§ Lords amendment: No. 1, in page 3, leave out lines 25 to 29 and insert ("—
- (a) providing for the erasure by the Registrar from the register of medical practitioners of the name of any person who applies, in the manner prescribed by the regulations, for his name to be erased from the register;
- (b) providing for the refusal by the Registrar of applications under paragraph (a) above in such cases and circumstances as may be prescribed by the regulations;
- (c) making provision")
§ Motion made, and Question proposed, That this House doth agree with the Lords in the said amendment.—[Mr. Sackville.]
§ Mr. Deputy Speaker (Sir Geoffrey Lofthouse)
With this, it will be convenient to discuss also Lords amendment No. 2.
§ Mr. Nigel Spearing (Newham, South)
Lords amendment No. 1 relates to the part of the Bill that allows registered medical practitioners voluntarily to withdraw from the register. The debate in this place, both Upstairs in Committee and here, was inevitably linked to the reasons for that, to the acceptance or otherwise of a voluntary application for erasure from the register and—I put this within the ambit of this discussion—to the terms on which there should be any application for readmission to the register.
Labour Members' concern was recalled by the noble Baroness Cumberlege, and I understand that I can quote her on this matter as she is a member of the Government, giving a Government view: She said:during the debate in another place there was concern that some doctors might abuse the provisions of clause 2 to avoid proceedings concerning serious professional misconduct. The Opposition tabled a number of amendments aimed at addressing that but none of them gave the GMC the flexibility it requires.I fear that she was not reading at least some of the concerns of Labour Members and, I hope, of the whole House. Parliament lays down the ambit for the rules within which the General Medical Council works, but it appeared from her remarks that the GMC was requesting a degree of flexibility that at least Labour Members, both in Committee and on Report, were asking for, and it was denied on those grounds.
The amendment provides(a) … for the erasure by the Registrar from the register of medical practitioners of the name of any person who applies, in the manner prescribed by the regulations, for his name to be erased from the register",and(b) … for the refusal by the Registrar of applications under paragraph (a) above in such cases and circumstances as may be prescribed by the regulations".701 The obvious purport of that amendment was made clear by the noble Baroness Cumberlege when she said:If a doctor decides he cannot maintain a good standard of performance or does not wish to undertake remedial training, he should be allowed to remove his name from the register. Clause 2 provides for this and other similar circumstances in which a doctor may simply no longer wish to be registered; for example, if he is going to work abroad. It also has the effect of providing a quick and easy way for a doctor to remove himself from practice.The Government and the noble Baroness claim that the loophole allowing a doctor to remove his name from the register when he is about to be, or suspects that he is to be, subject to either the performance channel, which is opened up in the Bill, or the professional conduct channel, which is there at present, is to be stopped up to some extent, but that is not so, at least in relation to the wishes of the House. The loophole is stopped up to allow the registrar to act on regulations prescribed by the General Medical Council, and we do not know what those are.
A continuous theme of the debate both upstairs and on the Floor of the House was that the Bill provides the General Medical Council with powers to make regulations and a very wide discretion which, in the view of many hon. Members, were too imprecise. The regulations to which the amendment refers cover one of seven pages of the schedule and about three pages of the main Bill and therefore there is concern that the clause, although no one could oppose it because it partially stops up something that has been spotted, does not go anything like far enough. The provision is not linked in any precise way with the following part of the clause, which is not being amended and which allows for application for reinstatement.
The GMC has the discretion to restore a member. That does not reassure the public, despite the fact that the noble Baroness said:The amendments will enable the GMC to make regulations to allow its registrar to refuse applications for voluntary removal in defined circumstances.I interpret those circumstances to be those defined in regulations, not defined by this House. She continued:this will not only give the GMC flexibility, but also send a message to the profession and the public that the GMC takes a grave view of matters of serious professional misconduct."—[Official Report, House of Lords, 21 July 1995; Vol. 566, c. 490–91]
§ It being Ten o'clock, further consideration of the Lords amendment stood adjourned.
Motion made, and Question put forthwith, pursuant to Standing Order No. 14 (Exempted business),
That, at this day's sitting, the Lords Amendments to the Medical (Professional Performance) Bill may be proceeded with, though opposed, until any hour.—[Dr. Liam Fox.]
§ Question agreed to.
§ Question again proposed, That this House doth agree with the Lords in the said amendment.
§ Mr. Spearing
I beg to contest the noble Baroness's statement. As I said, it is a very loose arrangement with the regulations being entirely in the hands of the GMC. My understanding—the Minister can correct me if I am wrong as these matters are not simple because there is a whole mass of interlocking regulations—is that the regulations must have the approval of the Privy Council, 702 which was the historic origin of the GMC, quite properly, a century ago, and indeed, probably quite properly, of its court of appeal.
I am not sure whether the regulations relating to voluntary removal and reinstatement have to come back to the House under a negative procedure. I am sure that it will not be the affirmative procedure because that proposal was thrown out in Committee. I suspect that the regulations will require only the approval of the Privy Council and no more. If that is so, contrary to what the noble Baroness said, it is evidence that the question of serious professional misconduct and what then happens is in the hands of the Privy Council and the GMC alone, without any reference to this House.
Another matter that was debated in Committee in the other place was raised by Lord Rea. He referred to me because his amendment related to the Archer case, which is well known to the GMC and to the House. His amendment would have allowed the existing professional conduct committee, of which the noble Baroness is so proud, to deny its right to send back to the professional performance committee a finding on a doctor whose performance was considered to be professional misconduct, but not serious. It was suggested that the matter would have to go back to the screener.
Although I do not think that anyone could oppose the Lords amendment, it exemplifies not only the complexity of the Bill and the schedule, but the fact that virtually the whole Bill allows the GMC enormous scope to make its own regulations. This House will have very little opportunity—in fact, none in some cases—to approve the regulations. The operation of the Bill, when it is enacted, may not provide—not least because the professional procedure is in secret—the advantages and the improvements that the GMC says that it wants and that the Government say that the Bill will produce.
§ The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville)
I am glad that the hon. Member for Newham, South (Mr. Spearing) said that no one could oppose the amendment. I am sure that we can dispose of it fairly quickly. I am glad that he approves of the amendment in principle, recognising the concern that some doctors could take advantage of the clause and the Bill to avoid proceedings for serious professional misconduct and that there could therefore be instances when the public interest would be served by a doctor remaining on the register and facing a committee hearing. The hon. Gentleman suggested that the regulations allowed by the amendment are too broad but we believe that experience shows that we can give the GMC the flexibility that it needs to strike a balance in the matter. I commend the amendment to the House.
§ Lords amendment agreed to.
§ Lords amendment No. 2 agreed to.