COMMONS AMENDMENTS (Hansard, 5 May 1978)

§ Lord WELLS-PESTELL

My Lords, I beg to move that this House doth agree with the Commons in their Amendments Nos. 1 to 7 en bloc. At the same time, I should like to ask your Lordships to allow me to speak to a large number of other Amendments. I am very much afraid that your Lordships may, to say the least, find daunting the number of Amendments which have been made to this Bill in another place. However, I hope that I may be able to reassure your Lordships by explaining that of these 97 Amendments three-quarters are merely technical, in that they either improve or correct the drafting of the Bill, as your Lordships last saw it, or they amend the earlier Medical Acts to make way for a much-needed consolidation of the legislation in this field.

All the new clauses and some of the Amendments concern the registration of overseas doctors. They fulfil the undertaking which I gave to your Lordships' House during the Report stage of the Bill, when the noble Lord, Lord Hunt of Fawley agreed to withdraw his amendments on this subject on the basis and on my assurance that the Government would put down in another place their own Amendments which would reflect the principles and the spirit behind the Amendments of the noble Lord, Lord Hunt of Fawley.

Those noble Lords who have followed the passage of the Bill in another place—and I know that the noble Lord, Lord Hunt of Fawley, has been following it most closely—will know that these clauses and Amendments were well received by all concerned and have been accepted unaltered. This is perhaps not surprising since they were drafted after careful and close consultation with all the organisations involved.

582 The other group of substantive Amendments which concern the electoral rights of overseas doctors and professional conduct and fitness to practice are all relatively minor and were nearly all made in response to points made by Labour back-Benchers or the Opposition or the Liberal spokesman in another place. They, too, are acceptable to all concerned.

In moving that the Commons Amendments Nos. 1 to 7 be agreed, I would seek your Lordships' permission to speak to a whole range of Amendments which come under this particular section. I would wish to speak to Amendments Nos. 12, 14 to 18, 30 to 44, 46 to 48, 51, 60, 68, 72, 79, 80, 82, 83, 88 and 92 to 96. In doing so, I should like to say—because I think it would be helpful to your Lordships in view of the complexity of this matter—that the noble Lord, Lord Sandys, with his accustomed and detailed thoroughness, I know has gone through the whole of the Bill and the Commons Amendments very carefully, and I think he will allow me to say that he himself and those he represents are in complete agreement with them. I think the noble Lord, Lord Hunt of Fawley, would also allow me to say—and both of them can say it for themselves—that he too finds all these Amendments acceptable.

Therefore, I should like just to say one or two other things with regard to these particular Amendments, to which I have asked your Lordships to allow me to speak while I am addressing your Lordships on Amendments Nos. 1 to 7. All these Amendments—and they are numerous, as I have already pointed out—deal with three major themes. They contain a number of new clauses, hence the number of Amendments, but they deal specifically with three matters.

One is the introduction of English language competence as a precondition of registration. I know that it may cause concern to some people to think that we are going to impose an English language competence, but perhaps I can allay anxieties by saying that this condition has been accepted by the overseas doctors. If it is acceptable to them, with respect, my Lords, it is probably acceptable to your Lordships.

Secondly, once the Bill becomes an Act, it will ensure that doctors coming to this 583 country who do not fulfil the necessary requirements for full registration can be given limited registration, for a specific period of five years. At the end of those five years, they must, if they are to continue in the medical services of this country, have satisfied the conditions for full registration laid down by the Bill, including the language competence.

I think that the only other point that I need touch upon is what is known as the reciprocity part of the Bill. Under existing legislation, the General Medical Council may only recognise for the purpose of full or provisional registration a qualification obtained in a country which provides reciprocal practice arrangements to United Kingdom doctors. The countries whose qualifications are currently recognised are Australia, New Zealand, some provinces of Canada, and South Africa. Other countries, for example, India and Sri Lanka, have qualifications recognised if granted before certain dates.

The Merrison Committee criticised this arrangement as not providing a proper basis for the recognition of qualifications, and said that in its view it should be ended. The Merrison Committee took the view that the basic criterion for recognition in future should be that the standard of the qualification should be that of a primary United Kingdom qualification. This is precisely what the Bill implements. It implements this particular recommendation and steps have already been taken to inform the various Governments concerned.

This again has been accepted by all sides in another place. I hope that your Lordships will feel that it is a desirable thing. I have mentioned the three important matters covering the whole batch of Amendments to which I have spoken. Subject to anything that the noble Lord, Lord Sandys, and the noble Lord, Lord Hunt, may wish to say, I beg to move.

§ Lord SANDYS

My Lords, I should like to thank the noble Lord, Lord Wells-Pestell, first for introducing the Commons Amendments to your Lordships and, 584 secondly, for his kind references to myself and my noble friend Lord Hunt of Fawley.

Before us we have a Bill, the Bill as first introduced to your Lordships' House, consisting of 39 pages, and the copy of the Commons Amendments, a total of 33 pages. This is a very remarkable story because, in the words of my noble friend Lord Butler of Saffron Walden, If the spirit is right, everything else will follow". This is a remarkable story because the Government were diffident about introducing the Bill in the first place, because I think that they felt it unlikely that agreement would be reached among all parties. I am happy to say—and I know that my noble friend Lord Hunt of Fawley will agree with me—that not only have all those concerned in the profession, in the General Medical Council, in the British Medical Association, the Overseas Doctors' Association, the Royal Colleges, the Secretary of State, and the Department of Health, reached agreement; but these Amendments, fully discussed in another place, and first introduced in a large number of cases in your Lordships' House and then withdrawn, are now before your Lordships for final approval.

I should like to take this opportunity of thanking the noble Lord for introducing the measure. I shall take further opportunity later for personal reference to the noble Lord, Lord Wells-Pestell, but I should like to say at this stage that he has so rightly dwelt on the major areas. I think that it would be for the convenience of your Lordships' House if we followed the practice when substantial numbers of Amendments are introduced together, and followed the blocks of Amendments so that short references may be made if necessary. I understand that my noble friend Lord Hunt of Fawley will not be making specific reference to each one, nevertheless the opportunity will be given by the Government as each successive block comes forward.

In closing these few remarks, I should like to say that some particularly difficult subjects have been agreed by very large numbers of people, skilled in interpreting the Bill. I believe that this is a triumph.