Draft Dentists, Dental Care Professionals, Nurses, Nursing Associates and Midwives (International Registrations) Order 2022 Debate

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Department: Department of Health and Social Care
Tuesday 6th December 2022

(1 year, 11 months ago)

General Committees
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Will Quince Portrait The Minister of State, Department of Health and Social Care (Will Quince)
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I beg to move,

That the Committee has considered the draft Dentists, Dental Care Professionals, Nurses, Nursing Associates and Midwives (International Registrations) Order 2022.

It is a pleasure to serve under your chairmanship, Mr Bone.

I turn first to international professionals. International dental care and nursing professionals form a vital part of the NHS workforce and make an important contribution to the delivery of healthcare in the UK—indeed, over a third of dentists joining the General Dental Council register in 2021 qualified outside the UK. There was a near-even split between domestic and international professionals joining the Nursing and Midwifery Council register over the same period, with 23,000 international professionals joining. The GDC and the NMC are the independent statutory regulators for dental, nursing and midwifery professionals in the UK and nursing associate professionals in England. They set registration standards for healthcare professionals who wish to practise in the UK, which ensures that registered and regulated professionals have the skills, competence, health and attitudes that command public trust and, importantly, patient confidence.

I turn to the international registration process. International professionals who wish to practise in the UK must meet the same rigorous standards that we expect of UK-trained professionals, so we believe it is also in everybody’s interest that such professionals can use registration processes that are a fair test of their professional competence and that provide them with a clear route to registration.

We are reforming the legislative framework for the regulation of healthcare professionals to make it faster, fairer and more flexible. The current UK model needs to change to better protect patients, to support our health services and to help the workforce meet future challenges. Ahead of that, action is required to provide the GDC and the NMC with greater flexibility to amend their international registration processes, and we have worked closely with these regulators, along with colleagues in the devolved Governments, to develop proposals that remove from the legislation prescriptive detail about how such processes should operate. That will help the regulators to ensure that future international registration pathways are proportionate and streamlined, while continuing to robustly protect patient safety.

I turn to the greater flexibility for the GDC, the overseas registration examination, the processes and the fee. The draft order provides the GDC with greater flexibility to apply a range of assessment options for international dentists beyond its overseas registration exam, or ORE. The regulator is provided with the same level of flexibility in relation to processes for international dental care professionals. The GDC will have much greater freedom to update the content and structure of its overseas registration examination now and in the future, as they will no longer be set in legislation that requires Privy Council approval to be changed.

Taiwo Owatemi Portrait Taiwo Owatemi (Coventry North West) (Lab)
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I welcome the changes proposed today, but can the Minister elaborate on whether the GDC will be given more support with reviewing the performers list validation by experience, which international dentists will have to go through to be NHS dentists but not for private practice?

Will Quince Portrait Will Quince
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I thank the hon. Lady for her question, and I will certainly come to that—probably in summing up—because the performers list is a wholly separate issue. The draft order is about the registration of dentists and dental professionals, whereas the performers list is about those providing NHS services.

As I said, the overseas registration exam will no longer be set in legislation that requires Privy Council approval for it to be changed. The requirement that dental authorities provide the ORE is removed, allowing the GDC to explore alternative providers, so candidates who were affected by the suspension of the exam during covid will also be provided with extra time to sit it.

We know that the GDC plans to increase OR fees to cover its costs for providing the assessment. A more cost-effective model is likely to be achieved over time as additional providers are identified. I understand that the GDC will first consult on new rules for its international registration process before they come into force.

I want to touch on consultation responses, because Committee members will have had a barrage of emails overnight on the subject. We plan to take forward all the proposals that we consulted on, and we made an amendment to the draft order in the interests of patient safety; that particular point was made in the email Committee members will have received from multiple people overnight. It relates to the requirement that a qualification relied on by an international applicant to the dental care professional register can no longer be a diploma in dentistry. If hon. Members want me to, I can go into further detail on that subject in my summing up.

I also draw the Committee’s attention to an issue raised by the Secondary Legislation Scrutiny Committee, which noted that the House may wish to seek reassurance as to how appropriate safety standards will be maintained. The primary purpose of the professional regulation is to protect patients and the public from harm by ensuring that those providing healthcare are doing so safely. Any new or amended registration pathways will be based on applicants meeting that same standard of training and knowledge as UK-trained professionals. Those standards are set by the independent regulators in consultation with the profession’s public and education providers.

The draft order also makes changes that help to lay the foundation for the regulator to improve processes further in the future. That includes a charging power, so that fees may be charged to international institutions for the cost of recognising their qualifications. That will support the GDC in registering individuals based on an assessment of their qualification, skill and training, or by recognising the qualification that they hold.

I turn to the Nursing and Midwifery Council and the changes to the Nursing and Midwifery Order 2001. The NMC will have flexibility to use two pathways in addition to its test of competence, which will remain the primary registration assessment. The first additional pathway is recognition of an international programme of education, so applicants holding a Nursing and Midwifery Council-approved qualification could meet the council’s requirements without needing to sit the test. The second is qualification comparison, whereby the Nursing and Midwifery Council may ascertain whether an international qualification is of a comparable standard to a UK one. The draft order provides the NMC with greater flexibility to amend such processes by, in effect, stripping out unnecessary detail from the legislation on how it should operate.

The draft order also clarifies the NMC good health and good character declaration requirements, misinterpretation of which can lead to confusion and unnecessary delays to the application process. With that, I commend the order to the Committee.