Regulation of Health and Social Care Professions Etc. Bill [HL]

Lord Turnberg Excerpts

2nd reading (Hansard): House of Lords
Friday 3rd February 2017 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, I congratulate my noble friend Lord Hunt on securing this Second Reading debate. The Bill arises out of frustration, because we should have had legislation on this some years ago. I should express my interest as a former member of the GMC council when I was the dean of a medical school in the long-distant past. I am no longer a practising physician. Unlike the noble Lord, Lord Patel, I am no longer even on the GMC register. I have to say that that has not stopped the occasional unsuspecting Member of your Lordships’ House seeking my advice. Regretfully, I have to tell them where to go. Perhaps I should rephrase that: I have to tell them where to go to get the best medical advice.

As we have heard, it is almost three years since the Law Commission’s report, more than two years since the Government welcomed it and more than a year since they said that they would put it out to consultation. The glacial progress makes the decision on the third runway seem positively hasty, yet the caring professions and the regulators are desperate for the Government to act. It is pretty clear that we have an outdated system of regulation: it is too elaborate, it is inflexible and it is splintered into too many regulators, which often have inconsistences between them. Those who regulate are already frustrated, and far too many front-line clinical staff are not even officially regulated at all. Healthcare assistants, physician associates and clinical physiologists, to say nothing of carers in nursing homes, are not regulated; they merely have voluntary registers. These can work well but they, too, are frustrated by their lack of powers. Yet all these healthcare workers are on the front line dealing with patients every day, and they do an essential and important job. They could do more, given the confidence of safe and proportionate regulation. We need them now in the NHS.

Let me say a few words about the GMC, which I know best. I am grateful to it for its excellent briefing. Its major complaint is that it is hamstrung by the inflexibility under which it is forced by law to operate. For example, of the 9,000 complaints a year it has to examine in its fitness to practise committees, a very high proportion could, and should, be dealt with locally by the responsible officer in each trust. But the GMC has to examine every case that meets its criteria. Since the cost of doing so consumes about 60% of the GMC’s total budget, it is an enormous waste of money, to say nothing of the trauma to doctors who could easily have been returned to good, safe practice by strong local action.

Then there are the enormously expensive and elongated hearings, with the full panoply of lawyers, in cases against doctors when many could be dealt with much more quickly and cheaply when the doctor admits responsibility for his errors and accepts remedial action. At the moment, that is not allowed. Finally, when there is a problem with an underperforming postgraduate training and education unit in a hospital trust, the GMC has to withdraw all trainees instead of using some sort of proportionate response in which only the relevant bit of the training programme is dealt with. In short, a proportionate response is very difficult under the current rules.

I have one final point, which concerns Brexit—no debate is complete without a reference to Brexit. In this case there are clear advantages—some of the very few. Doctors from the EU can come to practise in the UK without any assessment of their training or level of competence. We have to accept their EU training, and we usually do not know too much about it—unlike doctors from, say, Australia, the USA or anywhere else in the world, who have to go through a thorough appraisal. Now that we are coming out of the EU, it should prove possible for the GMC to assess EU doctors in the same way. I hope that the GMC is prepared and that legislation will allow it to do it.

We have waited far too long for a correction to all the anomalies in regulation that we have heard about today. Let us just get on with it. I hope the Minister will agree.