regulations and introduce a process that would require the GMC and other regulators to assess whether someone has a particular overseas qualification that is “substantially the same” as a UK qualification. In the case of the GMC, a person so deemed would then be eligible to practise as a doctor in the UK. This is because the GMC does not require those with UK qualifications to do anything further to demonstrate that they have the necessary knowledge and skills for registration. This could give automatic entitlement to practise to international medical graduates on the same basis as UK graduates.

Currently, the GMC has a very rigorous process for assessing whether international medical graduates are safe and fit to practise in the UK. Under this Bill, that rigorous assessment could be completely lost. It would be very difficult for an agency such as the GMC, given that it has more than 10,000 international medical graduates applying for registration each year, and it would be impossible to assess the number of qualifications from countries as diverse as India, Pakistan, Nigeria, UAE et cetera and their many medical schools. This could also affect postgraduate qualifications and the potential for those qualifications to be captured by the Bill and subsequent regulations. There is concern that the Bill as drafted could force health professional regulators to accept professionals into UK practice in a way that compromises patient safety and could have an impact on workforce supply by requiring them formally to assess thousands of qualifications in detail in order to allow professionals to practise in the UK.

The Minister said the Bill does not restrict the autonomy of regulators, although, as I have already pointed out, in the documentation accompanying the Bill the Government say it

“takes steps to reform regulators’ practices”.

We need to know what exactly the Government mean when they say that the autonomy of regulators will not be impacted. Today, the Minister said he would table an amendment before Committee to deal with this. That is welcome and I look forward to seeing that amendment, but I hope that the Minister will be able to answer on some of the more substantive issues in relation to the Bill.