Health and Social Care Bill

The noble Lords, Lord Walton and Lord Turnberg, asked me about postgraduate deaneries. Postgraduate deans carry out a crucial function of quality assurance and oversight of medical education, and we value those functions. The Government were clear in our response to the NHS Future Forum that we intend to retain the deans. In future they will become part of the new provider-led bodies that will be responsible for education and training locally. We have extended the timetable for the abolition of the strategic health authorities to April 2013 to allow for greater time to manage a smooth transition. We propose that Health Education England will be established next year as a special health authority in order to support the transition. The noble Lord, Lord Turnberg, made the telling point that the time available for teaching is steadily being shaved away so that clinical commissioning groups, as he put it, should have the budget to fund teaching sessions. Funding for clinical placements and the associated costs already comes via the multiprofessional education and training budget, which at the moment is £4.9 billion, a not insignificant figure. This budget will be allocated by Health Education England in future to healthcare and education providers. The noble Lord also asked me about the training of public health doctors and whether such doctors employed by Public Health England and seconded to local authorities would be caught by this. Health Education England will work with Public Health England to oversee education and training for public health staff. I suggest that there will be ample time on later clauses to discuss the role of public health doctors more generally; that is perhaps where we can come back to this, and I look forward to that. The noble Lord, Lord Patel, asked how Health Education England would hold providers to account and how local skills networks will be governed. HEE will have contracts with healthcare providers for education and training, and this will be underpinned by an education outcomes framework. We envisage that skills networks will need to have an independent chair and meet rigorous authorisation criteria set by HEE to demonstrate that they have appropriate capability, financial controls and the necessary partnerships with the education sector. I was also asked by the noble Lord, Lord Walton, and the noble Baroness, Lady Finlay, how we will ensure that the policy of ““any qualified provider”” does not harm education and training and, indeed, how private providers will be contributing to education. The noble Lord, Lord Hunt, asked me a similar question. By giving healthcare providers more responsibility for workforce development, we will place a greater emphasis on their working in a co-operative way to ensure a workforce supply of health professionals. This will be reinforced by duties on healthcare providers—I apologise to him for the phrase, but it is an all-embracing one —to consult on workforce plans and co-operate on the planning and commissioning of education. Proposals are being considered for a levy on all healthcare providers to contribute to the costs of education. However, this is a very complex matter and it needs more detailed consideration before being looked at for future legislation. With regard to the responsibilities of the board and clinical commissioning groups, an issue raised by the noble Lord, Lord Walton, paragraph 130 of Schedule 4 to the Bill amends Section 258 of the NHS Act 2006 so that the Secretary of State, the NHS Commissioning Board and clinical commissioning groups must all exercise their functions to secure that facilities are made available for university clinical teaching. I was asked about the role of the royal colleges and other professional bodies. We want to reinforce national standards and the role of professional bodies such as the royal colleges. That is why we are establishing Health Education England to bring greater national focus, leadership and expertise to contribute to the continuous improvement of education and training. Health Education England will work closely with the royal colleges, professional regulators and a wide range of other bodies. The noble Earl, Lord Listowel, asked about continued professional development of people in outreach services and midwives. I am more than happy to write to him on that important issue. My noble friend Lady Jolly asked about Monitor’s duty to have regard to the need for high standards in education and training. Monitor will need to consider how its regulatory activity affects education and training by providers, and bear in mind the need for high standards when imposing obligations on providers. I was asked by the noble Lord, Lord Walton, about the role of universities. Partnerships with the higher and further education sector are clearly important if we are to plan and commission education and training that continue to respond to the needs of patients. Where the NHS provides the funding for undergraduate education—for nurses and midwives, for example—the NHS will continue to lead on planning. It will work in partnership with higher education institutions and take account of advice from the Centre for Workforce Intelligence. For those courses not directly funded by the NHS, for example medicine, there are discussions at national and local level to ensure that supply matches demand, with advice provided by the Centre for Workforce Intelligence. For example, the Department of Health and NHS colleagues will work with the Department for Business, Innovation and Skills and the Higher Education Funding Council for England to review medical and dental undergraduate numbers. Health Education England will bring together stakeholders to provide clinical advice and consider the future needs of the service. The noble Baroness, Lady Finlay, asked how we could ensure that education and training takes a UK-wide perspective. Education and training is a devolved issue, as she is aware. However, much of the education system, in particular medical and dental education, operates on a UK-wide basis. We aim for co-operation and consistent arrangements, as there are at the moment. UK-wide liaison is currently formalised through the Medical Education UK scrutiny group, attended and chaired in rotation by the four UK CMOs. A memorandum of understanding ensures that any policy developed in one Administration that impacts across the UK is considered at a UK level and is signed by the DH director of medical education and the CMOs of the devolved Administrations. The Medical Education UK reference group, attended by officials from the four UK health departments, monitors that memorandum. It is intended that similar arrangements will be established as part of the reforms. I think I have spoken long enough. This has been an excellent debate and, to pick up a point made by my noble friend Lady Jolly, I am sure that members of the NHS Future Forum will consider it with great interest. My door is open to noble Lords for a continuing dialogue on these issues, not least to the noble Lord, Lord Walton, as I have already said. I hope that he and other noble Lords will feel able not to press their amendments for now on the basis of the Government’s amendment on which I am happy to provide further clarification if it is needed.