§ LORD CHALFONTMy Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
§ The Question was as follows:
§ To ask Her Majesty's Government what regulations govern the practice of medicine in the United Kingdom; what powers the General Medical Council has in this respect, and from what legislation these powers derive.
§ THE MINISTER OF STATE, DEPARTMENT OF HEALTH AND SOCIAL SECURITY (LORD ABERDARE)My Lords, the practice of medicine in the United Kingdom is governed by the Medical Acts 1956 to 1969 and certain other legislation. The General Medical Council is an independent body exercising powers conferred on it by the Medical Acts. Its general duty is to keep and publish the Register of duly qualified doctors, to regulate the standard of qualifications conferring the right to registration and to take disciplinary action against any registered doctors who may appear, by reason of their misconduct, to be unfit to remain on the Register.
§ LORD CHALFONTMy Lords, I am grateful to the Minister for that Answer. I wonder whether I may ask him one further question. Is the payment of a registration fee a part of the conditions upon which a doctor may be placed on the Register and therefore allowed to practise his or her profession?
§ LORD ABERDAREYes, my Lords, the General Medical Council has the power to charge a fee for registration, and therefore it has the power to de-register if the fee is not paid.
§ LORD SHEPHERDMy Lords, could the noble Lord say whether the existing legislation will have to be amended as a consequence of our entry into the E.E.C. to make it possible for Continental doctors, whose standards may not be exactly equivalent to United Kingdom standards, to come into this country?
§ LORD ABERDARENo, my Lords, not as the situation is at the moment. If there were to be any move towards facilitating the exchange of doctors it would have to be put into effect by directive, and although a directive has I believe been considered, it would of course require our assent before it became effective.
§ LORD BLYTONMy Lords, is the noble Lord aware that there has been consultation in the Colleges on the difference between European qualifications and ours? Is it not a fact that many members of the professional classes, such as doctors and accountants, who are not up to what is referred to as the European standard may not be allowed to practise?
§ LORD ABERDAREMy Lords, I am aware of the feelings the noble Lord has mentioned, but I can only repeat that any qualifications that were recognised in one country or another within the Community would have to be the subject of regulations made by the Council of the Community.
§ LORD POPPLEWELLMy Lords, would not the Minister have another look at this question of the registration fee? Is he aware that concern is felt among ordinary trade unionists that the Medical Council have powers that might almost be referred to as those of a kangaroo court, whereas anything that is done in this particular direction within ordinary normal trade union life is subject to, and would probably be referred to, the N.I.R.C.? There appears to be a wide difference between the professional classes and ordinary trade unionists. Is it not possible to have another look at this matter?
§ LORD ABERDAREMy Lords, as I am sure the noble Lord is aware, a Committee of Inquiry is in process of being set up—I announced the terms of reference before Christmas—to consider what changes need to be made in the existing 697 provisions for the regulation of the medical profession and so on, and the Chairman of this Inquiry will be the Vice Chancellor of Bristol University, Dr. Merrison.
§ LORD POPPLEWELLMy Lords, will this subject be covered by that Committee?
§ LORD ABERDAREMy Lords, the terms of reference are very wide; the Committee will be considering the whole question.
§ BARONESS SUMMERSKILLMy Lords, as the only appeal from the General Medical Council is to the Privy Council, would not appeal prove prohibitive to the average doctor?
§ LORD ABERDAREMy Lords, the General Medical Council is largely run by the profession itself. It is a professional body. I can only say that this Inquiry is now being set up, and all these matters can best be considered by the Inquiry.
§ BARONESS SUMMERSKILLMy Lords, I was asking about an appeal. The only appeal for a doctor against a decision of the General Medical Council, which, after all, determines his whole livelihood and his whole future, is to the Privy Council, and I am asking whether the cost of such an appeal would not prove prohibitive to the average doctor.
§ LORD ABERDAREMy Lords, I am only saying that this is the situation. I am not quite sure whether it is right that it would prove prohibitive. I can certainly tell the noble Baroness that there will be an Inquiry into all these matters.
§ LORD CHALFONTMy Lords, to clear my mind may I ask one final question? Is it a fact that the non-payment of registration fee by a medical practitioner will result in his being struck off the Medical Register?
§ LORD ABERDAREYes, my Lords; that is a fact.
§ BARONESS SUMMERSKILLMy Lords, is not this the only profession in the country—indeed, I should think the only field of work—in which a sum of money determines whether an individual is fit to follow his profession?
§ LORD ABERDAREMy Lords, the General Medical Council has been in existence for a great many years. It is responsible for doing much useful work in ensuring that doctors who treat the public are properly qualified. It has certain powers and it is acting under its legislative powers.
§ BARONESS SUMMERSKILLMy Lords, as this is so important, I am sure that the House will forgive me if I put a question to the noble Lord. Is not this a most unusual situation which has never arisen in this country before: that while an individual may be brilliant in his profession, may have a high moral standard, may have treated many patients successfully, and there is no reason why he should be regarded as unworthy person, because he does not pay £5 his services are denied to the country?
§ LORD ABERDAREWell, my Lords, this is the fact; this is legislation which has been in force for a very long time. The noble Baroness may think it wrong. I can only tell her that most of the doctors have now paid their fees, and of those that have been struck off for nonpayment of fees none so far has been employed in the National Health Service.
§ LORD WALSTONMy Lords, would not the Minister agree that from the point of view of patients, at a time when there is a shortage of doctors, it cannot be considered a desirable state of affairs that on a technicality of this kind well-qualified doctors should be denied the possibility of serving the patients who wish to use them?
§ LORD ABERDAREMy Lords, I do not think it is a technicality. If there is a body which regulates professional work and is responsible for the qualifications of the doctors, and is very largely manned by members of the profession, I think it is only reasonable to expect the doctors to carry out the law as it stands and pay whatever the General Medical Council may establish in the way of fees. But all this may change when we have received the report of the Committee of Inquiry.
§ BARONESS SUMMERSKILLMy Lords, may I ask the Minister one more supplementary question? Why is it that out of 48 members of the General 699 Medical Council there are only two women?
§ LORD ABERDAREMy Lords, I am not responsible for the appointment of the General Medical Council.