Health and Social Care Bill

My Lords, I thank the noble Lord, Lord Walton, for introducing his amendment, which began this debate, and other noble Lords for their excellent and powerful contributions. The Government recognise that we have some of the best health professionals in the world and we believe that they should be supported by a world-class education and training system. I am heartened by Amendments 2, 6, 8A, 8B and 44, because they indicate that many noble Lords here today share the Government’s view on this matter. That has been amply confirmed by the speeches that we have heard. Amendment 6, tabled by the noble Lord, Lord Hunt, and the noble Baronesses, Lady Thornton and Lady Finlay, and Amendment 2, tabled by the noble Lords, Lord Walton and Lord Patel, would both insert in Clause 1 a duty on the Secretary of State to maintain a system of education and training in the health service. Amendment 44, tabled by the noble Baroness, Lady Thornton, and the noble Lord, Lord Hunt, would insert after Clause 5 a new clause that would give the Secretary of State a new duty to maintain a comprehensive, multi-professional education and training system for health professionals, as well as to ensure the continued professional development of all staff delivering NHS services. Amendments 8A and 8B, tabled by the noble Baroness, Lady Finlay, would both insert in Clause 1 a duty on the Secretary of State to maintain a ““nationally co-ordinated”” system for professional education and training as part of the comprehensive health service. In its report earlier this year, the Future Forum emphasised the critical role that education and training will play in the continued improvement of healthcare services. In our response to its report, we not only made it clear that we agreed with this point but also, in recognition of this fact, committed to introduce an explicit duty for the Secretary of State to maintain a system for professional education and training as part of the comprehensive health service. Government Amendment 43 fulfils the commitment that we made in June in response to the Future Forum’s report. Indeed, it goes further than our original commitment. First, the Secretary of State’s duty goes beyond just health professionals—I say to my noble friend Lord Cotter that healthcare assistants would be included, as well as other health professionals. Secondly, the Secretary of State will be under a duty to maintain an ““effective system”” of education and training rather than just a ““system””. I was not quite clear, listening to the noble Lord, Lord Walton, whether the Government’s amendment has found favour with him. It has been very carefully drafted and I hope that he will support it. I say to the noble Lord, Lord Hunt, that the amendment is not restrictive of the Secretary of State’s accountability. I hope that he can see from the wording that the duty is clear. Subsection (2) is drafted so as to cover all potentially relevant powers. These are not necessarily powers in the 2006 Act. We are satisfied that he has sufficient powers. I take this opportunity to reassure the noble Baroness, Lady Finlay, and the noble Lords, Lord Warner and Lord Hunt, that our amendment provides for co-ordination of education and training at a national level. We agree that that is essential; it has never been in question. The Secretary of State will be under a duty to secure ““an effective system”” of education and training. No system of education and training could be considered effective were it not co-ordinated at a national level. The noble Lord, Lord Warner, was right to mention some of the wider issues that need to be factored into that process. In addition, a new body, Health Education England, will be set up to provide oversight and national leadership for education and training. In its leadership role, HEE’s task will be to bring together all the relevant parties to oversee and shape the development of the healthcare workforce, including the royal colleges and the professional regulators. Finally, the department will own the strategic design of the new education and training system and develop an education and training outcomes framework to set out the outcomes against which the system, and HEE, will be held to account. That is a first. We believe that the amendment that we have tabled most accurately reflects our policy intention and the Secretary of State’s legal functions in relation to education and training in the new system. Indeed, we have already seen a positive response from the BMA to our amendment.