Medical Act 1983 (Amendment) and Miscellaneous Amendments Order 2006

rose to move, That the draft order laid before the House on 19 June be approved [31st Report from the Joint Committee]. The noble Lord said: My Lords, this is an order about patients: they are at the heart of our changes to the regulation of medical practitioners and other health professionals. The order will improve the way in which the General Medical Council protects patients, first, by simplifying the registration structure and removing discrimination against suitably qualified overseas medical graduates. Secondly, it revises the training requirements for newly qualified medical practitioners with provisional registration. Thirdly, it clarifies arrangements for the temporary registration of visiting eminent specialists and other overseas practitioners visiting the United Kingdom for a special purpose—for example, embassy doctors. Fourthly, it requires new registrants to demonstrate at the point of registration that their fitness to practise is not impaired. It also takes steps to ensure that practitioners cannot derive any unintended benefit by virtue of their name being suspended from the medical register. It introduces compulsory indemnity insurance cover for practising medical practitioners, and it requires newly qualified or restored practitioners to work in an approved practice setting. The Government have a programme to modernise the way in which health professions are regulated, and this order fits into that. It continues the process of updating the Medical Act 1983 carried out in the amendment orders of 2000 and 2002. In a number of important respects, it follows the model used for dentists, nurses, opticians and other health professionals. Our work is making regulation more responsive to patients’ needs and better at protecting them. There have been some suggestions that the Government should end the present system of professional regulation, but that would be the wrong response. Instead, the Government are strengthening regulation in the public interest. It has also been suggested that issues such as the consideration of this order to amend the Medical Act would be better held back until after the release of the findings of the Chief Medical Officer’s review of medical regulation in the light of the fifth report of the Shipman inquiry. However, the contents of the order are essentially a fine-tuning of the regulation of doctors and the administration of the General Medical Council and are outwith the remit of Sir Liam Donaldson’s review. The order covers issues that we should want to be addressing irrespective of the findings of Sir Liam’s review, and it in no way pre-empt his recommendations. Regulatory bodies have risen to the challenge. The General Medical Council has played a full part in bringing the changes about and it has worked hard to develop the further proposals in this order with us—most of them began as GMC proposals. I will summarise the main changes that the order brings about. The first significant change that we encounter on reading the order, after some material about renaming the GMC’s registration decisions panel, is found in Part 2, which introduces amendments relating to the abolition of the register of practitioners with limited registration. This has several purposes. It improves the availability of suitably qualified medical practitioners for the benefit of patients, it simplifies the registration system and it removes possible discrimination against suitably qualified international medical graduates, wherever in the world they have trained. The second major feature is a revision of the training requirements for newly qualified medical practitioners with provisional registration who are training in the United Kingdom. In future, the GMC will require all provisionally registered doctors to complete a programme for provisionally registered doctors. The content of the programmes and the bodies that will be allowed to provide them will be determined by the education committee of the GMC, which will appoint visitors to check that the standards that it has set are being complied with. The next major feature is a clarification of the provisions covering temporary registration for visiting practitioners who qualified outside the European mutual recognition area. Section 27 of the Medical Act is to be replaced by new Section 27A, on temporary registration for visiting eminent specialists, and new Section 27B, on special purpose registration. Both new sections set out arrangements for the conditional, temporary registration of overseas doctors. We then turn to questions of fitness to practise in connection with registration covered in Part 5. Entitlement to registration under the Medical Act will be conditional on the demonstration that an applicant’s fitness to practise is not impaired. The registrar of the GMC is given extended powers to obtain information to confirm that an applicant’s fitness to practise is not impaired at the point of registration. If new information emerges later showing that the practitioner’s fitness to practise was so impaired at the point of registration, the registrar may take steps to remove the practitioner’s name from the register. In Part 6 there are new powers for the GMC, post-registration, to apply to the relevant court to require the production of documents or information related to fitness to practise that have not previously been forthcoming. Part 6 also provides clarification of the GMC’s powers to disclose fitness-to-practise information where it regards it as being in the public interest to do so. Part 7 provides that, where a person’s name is suspended from the register, they be treated in certain circumstances as if their name were still on the register, to avoid them deriving any unintended advantage where fitness to practise may be pending. Part 8 simplifies the arrangements for dealing with cases of fraud or error with regard to registration, allowing these to be dealt with by the GMC’s registrar with a right of appeal to a registration appeals panel. Part 9 clarifies that the revalidation of a medical practitioner’s licence to practise can take place at any time, and it permits the GMC to make regulations that will require medical practitioners to provide the GMC with information to assist it in determining when and how to revalidate them. Part 10 contains a new requirement that all practitioners with a licence to practise should be covered by an adequate and appropriate indemnity or insurance arrangement. That has previously been good practice, but not mandatory. It is in line with arrangements introduced or soon to be introduced for other major healthcare professions. Part 11 requires all newly registered practitioners and certain of those newly restored or transferred from the limited register to work in an approved practice setting until their first revalidation. That will ensure that such practitioners receive the support that they need to enable them to practise effectively and safely. There are also one or two lesser provisions, including some relating to registration fees. For instance, the renewal of registration fees will no longer necessarily be linked to the date of a practitioner’s first registration. Finally, there are minor unconnected amendments to the OpticiansAct 1989, relating to the main purpose of the General Optical Council, and to the Nursing and Midwifery Order 2001, relating to its election scheme. These are significant reforms, which will make a real difference to patients. Organisations as varied as the GMC, NHS bodies and the BMA have expressed support in a full public consultation exercise. The results of that consultation have been made available. I commend the order to the House. I beg to move. Moved, That the draft order laid before the House on 19 June be approved [31st Report from the Joint Committee].—(Lord Warner.)