Joint Committee on Statutory Instruments Eighteenth Report


Memorandum by the Department of Health


The Committee has requested a memorandum on five points concerning the above Regulations.

The Committee's first point

Regulation 6(6) imposes on the Joint Committee on Postgraduate Training a duty in particular to secure that training complies with the requirements of article 31(1) of the Medical Directive [in Schedule 1] in the case of part-time training "as appropriately modified". Given that article 31(1) (as distinct from 34) prescribes requirements for minimum full-time training, explain what the modifications are.

Regulation 6(6) derives from regulation 5(3A) of the National Health Service (Vocational Training) Regulations 1979 (S.I. 1979/1644) ("the 1979 Regulations") as inserted by regulation 7(4) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994 (S.I. 1994/3130). In relation to part-time training, the obligation which is imposed on the Joint Committee on Postgraduate Training by regulation 6(6) is to secure that it complies with the requirements of article 31(1) of the Medical Directive as appropriately modified, together with article 34. Article 31(1) prescribes general requirements for specific training in general medical practice. In the view of the Department, those requirements apply equally to full-time and part-time training, except in so far as paragraph (b) requires training to consist of a full-time course lasting at least two years, and paragraph (c) prescribes certain maximum and minimum periods of training of different types. To interpret the relationship between articles 31(1) and 34 otherwise would be to defeat a principal objective of the Medical Directive, which is to set minimum standards of training for doctors. The requirements in paragraphs (b) and (c) of article 31(1) must be modified in their application to part-time training so that the references to periods of full-time training are treated as if they were references to part-time training which is of equivalent duration, and meets the other requirements of article 34.

The Committee's second point

Regulation 9(5) prescribes, for statements of satisfactory completion of training, that, in the case of periods of training within regulation 6(3), the statement shall be completed and signed by "the practitioner or practitioners" with whom the training took place and, in the case of periods of training within regulation 6(4), by "the practitioner" who has supervised the training. Given that the regulation 6(4) training must be in several specialties, is it intended that the statement applicable to that training shall be completed and signed by more than one practitioner, or only by one.

The experience prescribed by regulation 6(3) is employment for at least 12 months as a General Practice (GP) Registrar. That experience may be undertaken with one trainer, or split between several different trainers, hence the requirement that "the practitioner or practitioners with whom the training took place" must sign the statement of satisfactory completion. Whether or not it is undertaken with different trainers, employment as a General Practice (GP) Registrar is assessed as a whole (by means of summative assessment), hence all the trainers involved will sign the same statement.

In contrast, the experience prescribed by regulation 6(4) will always be undertaken by means of training which is supervised by more than one practitioner, because the requirement is for training in at least two different specialties. It is envisaged that a statement of satisfactory completion of training will be produced in respect of each specialty, hence the requirement in regulation 9(5)(b) that the statement must be signed by "the practitioner" who has supervised the training.

The Committee's third point

Regulation 15(2) precludes the rescinding the appointment of a member of an appeal body for refusal to carry out his duties if he has indicated to the other members how he casts his vote. Explain how a member who has done this could be regarded as having failed to carry out his duties on the appeal.

Regulation 15(2) derives from regulation 11(2) of the 1979 Regulations. It covers the situation where a member of the appeal body participates in the process as far as deciding how he would determine the appeal, but then is unable or unwilling to participate further (for example in relation to the preparation of written reasons for the appeal body's decision, in accordance with regulation 17(2)).

The Committee's fourth point

As regards regulation 15 and 17, explain exactly what constitutes an "indication" of how a member casts his vote and to whom it is made for the purpose of participating in the decision.

Regulation 15(2), as mentioned above, derives from regulation 11(2) of the 1979 Regulations, as does regulation 15(4). The word "indicate[d]" in regulation 15(2) is intended to bear its ordinary meaning. "Indicate" is defined in the Shorter Oxford English Dictionary as "to make known" or "show", "to direct attention to, by speech or writing or gesture". It is open to a member of an appeal body to indicate how he casts his vote by any of these means, and it is not intended that the Regulations should require him to employ any particular method of doing so. Regulation 15(2) requires the indication to be given to the other members of the appeal body. Again, it is not intended to impose any restriction on how this might be done.

The Committee's fifth point

Regulation 17(1) provides that the decision on an appeal is to be a majority decision but that the member who is the Convenor is not entitled to vote "except in the case of an equality of votes". Given that an appeal body is to "consist of four persons" (regulation 14(3)), explain how there can be an equality of votes.

Regulation 17(1) derives from regulation 10(7) of the 1979 Regulations. An equality of votes may in theory occur if one of the members of the appeal body declines to express a view on the appeal and of the other two members who are not the Convenor, one votes in favour of granting the appeal, and one votes against granting the appeal.

15th December 1997

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