European Union Bill

Lord Teverson Excerpts

Tuesday 22nd March 2011 Lords Chamber

[Lord Kakkar]

My Lords, from the outset I declare an interest as a practising surgeon and professor of surgery at University College. The matters that I wish to deal with are not as grand as the overall principles of this important Bill—I am grateful to the Minister for having outlined its important purpose in establishing an opportunity to reconnect our people with the European Union—but on matters of unintended consequences of past European legislation and regulation and how this or future legislation might better protect against these problems. I shall do so by giving examples from my own discipline and area of practice, that of medicine and healthcare.

We have heard mention of the European working time regulation, for instance. It is an important piece of legislation, designed to improve the safety of workers in the workplace and their rights overall by restricting working time to 48 hours. However, its application to the practice of medicine has led—in an unintended way, I believe—to detrimental effects on the training of our junior doctors. We hear stories continuously about the way, and I have experience of this, that it has eroded the training of those particularly in craft specialities, such as those like myself in general surgery, to the extent now that the training offered within a 48-hour week is quite inadequate and we are producing generations of doctors who potentially might not feel sufficiently confident in the structure of the way that we deliver healthcare in our country, compared with the delivery of healthcare in other European systems, to practise independently and provide the standard of service and care to patients in the National Health Service in future. That is clearly an unintended consequence but it could have serious implications.

Another example is the application of employment law, driven by the principles in legislation derived from Europe. It is good in many ways to ensure that there is a free movement of labour across the European Union, and that has brought many advantages to our country. However, it has created a serious and important problem regarding the end of medical school undergraduate education. By tradition, the first year of employment after graduating from medical school—the so-called “house job”, now known as the foundation 1 year—is a year where junior doctors take up a post under the continued supervision of the dean of their medical school. They have to complete that post before they can be fully registered with the General Medical Council and be in a position to practise independently in our country. However, because that first year is a year of employment, it must now be open to competition throughout the EU for applicant doctors from anywhere in Europe. As a result, we now run an increasing risk of our successful graduates being unable to find posts in their first foundation year because they have been taken by others. They will therefore not be able effectively to complete their undergraduate education, and will never be able to register with the General Medical Council and serve the people of our country. Again, this is an unintended consequence of previous legislation and regulation from Europe that has had a detrimental effect.

I turn now to the primacy of our regulatory body for medical practice in the United Kingdom—the General Medical Council. There is a European medical directive and it is a requirement that the Medical Act passed by this Parliament be consistent with the requirements of that directive. The directive covers several areas, such as defining what specialties exist in the European Union with regard to medicine, surgery and so on. It deals with the number of hours that are required for a recognised undergraduate medical course. It deals with the question of the duration of postgraduate training for doctors, surgeons and others. However, it also ensures that an EU national—a qualified doctor registered anywhere in the European Union—has the right to practise here, in the United Kingdom, by seeking registration with the General Medical Council. That, in itself, is fine. However, it also therefore prevents the General Medical Council determining the quality and content of the training schemes that those doctors have been subjected to. It prevents something that we all well recognise the importance of now—the ability to test the English language skills of those doctors before they come to practise in our country. As a result of that, there have been some serious problems—unfortunate events where our own citizens have died as a result of poor medical practice that could have been avoided if these unintended consequences had been foreseen. It is interesting that the General Medical Council is able to deal—

[Lord Teverson]

Can I just clarify that? Surely it is the responsibility of the employer to make sure that the person is competent to speak English and carry out their duty. They have the right to do that. It is surely a primary responsibility of any employer to make sure that the people they employ meet the standards of that organisation or business.

[Lord Kakkar]

Indeed it is but it is not always done. I was coming to the point that the General Medical Council has the obligation to do this for doctors who come from outside the European Union. It must ensure that they have the language skills, that they have sufficient competence in skills, and that their training programmes and undergraduate medical education are of a sufficient standard and quality.

--- Later in debate ---

[Lord Pearson of Rannoch]

At this rate I will be at more than 20 minutes. I suggest that noble Lords do not interrupt, but it is of course up to them. As I was just saying, this new campaign has people on it who believe that we should stay in the EU but who still want a referendum. So far, some 50,000 people have signed it and thousands more have volunteered to campaign as activists. I suggest that noble Lords have a look at it at peoplespledge.org.

Then there is UKIP and its performance at the recent Barnsley by-election, where it beat the Conservatives and Liberal Democrats into second place. In fact, we got nearly as many votes as those two parties combined. I am sure that much of the success was due to the fact that it now has a decent leader again, and it was of course only a by-election, but something is moving out there in the country. That something is the country’s growing wish to have a referendum on our EU membership. That wish will not be met by the Bill. The Bill is an irrelevance to that wish.

Why do Her Majesty’s Government refuse the people the referendum that they want and which they were promised, and instead offer them the pale imitation that is the Bill before us? The answer is clear; they think that they would lose the referendum which the people want and we would then have to leave the EU. In the Government’s defence, they seem to really believe, as do most of our political class, that leaving the EU would somehow be bad for trade and cost British jobs. I think they believe that because so few of them have ever run an international business. They just do not know how it works.

I guess that this would be the central debate in any referendum campaign about our membership. I give the Government and your Europhile Lordships four brief reasons why leaving the EU would have the opposite effect to the one that they might genuinely fear. First, we indeed have 3 million jobs exporting to clients in the EU, but it has 4.5 million jobs exporting to us, so it would want to continue its free trade with us. We are in fact its largest client. Would the French stop selling us their wine or the Germans their cars just because we are no longer bossed around by Brussels? Our trade and jobs would continue. There is no fear on that score.

Secondly, the EU has free-trade agreements with 63 countries worldwide, with more in the making, so why not with us—their largest client? Thirdly, the World Trade Organisation would also prevent any retaliation, and anyway the EU’s average external tariff is now down below 1 per cent so there is not much point to retaliation. Fourthly, Switzerland and Norway, which are not in the EU, also enjoy free movement with the EU and every other facility that we have. They control their own immigration and export much more per capita to the EU than we do—Norway by five times and Switzerland three times.

[Lord Teverson]

I thank the noble Lord for letting me intervene. Although Norway and Switzerland are not within the European Union and have full relations with it, the result is that they have very little control over their legislation. The way it works is that the European Union faxes instructions to the Governments of Norway and Switzerland in those areas and they have to comply or withdraw from the European Economic Area. That is the problem. You have the single market but far less control and no input into the legislative process.

[Lord Pearson of Rannoch]

That point is often made. Of course, if we were not in the European Union, we would have to obey the EU rules for the exports that we sent to them, but not in our own internal market and not to the rest of the world. Most countries in the world export to the European Union without that problem. It is really not a real one.