Professions Supplementary to Medicine (Hansard, 9 May 2000)

§ Lord Clement-Jones
asked Her Majesty's Government:
What prior consultations were carried out in relation to circular HSC 2000/006 Professions supplementary to medicine: employment of practitioners in the NHS and social services departments, issued on 13th March, particularly in relation to "Acquired Rights".

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, this circular was subject to consultation, in draft, with the professional bodies representing the nine professions then regulated by the Council for Professions Supplementary to Medicine (CPSM) and 1370 with NHS trusts, health authorities, the NHS Confederation, local authorities and social services directors.

§ Lord Clement-Jones
My Lords, I thank the Minister for that reply. However, it is quite clear that this circular was imposed on the professions involved rather than being the subject of consultation. All the organisations related to the professions allied to medicine are unanimously of the view that these arrangements and methods of dealing properly with non-fully qualified professionals will have an adverse effect on the quality of NHS treatment and also bode extremely badly for the way in which the new health professional council will be set up. Can the Minister give an assurance that arrangements related to the entry of non-qualified professionals for the other professions allied to medicine will be dealt with in a different manner? Furthermore, will there be proper consultation in the future?

§ Lord Hunt of Kings Heath
My Lords, this is a matter of regulation and it is entirely appropriate that the CPSM forwarded to the Government comments as regards acquired rights, which we have taken forward. It is of course for the CPSM itself to engage in discussions with its constituent boards as to how this is to be taken forward. However, I can assure the noble Lord, Lord Clement-Jones, and all noble Lords that in terms of acquired rights, this would apply to a relatively small number of people. Agreement would be given only after a rigorous process in which the individual board concerned with the individual profession will have a say.

§ Lord Peyton of Yeovil
My Lords, I must apologise because I have not read every word of the circular referred to in the Question. However, I am curious about the phrase, "professions supplementary to medicine". Does that phrase embrace accountants, who nowadays seem far to outnumber the medical profession, whose business it is to make people feel better? No accountant has ever done anything of that kind.

§ Lord Hunt of Kings Heath
My Lords, that is an extraordinarily interesting reflection. Sadly, the number of professions that can be regulated under the heading "professions supplementary to medicine" is 12. We have now reached that figure and so I am afraid that there is no room for accountants.

§ Earl Howe
My Lords, if it is the Government's aim to improve public protection, how can it be right to create a new regulatory body in which the majority of members will have no relevant qualifications and no first-hand knowledge of the professions in question but whose function it will be to decide whether a particular individual is fit to practise? How can that possibly be appropriate?

§ Lord Hunt of Kings Heath
My Lords, the new health professions council, which is to be established, 1371 will ensure that the public interest is brought to the fore. That is why we wish to increase the number of lay persons on the council. They will help to give strategic direction, to protect the public and to ensure that the interests of the public are given primary concern. However, I can assure the noble Earl that, as regards specific issues relating to specific professions and also to disciplinary procedures, there will be opportunities for those individual professions to be involved and consulted. At the end of the day, the new health professions council will work well with a strong, public lay involvement along with the stewardship of the relevant professions.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware that acquired rights applied in dentistry in 1921? Anyone who had been practising as a dentist could be registered. However, it was never accepted that those who were registered as a result of acquired rights had the same skills. The circular states that there are two ways in which such rights can be acquired: first, by "grandfathering"—which means that a practitioner has been in the field for long enough; and, secondly, by acquired rights applied to employees who possess neither qualifications nor the relevant education, training and experience. As the noble Lord, Lord Clement-Jones, said, it appears that many of these people will not be adequately qualified. Does the Minister accept that there is a danger here and can he assure the House that something will be done to check on this?

§ Lord Hunt of Kings Heath
My Lords, the noble Baroness is right to refer to the specific classification on the use of acquired rights which will apply to practitioners who do not qualify for automatic registration but are none the less regarded as practising safely as prosthetists, orthotists or arts therapists, but not necessarily—as the noble Baroness inferred—across the full range of the practice of their particular profession. Each case will be considered on an individual basis. The board, as well as the CPSM, will have to give its approval. I can assure the noble Baroness that I suspect that there will be very few cases indeed where any problems occur. Finally, the public interest will be paramount in any decision taken.

§ Baroness Masham of Ilton
My Lords, does the Minister believe that complicated professions such as psychotherapy should be regulated? Their practitioners have to deal with extremely difficult problems and there could be cowboys in those fields.

§ Lord Hunt of Kings Heath
My Lords, I know that concerns have been expressed as to whether counselling professions in general should be regulated. The health professions council, along with provisions in the Health Act 1999, allow us to extend regulation. We have no specific plans to extend regulation in the 1372 way suggested, but we are talking to stakeholders in that field. We shall consider the matter further in the light of those discussions.

§ Lord Walton of Detchant
My Lords, does the Minister accept that, while professional self-regulation has been criticised in several quarters over the past few months, and while full lay representation on the new council is entirely right and appropriate, it would be extraordinary if qualified members of each of the 12 professions to be regulated were not to serve on the council so that they could present the professional view?

§ Lord Hunt of Kings Heath
My Lords, I pay tribute to the noble Lord for the contribution he has made over many years to self-regulation, in particular within the General Medical Council. I can assure the noble Lord that there will be one qualified person from each of the professions serving on the new health professions council. However, I believe it is right to balance that by increasing the number of lay representatives. Self-regulation works, but it is vitally important that there is a strong element in place to represent the public interest. In that way, the public will have confidence in what the regulatory organisation does when acting on its behalf.