HL Deb 26 March 1996 vol 570 cc1645-7

7.47 p.m.

The Earl of Courtown rose to move, That the draft order laid before the House on 8th March 1996 be approved [13th Report from the Joint Committee].

The noble Earl said: My Lords, this order under the Employment Protection (Consolidation) Act 1978 is to preserve the continuity of employment of doctors and dentists in the registrar grades when they move between different health service employers. By the registrar grades I mean the grades of registrar, senior registrar and specialist registrar. The new grade of specialist registrar will gradually replace the grades of registrar and senior registrar.

Registrars, like other doctors and dentists in training, provide services as well as receive training. Indeed, doctors' training in this country is a practical training. They provide a valuable part of the National Health Service.

When National Health Service trusts were established, following the National Health Service and Community Care Act 1990, the contracts of employment of the staff working in hospitals were in general transferred to the trust. However, an exception was made for doctors and dentists in the registrar and senior registrar grades. This recognised the importance of higher specialist training and the fact that most doctors in higher specialist training would have to move between different hospitals in order to gain the necessary experience to complete their specialist training.

In practice, the health boards in Scotland are no longer involved in the provision of clinical services or indeed in personnel management for staff who work in hospitals. It is quite usual to have the situation at present that a registrar is effectively employed by a trust on behalf of the health board, which is the nominal employer. The boards, however, recognise that the employment of the doctor is effectively on behalf of the trust which is responsible for the hospital in which the doctor works. We are going to simplify this by transferring the contracts of employment of hospital registrars to trusts.

The situation in England is roughly parallel to that in Scotland. The registrar grades have been employed by the regional health authorities, which are to be abolished under the Health Authorities Act 1995. The registrar grades will have their contracts transferred to NHS trusts with effect from 1st April this year, and they will have their continuity of service protected. This date, 1st April 1996, is also the grade commissioning date for the specialist registrar grade.

Following consultations with the British Medical Association, Ministers in Scotland as well as England have given an assurance that they are willing to preserve the continuity of service of doctors and dentists in the registrar grades. In other words, a doctor should not suffer a disadvantage from having to rotate between different hospitals as part of his or her training.

Under the Employment Protection (Consolidation) Act 1978 the right to sue for unfair dismissal is restricted to employees who have had a minimum period of service. While we do not expect any doctor to be dismissed, the order will provide that a registrar would not lose continuity of service by virtue of having moved between different health service employers. There are certain other rights under the Act which also depend on a qualifying length of service.

The transfer of the contracts of employment will not alter the terms and conditions of service of the training grade doctors nor is it intended that it should have any adverse effect on their career prospects.

In Scotland the Scottish Council for Postgraduate Medical and Dental Education holds the funding for 100 per cent. of the basic salary costs of doctors and dentists in the training grades. We do not envisage that the transfer of the contracts of employment will in itself affect the funding arrangements.

These changes will affect about 1,000 hospital doctors in Scotland in the registrar and senior registrar grades, most of whom will, over the next year, enter the new specialist registrar grade. The creation of the single grade in higher specialist training was a key recommendation of the working group on specialist medical training otherwise known as the Calman Report.

The order will assist in making an orderly transfer of the registrar grades to trust employment. The educational supervision through the postgraduate deans and the Scottish Council for Postgraduate Medical and Dental Education will remain. I hope that the medical and dental professions will recognise the value of this further safeguard for the registrar grades. I commend the order to the House. I beg to move.

Moved, That the draft order laid before the House on 8th March 1996 be approved [13th Report from the Joint Committee].—(The Earl of Courtown.)

Lord Dubs

My Lords, I shall not take up the time of the House for more than a moment or two. Perhaps I may first declare an interest in that I am a non-executive director of a NHS trust. I have one question. I notice that the order comes into effect on 1st April 1996. What is the position as regards people in the medical and dental professions in the period up to 1st April 1996? Presumably, the point of continuity is that they will be prevented from suffering certain disadvantages through a break in their employment. That is a welcome feature of the proposal.

I wonder, however, whether some persons who changed their position in the period up to 1st April 1996 may not be covered by the order. If that is the case, what can be done to stop their being at a disadvantage? Obviously, no one is in favour of retrospective legislation. In this case, however, retrospection would remedy what I fear could be some significant injustice caused to people caught by the order not having been introduced earlier.

The Earl of Courtown

My Lords, I thank the noble Lord, Lord Dubs, for his support of certain parts of the order. It is a shame that his noble friend Lord Graham of Edmonton did not come to the Dispatch Box as I had hoped because I was intending to wish him a happy birthday.

Lord Dubs

My Lords, as I understand it, my noble friend Lord Graham of Edmonton is celebrating his birthday with his family, which is why I am here in his place.

The Earl of Courtown

My Lords, as regards the noble Lord's query concerning the situation up to 1st April, I am told that contracts transfer from the health boards to the trusts from 1st April 1996. I am not sure whether that completely answers the noble Lord's question. I shall read Hansard and if I can give him further information I shall write to the noble Lord.

On Question, Motion agreed to.