Health and Social Care Bill

My Lords, I should like to press this question in the context of the amendments in this group. What is the Government’s rationale for making a difference between statutory registration and quality-assured voluntary registration? The noble Baroness, Lady Pitkeathley, has used terms such as ““light-touch””, ““proportionate””, ““appropriate””, ““not so expensive”” and so on. However, I have difficulty in seeing consistency here. On the one hand, we can see that there are very small groups such as clinical perfusion scientists who are employed in only a few centres where open-heart surgery is being done. One could see that there may be a degree of expense in setting up a whole scheme of statutory registration. However, when it comes to groups such as clinical scientists and physiologists, there is a much larger number, but almost all of them are employed in the National Health Service. I understand the argument that they are all, or almost all, operating under the supervision of people who are statutorily registered and are operating in the context of the NHS, which deals with financial claims and so on. However, as noble Lords will know, I have raised repeatedly—perhaps even tiresomely—the question of statutory registration of psychotherapists and counsellors. When I raised it again not so long ago with the Minister, he responded that, no, the Government did not want to go ahead on that front; they wanted quality-assured voluntary registers. The same kind of rules do not apply. Why? First, there is a huge number of these people—certainly enough for it not to be a financial question, as small contributions from all of them would be enough to set up a statutory registration scheme. Secondly, the majority of psychotherapists and counsellors work outside of, and therefore are not subject to the kind of regulation that takes place in, the National Health Service. On top of that, a large proportion of them work on their own, so they are not supervised by statutorily registered colleagues and they are not employed by employers who, Ministers have assured us, would consider their qualifications and supervision. Although, in the context of the current crop of amendments, the argument has been made on the basis of expense and on the basis that these people operate within and are employed by the health service—and are therefore under the supervision of statutorily registered senior colleagues—none of those arguments applies to those who are working in the private sector on their own account. Such people are employed only by the patients who are consulting them, and there is a large number of them. What requirements help Her Majesty's Government to judge whether a profession has statutory registration or quality-assured voluntary registration? None of the arguments that have been adduced is applied consistently.