I thank noble Lords for their contributions to the debate. I shall attempt to answer the questions set. As ever, I will happily follow up in detail afterwards.
I accept the premise that no one believes that this is a silver bullet that answers all the issues around recruitment and workforce needs. At the same time, I think there is a belief that this is one of many things that can, hopefully, help increase access at the end of the day. I reiterate our commitment to independence, in answer to the question from the noble Lord, Lord Hunt. That is fundamental to this issue and, hopefully, something that the noble Lord, Lord Harris, has recognised through this process.
Probably the point I would like to devote most time to is the one about the DCP register. I must admit that it is something I brought up specifically and wanted to go around the houses on. I absolutely understand the issue: are we cutting off our nose to spite our face? On the equivalence argument—our dentists cannot apply overseas—part of that, as it was described to me, was also the feeling that even in the UK our dentists cannot use the DCP route, so to speak, in that they might be a qualified dentist but want to use some other qualifications, rather than be a dentist. So it was felt that there was no consistency there either.
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To be honest, I inquired about what the circumstances would be if we said we did not want to go forward with that piece of it. As has been mentioned, a large number of people objected to this part of the proposal. To the point from the noble Baroness, Lady Merron: yes, absolutely—I will make sure that Minister Quince’s findings are published everywhere. As I inquired into what would be the consequences of trying to do that, a couple of points were made. One was that this was very much the recommendation of the GDC, and it is important that it is independent and leads this process.
There is also the point that, if we were to try to change something, we would have to go through the whole process again, which would probably result in a
six-month delay. The noble Lord, Lord Harris of Haringey, made the point that we have already tried to introduce this twice before. There are a lot of things that we are trying to do to ease the backlog and make sure we can increase the flow of people going through. This was a conversation I had with Minister O’Brien, who has direct responsibility. It was felt that, rather than delay it a third time to try to change something such as this, on balance it was better to go ahead with the suggested approach.
On the review that was mentioned—a point made by the noble Lord, Lord Allan—I feel we very much need to keep at top of mind the question of how we will review this. While, on the one hand, one criterion is whether this has increased the flow of international dentists into the whole process, another is whether we have reduced the flow of nurses so much that we are, to borrow the phrase from the noble Lord, Lord Hunt, cutting off our nose to spite our face. I see that as a very important part of the review. On balance, I felt that the pros of going forward with this, for all the reasons we have said, probably outweighed the cons of stopping it once more.
On the point from the noble Baroness, Lady Merron, about whether the ability of the GDC to recoup its costs will increase the price so much that it deters people, my understanding is that the problem with the ORE process being such a bottleneck at the moment is partially because of constraints in capacity and partially because it is being done at a deficit. If you increase the price, that gives you the opportunity to expand the number of places and so increase the flow. Again, that is very much something we should look to see through the review—whether, with the increased price, the benefit in terms of increasing supply is not outweighed by the decrease in demand. That will be another piece of the review, as well as the point made about ensuring the consistency of decision-making.
I know that whether there will be any changes to EU applications from this is very much a live issue. The noble Lord, Lord Harris, might be able to give us more insight into the views of the GDC on this; all I will say at this point is that we are very mindful, as noble Lords have said, of the importance of international recruitment to all this. We do not want to introduce more hurdles. Given that our system is currently working and we are making sure that we get that flow from the EEA, we should be mindful about making any changes that might make the process more difficult.
The noble Lord, Lord Patel, raised the point about making sure that experience is as much a criterion in all this as training is. That belief is definitely held on this side, from my experience, to the credit of the system—albeit that, under the past system, I remember helping my wife detail all the experience she had over 20 years or so. Those were very much the assessment criteria then, and I know that that is definitely the intent going forward.
I appreciate the point made by the noble Lord, Lord Allan, that we have to own this decision. On balance, we feel that it is the right thing to do but, inevitably, none of these things is ever risk-free. There may be occasions where we have an unfortunate circumstance, but I absolutely appreciate the sentiment that we must own all of this.
I did not quite catch the acronym from the noble Baroness, Lady Merron, in her question about the recognition of the difficulties with the—I think she said—PRLV. I might need to respond to her in writing, if I may. As I mentioned before, on reviews, clearly we want to make sure that everything in place on protected characteristics remains. When we come to review all this, we will need to make sure that that is applied and that there are no detrimental effects from this.
I hope I have covered most of the points raised. On balance, we believe that the flexibility this gives the GDC and the national Nursing and Midwifery Council will be one of the many tools in our armoury to increase workforce capacity and numbers. As mentioned earlier, it is absolutely not a silver bullet, but it is an important part of all this. I know that Minister O’Brien is working quite hard on the future of NHS dentistry in the contract—I was speaking to him about it just today—so hopefully the House will see proposals in that direction coming forward quite soon that will help the overall position.
I appreciate the contributions of noble Lords and will happily follow up in detail if I have missed any points. I hope that this provides a reassurance that we are arming the GDC and the NMC with the flexibility as independent—I emphasise “independent”—statutory regulators to give them the tools to fulfil their duties in developing and maintaining a robust, proportionate international registration process, hopefully allowing us to continue to recruit from overseas while protecting standards at the same time. I commend this order to the Committee.