§ Mr. Deputy SpeakerWith this, it will be convenient to discuss also the following amendments: No. 2, in page 5, line 25, at end insert 'and
(b) the address at which he has his practice or principal practice or, if he is not practising, such address as may be prescribed.
§
No. 3, in page 6, line 9, at end insert—
'(m) the meaning of "principal practice" for the purposes of subsection (1).
§ No. 29, in clause 39, page 28, line 20, leave out 'as his address'.
§ Mr. MossAmendment No. I will require the statutory register to show the osteopath's practice or principal practice address as well as the type of registration—full, conditional or provisional—that he or she holds. The register forms the heart of the statutory scheme. It will provide the assurance to members of the public that a practitioner whose name appears in the register has been appropriately trained, is properly qualified and is fully competent in the practice of osteopathy.
The provisions of clause 37 exempt osteopaths from the rehabilitation of offenders legislation, and place them under an obligation to declare all their criminal convictions, including spent convictions if asked, when applying for registration. So members of the public will be provided with an additional assurance as to a registered practitioner's bona fides and character.
The statutory register will elevate the scheme from the current system of voluntary registration. Voluntary registration has worked exceptionally well for the majority of practitioners. It has also played a key role in paving the way for statutory regulation. However, by its very nature, the voluntary system cannot enforce standards of competence or conduct. If a practitioner chooses not to participate in the scheme, the body that administers the scheme is completely powerless to exercise any jurisdiction over that individual's practice. That fundamental weakness brings into sharp focus the need for a statutory scheme.
As the law currently stands, anyone can call himself an osteopath and set up in practice. There is no obligation to undergo formal training of any nature or to comply with the standards of professional competence. Through the establishment of a statutory register maintained by a statutory council, standards of training, education, proficiency and professional conduct can be enforced throughout the profession in the United Kingdom. The statutory scheme will also require anyone who wishes to practise as an osteopath to conform to the standards set, to be registered on the statutory register and to submit himself to the authority of the statutory council.
Recording the address of a practising osteopath's practice or principal practice will not only provide members of the public with an essential piece of additional information—where to go for treatment—but will play a vital role in the election of members to the general council. The latter point will also apply to the address shown on the register for non-practising osteopaths. The precise detail is set out in the schedule which we shall examine later.
401 I draw the attention of hon. Members to paragraph 9 of the schedule. It specifies that eight of the osteopathic members of the general council are to be elected by fully registered osteopaths whose registered addresses are in England. Three others are to be elected by fully registered osteopaths with registered addresses in Wales, Scotland and Northern Ireland—one from each of the three countries. The schedule also provides for a 12th member, who must be a registered medical practitioner at the time of his election, to be elected by fully registered osteopaths whose registered addresses are in the United Kingdom.
We spent some time thinking about the address that should appear on the register in the case of a non-practising osteopath. Our initial instinct was to select the osteopath's home address, which would have been defined more precisely in the rules. However, two examples came to mind to discount that option. The first was the case of a practitioner who might no longer be in current practice but was widely respected within the profession and had established a clinic, perhaps under his or her name, which attracted practitioners of the highest calibre and was held in the highest esteem by its clientele.
Although no longer in current practice, the practitioner might continue to hold the reins of the clinic and may be regarded as the driving force behind its success. Such a person would undoubtedly want the address shown in the register against his name to be that of the clinic rather than his home address, regardless of how "home" was described in the rules.
The second example raised arguably more serious anxieties. A practitioner might have received menacing threats sufficient to make him consider temporarily suspending practice or, even worse, to make him cease practising because the threats so affected him that he was no longer able to practice. The worst thing that such a person could face if he decided to withdraw from current practice would be the appearance of his home address in the register because he chose to maintain his registration.
I accept that the examples are fairly extreme. Setting them aside, it is likely that some osteopaths will wish to keep their professional and private lives separate and, for such reasons, will not want their home address to be shown on the register. For all those reasons, it is felt that the matter should be left to the rules. The rules could provide a list of different types of address which a non-practising osteopath could choose to be recorded on the register.
§ Mr. Quentin Davies (Stamford and Spalding)Clause 6 is the heart of the Bill because it establishes the register which distinguishes a professional osteopath from simply anyone who decides to use that term. Clause 6 is extremely important if the Bill is to get on to the statute book. Over the years and the generations, there has been considerable scepticism by the medical profession about osteopathy and practitioners of other forms of what is now called complementary or alternative medicine.
Before I came here to speak today, I took advice from a member of the medical profession for whose judgment I have the highest regard—my father. He tells me that, in 40 years of medical practice, he has never yet referred a patient to an osteopath. He has never yet come across a case in which he believed that the conventional medical disciplines of orthopaedics and physiotherapy were insufficient to deal with the complaints for which 402 osteopaths believe that their talents make them exceptionally qualified. Nevertheless, my father, in common with many members of the medical profession, has an open mind and, what is more, he has no doubt as to the integrity of osteopaths. No doubt there are some bad apples in that profession, just as there are in any other profession or activity.
It can only contribute to the confidence of the public and that of the medical profession to advise people whether an osteopath might be able to contribute something to the treatment and cure of symptoms, if it is absolutely clear who is and who is not an osteopath. Such confidence will also be enhanced if everyone is clear about the definition of the word "osteopath". It is therefore essential that we have such a register.
I congratulate my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) on his success in steering the Bill through Committee. He has put a great deal of hard work and careful thought into the Bill, and I have considerable regard for his judgment. That encourages me to offer the Bill my general support.
If the general council is to have the responsibilities set out in clause 6 conferred on it, there should be no doubt about its proactive role. There should be no doubt about the precision and rigour with which the register will be drawn up and maintained. It is therefore important that the amendments proposed by my hon. Friend the Member for Upminster (Sir N. Bonsor), in particular amendment No. 2, which leave out "may" and inserts "shall"—
§ Mr. Deputy SpeakerOrder. the hon. Gentleman is talking about amendment No. 48, which we have not yet reached. Amendment No. 2 refers to the address of an osteopath.
§ Mr. DaviesI hope that I will be able to catch your eye, Mr. Deputy Speaker, when we reach amendment No. 2.
If we are to have a register, a name and address must be provided. There should be no misunderstandings about that address and, therefore, the proposed amendments greatly contribute to the precision and the credibility of the Bill.
§ Amendment agreed to.
§
Amendment made: No. 2, in page 5, line 25, at end insert
'and
(b) the address at which he has his practice or principal practice or, if he is not practising, such address as may be prescribed.'.—[Mr. Moss.]
§ Sir Nicholas BonsorI beg to move amendment No. 48, in page 5, line 26, leave out 'may' and insert 'shall'.
I am grateful for all that my hon. Friend the Member for Stamford and Spalding (Mr. Davies) said about the importance of the amendment. I stress, as my hon. Friend did, the importance to the Bill of the register and the concept of registration. My hon. Friend is right to say that they are central to the Bill.
It is also important to ensure that that registration process is open. There is no point in keeping a register if no one is clear about its purpose or the rules that guide its compilation. It is particularly important that people are aware of the rules that guide who may or may not be included on that register. It is for that reason that I have tabled the amendment, which would amend clause 6(2):
The General Council may make rules in connection with registration and the register and as to the payment of feesto read: "The General Council shall" and so on.403 I am particularly keen that the rules that apply to registration should be made clear to the public as well as to osteopaths, so that a proper assessment can be made of the value of that registration. If, for example, the general council decided, in its wisdom, not to make rules in connection with some of the matters set out in clause 6(3), the value of the registration would be greatly diminished.
The registration procedure will cover a number of matters. For example, clause 6(3)(e) states that the general council may make rules about
the manner in which the Registrar is to satisfy himself as to the physical and mental health of any person applying for registration and the procedure for so doing".Clause 6(3)(d) provides that the general council may make rules aboutthe manner in which the Registrar is to satisfy himself as to the good character and competence of any person applying for registration and the procedure for so doing".Unless people can be satisfied that the registrar has made a proper decision and explored fully the facts behind it, the value of the register will be low.10.15 am
I am not happy that the general council's ability to make a discretionary ruling as to what is and what is not to be disclosed should be left unfettered. Perhaps my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) can tell me whether it is proposed that the rules that govern the establishment of the register and its contents will be made public. I am concerned about the use of the word "may", because, as I read it, it is possible under the Bill for those rules to be unrecorded and undisclosed.
I hope that the general council will have to make rules that set out clearly the background against which the register has been compiled. I hope that it will also set out clearly the criteria that will be taken into account by the registrar when he sets up the register. The register should be available to anyone who wishes to read it, so that he is clear as to its value. I hope that my hon. Friend the Member for Cambridgeshire, North-East will be able to assure me on those issues.
§ Mr. Quentin DaviesI have already paid the compliment to my hon. Friend the Member for Upminster (Sir N. Bonsor) of approving his amendment, even before he had a chance to move it. My hon. Friend has made the essential argument in favour of it, and there is not much that I need to say in support.
When we legislate to give a professional body the power to make rules, it is unsatisfactory if we do not stipulate that that body has the responsibility to make those rules and that, therefore, it must make the appropriate rules. Otherwise, we take away with one hand the responsibility that we have appeared to confer with the other. I set some store by my hon. Friend's amendment, and I agree with what he said about tightening the terms of this crucial clause.
§ Mr. MossMy hon. Friend the Member for Upminster (Sir N. Bonsor) may be aware that at least two similar amendments were considered in Committee. My fundamental reason for resisting my hon. Friend's amendment is the same as that which I gave in Committee. Such an amendment would deprive the general council of the responsibility of exercising its own judgment on important matters—for example, the rules connected with registration and the payment of fees.
404 The Bill is founded on the principle of self-regulation, and it should not render the general council impotent in determining policy and priorities by inflexibly prescribing all its functions in legislation. That would reduce the status of the general council to that of purely an administrative body. The purpose of the Bill is to provide the profession with the statutory framework to enable it to regulate its own activities and chart its future development and growth.
It is worth remembering that the profession itself is seeking the measure. The proposed scheme of statutory regulation will replace the current system of voluntary registration. It is doing so not because, under the voluntary schemes, the profession has failed satisfactorily to register its affairs, but to give it the authority to do more effectively what it has been doing successfully for almost 60 years. Half the members of the general council will be specifically serving the interest of the profession.
Therefore, there is absolutely no basis on which to think that the general council would not make sensible decisions on matters of registration, the payment of fees or other key issues. Furthermore, there is no basis for assuming that such decisions would be detrimental to practitioners. If the profession had any expectation of operating anything but a fair scheme, it would not seek statutory regulation.
My hon. Friend the Member for Upminster asked whether the rules would be made public. I am most happy to confirm that they will.
§ Mr. Quentin DaviesI am grateful for my hon. Friend's assurance, as the issue of the rules being made public is important for the transparency and the public confidence needed if the new system, envisaged in the Bill, is to work. However, if my hon. Friend can give that clear assurance, why is it not written on the face of the Bill?
§ Mr. MossI was about to come to that matter.
The profession is also looking to submit itself to the authority of the Privy Council. If the Privy Council felt that the general council was failing to perform a function that it should perform, it would be able to intervene and direct the general council as appropriate. In extreme cases, the Privy Council could step in and take over the general council's responsibilities. Since the profession, through the legislation, is placing itself under the scrutiny of the Privy Council, that council will show the way in which matters are proceeding in the public interest by making a statutory instrument which is in the public domain.
The Bill already provides the necessary safeguards against the concerns of my hon. Friends. It also entrusts to the general council the ability to exercise its judgment in fulfilling its statutory duty to regulate the osteopathic profession.
§ Sir Nicholas BonsorI must confess that my hon. Friend has not wholly satisfied me on why the Bill contains a great divide between what the general council "shall" do—which applies to about half the provisions—and what the general council "may" do—which applies to the other provisions. I am puzzled over the positioning of the dividing line between discretion and ruling. However, I am grateful to my hon. Friend for giving his assurance about the openness of the rules that lie behind regulation. Therefore, in the light of what my hon. Friend has said, I seek leave to withdraw the amendment.
§ Amendment, by leave, withdrawn.