Draft Nursing and Midwifery Order and Draft Health Professions Order 2001

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Mr. Heald: The SMAE Institute wrote to the Minister to set out its training. I understand that further detail is required and that there is an on-going discussion. Indeed, the Minister or his officials recently met its representatives to discuss the matter.

Is it right that, if no agreement is reached, the end game will be that the HPC will insist on the same requirements for qualification as the society and that state registration will require a three-year honours degree? Only if an agreement is reached will that not be the case, which is why I told the Minister that he should ensure that an agreement is reached before we legislate.

Mr. Hutton: The hon. Gentleman's point, which I want to rebut, was the suggestion that those who are already qualified from the non-state-registered sector and have an established record of safe practice will none the less be required to undertake a three-year undergraduate degree. That is not how the proposals will work in practice. His concern is due, at least in part, to a misunderstanding and misreading of the orders.

Mr. Heald: Of course we all hope that the outcome will involve the HPC agreeing that the qualifications—for example, the institute qualification that involves two years' training plus one year's clinical practice—are sufficient or that only a small top-up is required. However, that has not been agreed yet, and may not be agreed. At the moment, are we not just guessing?

Mr. Hutton: There must come a time when we can constitute the council, so that it can take such decisions. Ultimately, only the Health Professions Council can take them and if we took the hon. Gentleman's prescription to a logical conclusion, we might be some years away from establishing the council. That would not be a sensible course of action for any Minister to recommend to the House. We must make progress. We can be confident that the HPC will discharge its responsibilities sensibly and reasonably, as it is required to do as a public body. I do not think that the hon. Gentleman's proposal is a course of conduct that I could recommend.

The hon. Members for Oxford, West and Abingdon and for North-East Hertfordshire raised specific concerns about professional advisory committees. The draft order provides for the council, as the hon. Gentlemen know, to set up whatever committees it considers necessary to assist with effective working. In particular, it provides for the council to set up PACs to advise it and its statutory committees on matters that affect any relevant profession. The draft order provides also for a professional majority on the advisory committees, which should be a consolation to the hon. Member for Oxford, West and Abingdon, and for the council to delegate functions apart from those of rule-making.

It will be for the council to determine the appointments processes for the PACs. Given its overarching duty to consult those with an interest, it is inconceivable that professional chiropody bodies of both sectors will not be fully involved in the selection process. I hope that that reassures the hon. Members for Oxford, West and Abingdon, and for Romsey about the involvement of the non-state-registered chiropodists in the work of the PACs. It is important that they are involved because they provide a public service and, in the vast majority of cases, do an excellent job. The proposals are not about denying those competent and safe practitioners an opportunity to continue in the profession of their choice, and we should avoid any absurdity of practitioners reclassifying their profession as foot care therapy, for example, to escape a scheme of sensible regulation. That is not the way forward.

The hon. Member for Oxford, West and Abingdon raised a point about membership of the HPC. He is concerned that current laws deny non-state-registered chiropodists a guaranteed place on the Health Professions Council. The HPC will regulate 12 professional organisations. It is important for the integrity of the overall architecture that we stick with the general rule of one representative for each profession. It would be unsustainable to depart from that principle in relation to one profession, as it would be unfair to the other professions, and it would not be a plausible way forward.

The orders establish the procedure for proper elections of representatives on the new HPC. In the first instance, we have rightly had to appoint in consultation with the professions. In future, an electoral process will be established, and it will be necessary, if not essential, for non-state-registered chiropodists to be fully involved in that process. The numbers are fairly equal, and so it could be an interesting contest.

Dr. Harris: The Minister has been constructive. The answer lies in the professional advisory committees, as he has hinted. He is saying that he expects the HPC to ensure that there is adequate representation from the non-state sector on professional advisory committees. That might reassure the council that the standards for mediated entry to the register will not be set so onerously beyond what is required to reassure the public about quality. I agree with the Minister that we must get on and establish the council. We cannot wait for agreement, because that agreement may never occur.

Mr. Hutton: It is clear from the orders that when the council sets standards and adopts proposals, it must do so within the framework of its role, functions and responsibilities. It could not pursue an agenda, as the hon. Gentleman suggested, that punished or discriminated against a group within a profession for any reason other than the proper discharge of its statutory functions. Such a serious situation could not develop. However, I am grateful to the hon. Gentleman for responding to my point in the way that he did, because we clearly expect the non-state-registered chiropodists to be fully involved in the work of the professional advisory committees. I am sure that that is what the HPC will want to do.

If I have not persuaded the hon. Member for North-East Hertfordshire to support the order, I may have persuaded the hon. Member for Oxford, West and Abingdon and my hon. Friends.

6.21 pm

Mr. Heald: We are not satisfied, but we are in favour of setting up the HPC as a matter of urgency.

On chiropodists and podiatrists, it is unusual for a profession to be almost equally split. The Department of Health has been acting as a broker in negotiations within the profession, and it is important to protect the position of both sides. The Minister could impose a solution, if necessary, but he does not propose to do that. He is saying that the HPC must impose its own solution, and therein lies the problem. It has not been possible so far for the shadow HPC to reach any agreement, and the Minister should intervene to protect the interests of both sides. If he is not prepared to intervene, then we must oppose the order.

6.22 pm

Dr. Harris: I can see that the Minister, quite reasonably, has other business to attend to, so I will not detain him. I am grateful for his comments. We must bear in mind that we cannot expect to ask the Government to recognise professional self-regulation, and then ask the Minister to make the final decision. Therefore, I suggest that the shadow HPC be invited to make clear to the House of Lords what it considers to be the way forward. We will not oppose the order at this point, although we do not bind our colleagues in the House of Lords.

Is it likely that psychotherapy and complementary medicine will be brought within the council's ambit? It would be useful to know, although it is difficult, where the council draws the line.

6.24 pm

Mr. Hutton: I apologise to the hon. Member for Oxford, West and Abingdon for not responding to that point. The HPC must initiate the proposals with regard to how it might extend its remit into other areas. The psychologists have been a candidate for a long while, and they will be strongly pressing their case. In an earlier speech—it feels like a lifetime ago—I mentioned that the operating department practitioners and the perfusionists are also in the queue, and they, too, are early candidates. However, those matters are for the HPC to initiate, and I am sure that they will want to do that in the manner that public bodies usually expedite their business.

Question put:—

The Committee divided: Ayes 9, Noes 4.

Division No. 2]

Begg, Miss Anne Betts, Mr. Clive Fitzpatrick, Jim Hutton, Mr. John Joyce, Mr. Eric
Purnell, James Rapson, Syd Walley, Joan Ward, Ms Clair

Beresford, Sir Paul Cameron, Mr. David
Heald, Mr. Oliver Wilshire, Mr. David

Question accordingly agreed to.


    That the Committee has considered the draft Health Professionals Order 2001.

Committee rose at twenty-six minutes past Six o'clock.

The following Members attended the Committee:
O'Brien, Mr. Bill (Chairman)
Begg, Miss
Beresford, Sir Paul
Betts, Mr.
Cameron, Mr.
Fitzpatrick, Jim
Gidley, Sandra
Harris, Dr. Evan
Heald, Mr.
Hutton, Mr.
Joyce, Mr.
Purnell, James
Rapson, Syd
Walley, Ms
Ward, Ms
Wilshire, Mr.

The following also attended, pursuant to Standing Order No. 118(2):
Drown, Ms Julia (South Swindon)
Lyons, Mr. John (Strathkelvin and Bearsden)

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Prepared 26 November 2001