HC Deb 18 July 1977 vol 935 cc347-9W
Mr. Arnold Shaw

asked the Secretary of State for Social Services whether the Government has yet come to a decision on the implementation of the Report of the Merrison Committee on the Regulation of the Medical Profession; and whether he will make a statement.

Mr. Ennals

The Government have consulted widely on the Report's recommendations, and although many points, including some of major importance, require further consideration, it accepts the clear consensus of opinion within the profession that the Morrison recommendations should generally be accepted.

The Government accept in principle that the General Medical Council should be given responsibility for co-ordinating all stages of medical education, and should maintain an indicative specialist register. It is clear, however, that the specific Merrison suggestions on graduate clinical training have not commanded universal support and that more time is needed to study their full implications. In any case, in the current economic circumstances no commitment could be given to making available the additional resources needed to implement these particular suggestions.

The Government accept in principle the Merrison proposals on altering the legislative arrangements which govern the registration in this country of doctors with overseas qualifications.

The Government accept that the General Medical Council should be given power to control the registration of doctors whose mental or physical health is such as to endanger their patients.

The Government accept in principle the Merrison proposals on the reconstitution of the General Medical Council and in particular that there should be an overall majority of elected members. In the Government's view, however, the chief medical officers or their deputies of the four Health Departments should have seats on the General Medical Council, as, in the case of England, Scotland and Northern Ireland, they have at present, and not observer or assessor status as recommended by Merrison. This would be in addition to the 10 lay Crown nominees recommended by Merrison. This would mean an overall majority for the elected members of six rather than the 10 recommended by Merrison.

A major Bill will be necessary if the Merrison proposals are to be implemented as a whole. Before any such Bill can be introduced, considerable further discussions with the bodies concerned will be needed. As the next step, the Government intend to work out provisional proposals for possible legislation, taking into account the views which have been expressed by the bodies we have consulted, and to initiate further consultations on the basis of those proposals. In further discussions on what changes are desirable in the General Medical Council's responsibilities in the field of medical education, regard will have to be had to the doubts which have been expressed about graduate clinical training and to the resource constraints to which I have referred.

The Government can give no undertaking at this stage when a comprehensive Bill might be introduced; this will clearly depend, amongst other things, on the progress and outcome of consultation. The Government recognise, however, that although the Merrison recommendations on composition of the General Medical Council flow logically from those on functions, and that arguments on that basis can be levelled against piecemeal legislation, there is a strong desire on the part of the medical profession as a whole that legislation providing for the reconstitution of the General Medical Council on the lines suggested by Merrison should be introduced as soon as possible. Moreover, in the Government's view it would be desirable for the General Medical Council to be given as soon as possible, the powers which Merrison recommends to deal with the doctor who is unfit to practise for reasons of physical or mental ill-health, and in its view it would not be right for such powers to be given to the General Medical Council unless its constitution were revised so as to give a greater representation to doctors elected by the profession as a whole. The Government have also had regard to the fact that the General Medical Council has recently been given new functions in the field of recognition of specialist qualifications as a result of the EEC medical directives and that a greater representation on the General Medical Council of bodies responsible for postgraduate medical education is therefore appropriate.

If, therefore, parliamentary time can be found before it is possible to proceed with comprehensive legislation, the Government will introduce a Bill providing for the reconstitution of the General Medical Council along the Merrison lines, with a requirement that there should be a majority of elected members. The reconstituted Council would be required to establish an Education Committee with a majority of appointed members which would assume the Council's existing statutory functions relating to medical education. The Bill would also give the Council powers to control the registration of doctors unfit to practise on health grounds.