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Baroness Kennedy of The Shaws: My Lords, can my noble friend say whether, in answering this Unstarred Question, it is her position that suspension would be wholly inappropriate in cases which involve personal differences between staff? It seemed to me that the Minister was saying that suspension should operate only where there is a risk to a patient or where patient care is involved. Therefore, issues such as those

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mentioned by the noble Baroness, Lady Knight, in opening, would not be appropriate for suspension; nor, for example would attempting to raise the standards of young colleagues and that creating some friction.

Baroness Hayman: My Lords, my noble friend is attempting to draw me into passing judgment on circumstances in specific cases where it would not be appropriate.

Baroness Kennedy of The Shaws: My Lords, in speaking to this matter the Minister said that the priority has to be patient care. No one in this House would disagree with that. But I ask again: is it right that that should be the primary consideration and that matters which are of a different order should not merit suspension?

Baroness Hayman: My Lords, I have to say to my noble friend that there is central guidance covering suspension on clinical matters. That central guidance makes clear, as I stated, the areas where serious accusations have been made which need quick investigation and where patient protection is essential.

I did not wish to be drawn because the grounds for thinking that those circumstances may arise can come from a variety of factors and I do not want to pass judgment on what may be individual circumstances. Guidance exists at the moment. I accept that it is not satisfactory, but on disciplinary hearings which cover non-clinical matters--this was a matter to which my noble friend Lord Rea referred--they are the same for all members of staff within the NHS organisation.

As I said earlier, it is important to see what we are attempting to do in this area and to differentiate suspension from a specific post by an employer from suspension from the register of the General Medical Council. A NHS employer can suspend a doctor from clinical practice only within the confines of the employment contract and while the specific allegation is investigated. Of course, that in turn gives rise to certain other problems, as the noble Lord, Lord McColl, pointed out and we perhaps do not have a satisfactory procedure in the private sector. He saw it as one side of the coin; I have to say that it also works the other way when people can continue to work in the private sector after being suspended for good reason and with good proof from the NHS. The message that that gives, particularly to me, is that it is absolutely essential that the mechanisms to deal with poor professional performance which are held by the General Medical Council, the colleges and other professional bodies, are integrated carefully with those of the National Health Service.

My noble friend Lord Rea asked me a little about the health Bill that will shortly come before Parliament. He is not going to tempt me into disclosing the contents of a Bill that is not yet published, but I think we have made it quite clear that we shall be looking to have order-making powers to enable us to update more effectively and more speedily the arrangements for professional self-regulation. I think that that will be to the benefit of the professionals and patients alike.

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The NHS procedures have not proved adequate to deal with the complex problems of professional practice and conduct which have emerged, and they need to be modernised. We recognise that, and my right honourable friend the Secretary of State for Health has asked the Chief Medical Officer to produce for consultation a set of proposals to address poor clinical performance, concentrating on presentation, early recognition and problem resolution. I think that that goes to the heart of some of the issues about there only being suspension and nothing else as a weapon with which to deal with concerns that need to be addressed but which do not need to be addressed in a way that means you take away someone's professional status and their way of working completely. We would envisage a retraining and

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differentiation of what sort of work is done as being absolutely appropriate and necessary for the protection of patients.

I hope that, in replying to your Lordships this evening, I have made clear that we recognise that there is a problem, and that we are taking firm action to produce solutions and improvements in the current system. However, I must reiterate that that has to be done as part of an overall commitment to improving the quality of care and protecting patients. The systems in place at the moment have not served either some suspended doctors or some patients well in the past. It is our responsibility to change them as part of the modernisation of the National Health Service and to ensure consistently high standards of care for all patients.

        House adjourned at eight minutes before nine o'clock.


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