HC Deb 21 July 1950 vol 477 cc2714-9
Mr. Blenkinsop

I beg to move, in page 9, line 37, at the end, to insert: () for requiring that before any matters are referred to the Committee they shall, in such manner as may be provided by the rules, have been brought before and investigated by a Committee of the Council constituted in accordance with the rules, and for securing that a person, other than the President of the Council, who has acted in relation to any matter as a member of the Committee constituted as aforesaid shall not act in relation to that matter as a member of the Medical Disciplinary Committee. This is to meet a point raised by the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) and other hon. Members, and its effect is to give statutory form to the present Penal Cases Committee of the General Medical Council, and to secure that there shall be no overlapping of membership of these two committees.

Lieut.-Colonel Elliot (Glasgow, Kelvingrove)

This Amendment carries out suggestions which we made, and we are glad to see it.

Amendment agreed to.

Sir H. Lucas-Tooth

I beg to move, in page 10, line 14, at the end, to insert: (f) for securing that no matter other than a decision in a court of law shall be referred to the Committee unless a statement in writing of the essential facts of the matter has been made and signed by a responsible person. It will be remembered that in Committee there was some discussion on an Amendment moved by the hon. Member for Luton (Dr. Hill) in which it was suggested that a Government Department, before making a complaint to the Council, should institute some preliminary investigation and that the complaint should be fortified by the sworn statement of an officer of the Department. This Amendment is on somewhat similar lines, but is much more moderate. We now suggest that before a matter is referred to the Council for consideration, it should be set down in writing and that some responsible person should take responsibility for the statements upon which the complaint is founded.

All we desire is that a matter which might possibly have a prejudicial effect upon a doctor should not be thrown at the Council without some responsible person putting his name to the matter complained of. We do not ask for an investigation by the Department and we do not ask for a sworn statement.

Mr. I. J. Pitman (Bath)

I beg to second the Amendment.

The Minister of Health (Mr. Aneurin Bevan)

As the hon. Member has just stated, this gave rise to some discussion in Committee and also some feeling that Government Departments ought not themselves to act in such a way as might prejudice the chances of a doctor before the General Medical Council or that they should not themselves act as a Paul Pry. I gave an assurance in Committee, which I think was satisfactory, that where the tribunal under the National Health Service upheld an appeal by a doctor, no documents should be sent to the General Medical Council in such a case. So we have to some extent covered many of the points raised in Committee. The point now raised is that the documents ought not to be pushed at the General Council without any assurance that they were not trivial and irresponsible, and should not set in motion the ornate machinery of the General Medical Council on what might not be a well-founded complaint.

1.15 p.m.

Perhaps the House and hon. Members opposite would be reassured if I stated the actual practice. There was an agreement with the General Medical Council in 1932, after informal consultation with the representatives of the Assurance Act Committee of the British Medical Association. Under this agreement particulars of disciplinary cases investigated by executive councils that were before the insurance committees are set before the General Medical Council when they relate (1) to cases of irregular or lax certification. Obviously, such cases must go forward because in those instances there is not a complainant. In fact, it is the public who is complaining in such a case; obviously, the individual has gained by the kind of certificate he wanted and we must protect public funds against lax certification; (2) to cases of unprofessional conduct; (3) to cases in which allegations of canvassing or fraud are established or substantially supported; (4) since 1944, to cases involving professional negligence.

Those are the classifications of the cases to which the papers relate, and this is what actually happens in connection with the documents. The documents which are sent to the General Medical Council comprise copies of the following: (a) The report of the Medical Service Committee or the local medical committee in certification cases of the Executive Council. Hon. Members, I am sure, are familiar with the machinery here; (b) The decision of the Executive Committee on the report; (c) The report of the persons who hear any appeal against the decision of the Council; (d) The representations, if any, made by the practitioner to the Minister on the question whether any money should be withheld from his remuneration; (e) The letter of the Department conveying the decision of the Minister; (f) The report of the Tribunal in cases where the Tribunal decide to remove the practitioner from the list.

All these documents are, of course, either signed or, in the case of the reports of the Medical Service Committee, approved by persons or bodies; that is, signed by the clerk of the Executive Council or the practitioner himself. However, it is not practicable for the Department to endorse the facts therein stated which are not within the direct knowledge of the Department. In other words, the papers are sent forward signed either by a responsible person or a responsible body, but obviously, we cannot say that the facts in those papers are correct because, before we could state that, we would ourselves have to investigate them, which would mean a pre-trial. If, however, the practitioner contests, for instance, the facts in the report of the General Medical Service Committee, his remedy is to appeal, and the report on the appeal would set out his case.

I think hon. Members will therefore appreciate that in all those cases the facts that are sent are sent through approved machinery, and so no papers would be sent in containing merely tittle tattle which would not be sent or signed by an authorised person. I hope that in those circumstances hon. Members will not find it necessary to press the Amendment.

Sir H. Lucas-Tooth

Could the right hon. Gentleman deal with one possible class of case, where representations have been made by an irresponsible person, through his Member of Parliament, to a Minister? It would be possible for the Department of the right hon. Gentleman to send those papers on without any responsible signature having been set to the matters complained of at any stage. I think the right hon. Gentleman will say that in no circumstances would those papers be sent on to the Council, but an assurance on that point would be valuable.

Mr. Bevan

I cannot conceive of circumstances in which that could take place, but I am quite sure that if there were an exceptional case of that sort, and the Department did send in the papers, then there would be attached to the papers the signature of a responsible person.

Lieut.-Colonel Elliot

There is not much between us on the point. It is simply this, that when papers came up from the insurance committees they were forwarded by a body and, if I remember rightly, the clerks of the insurance committees sent a covering note with them. This proposed procedure seems to us somewhat untidy. I should have thought that some precis or statement on the documents could be submitted, signed by the person sending forward the dossier, as it were, would have been convenient to the Department, the General Medical Council and the person against whom complaint is made.

I should have thought it would have been for the convenience of all concerned, if the suggestion in our Amendment, which I do not think goes very far, had been adopted. This is that there should be a statement in writing of the essential facts of the matter, which would be no more than a precis of the documents sent forward, and that it should be sent forward under some name or other. It is so much simpler than having to refer to innumerable documents.

Mr. Bevan

The difficulty is that in making a precis of documents, the Ministry of Health, which at this stage is not really concerned but is merely acting as a post office for sending the documents on for such action as the General Medical Council considered to be wise, may, by this pre-digestion of the documents, themselves be tendentious. We all know very well that when we have a number of documents and try to assemble their purport in a summarised form it can be highly tendentious. As a matter of fact, I imagine that most of these documents would be in some consecutive order, because they would have been the subject matter of machinery set up under the National Health Service Act—local tribunals, medical committees and what not. I do not think we should be called upon to do rather more than that.

I think, however, that I have satisfied the apprehensions, which were quite legitimate, that the machinery of the Ministry of Health might be used for the purpose of sending frivolous complaints from people, to which no respon- sible signature was attached. Furthermore, I most heartily agree that now we have the National Health Service in existence, and almost all the general practitioners are in contract with the local executive council, we ought to make doubly sure that the State apparatus is not being used for what might develop into an unfortunate system of espionage. We must make sure that it is not turned into a sort of lion's mouth into which all kinds of people might put all kinds of charges against general practitioners, and the Ministry make itself the main instrument of an irresponsible piece of machinery to set afoot investigations into something which might not be tangible at all, but which might be extremely annoying and vexatious to those concerned.

Mr. John Hay (Henley)

The Minister will realise that the point we had in mind on the Committee stage has been very largely cleared up by the statement made this afternoon. Perhaps it is a pity that we did not have that information earlier. The great fear I had was that a doctor might possibly be brought before the General Medical Council by some sort of backdoor method, without any statement of the case against him which be could get hold of and understand. That is now met.

Sir H. Lucas-Tooth

The information given by the Minister will be very valuable to those concerned. I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.