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Baroness Hayman: That would be extremely helpful, and I will ensure that the noble Baroness receives a letter on that point.

I come now to what seems to be the most important issue: that of whether any of the four fundamental functions that I have described can be removed from the existing regulatory bodies. I have listened very carefully to the arguments on this point. I understand the concerns that have been expressed, particularly by those who are proposing these amendments. I would like to reassure them that it has never been our intention to transfer the fundamental functions of the regulatory bodies to any government-appointed puppet body; nor has it been our intention to transfer such functions to representative bodies or trade unions such as the BMA, the RCN or the BDA. If the drafting allows for that, then it is inadvertence rather than malice that is to blame.

We sought to ensure that there was the flexibility to transfer functions from one professional regulatory body to another professional regulatory body, should it be appropriate to do so at some point in the future. In the light of the points which have been raised this evening and my discussions with the various regulatory bodies, however, it seems that the balance of which I spoke earlier, and for which we are aiming, has not quite been achieved in paragraph 8(1) of Schedule 3 to the Bill. There is a concern that the removal of any one of the four fundamental functions from the main regulatory body of the profession through the use of the order-making power would extend the scope of the Bill too far. Therefore, I shall bring forward an amendment at Report stage to ensure that the order-making power does not encompass such a step.

As we intend that the Professions Supplementary to Medicine Act 1960 and the Nurses, Midwives and Health Visitors Act 1997 should be repealed under this

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Bill, special provision will be needed in the case of the CPSM and the UKCC. I can assure the Committee that any successor bodies should have the same protection of functions as that reserved to the existing regulatory bodies. We will be putting the same safeguards on the face of the Bill for the successor bodies to the CPSM and the UKCC.

I hope that the Committee will feel that we have listened carefully to the concerns expressed both outside the Chamber and in today's debate. I trust that noble Lords will understand that we have tried very hard to ensure a balance that perhaps reflects more accurately our recognition of concern that we should ensure enough flexibility to be able to get on with doing what is agreed to be necessary but that we should not leave the possibility of undermining the structure of professional self-regulation which is valued not only by the professions but also by the Government. On the basis of the assurances I have given, which will be backed up by amendments I shall bring forward at the next stage, I hope that the noble Lord, Lord Walton, will feel able to withdraw his amendment.

Lord Walton of Detchant: In many respects this has been an exceptional debate. It has been inspiring in many ways and, certainly for me and, I am sure, for others, heartwarming and immensely interesting. I pay an exceptionally warm tribute to the Minister for the very careful, well-judged and, if I may say so, co-operative, constructive and courteous way in which she responded to our concerns. I pay also special tribute to my noble friends Lord Kilpatrick and Lady McFarlane, and to all of those Members of the Committee who have spoken. I assure the Minister that in tabling the amendments we recognised the good will of the Government and the fact that they had no intention of dismantling the present self-regulatory mechanisms which I genuinely believe have served the professions, and especially the public and patients, very well over many years. However, these are mechanisms in need of modification. The establishment of order-making powers will enable long-awaited changes to be made.

In passing, I should like to tell the noble Lord, Lord Desai, of a recent opinion poll which showed that 92 per cent. of the public trust their doctors. Politicians came out at about 30 per cent., and journalists at about 15 per cent. I do not remember where economists came.

I should point out to the noble Lord, Lord Peston, that I have had several approaches in this respect, although I have not heard from the noble Lord, Lord Christopher. I was not aware that he had become a lay member of the GMC after my presidency ended. However, I have had several approaches from existing lay members of the GMC saying how much they wish to see the powers changed by order-making but how much they also wish to see the fundamental structure of the council's functions preserved.

I am sorry to learn that the lay membership of the noble Lord, Lord Christopher, ended on grounds of age. As a former trade union leader, he must have felt a little like the trade union leader who had been in hospital and

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received a letter from his executive committee wishing him a speedy recovery by nine votes to six, with five abstentions.

We have had an extremely useful debate. I was surprised to learn from the Minister that, under the Professions Supplementary to Medicine Act, the term "infamous conduct in a professional respect" is still used. That was introduced, on the advice of Lord Justice Lopes, into the medical Acts in the 1890s. However, it was subsequently amended to "serious professional misconduct", which is the term most recently used. I am surprised that that archaic term still persists; I am sure that it needs to be changed.

The Minister said a great deal about the safeguards she proposes to introduce into the Bill by government amendments at Report stage. I also seem to recall that she said the word "regulatory" might well replace the word "professional" and that the issue of transfer of powers, about which we have been very concerned, will be dealt with by way of amendment. Moreover, I understand that the very important question of the interposition of the Privy Council between the self-regulatory bodies and government will be dealt with on Report. Indeed, I believe we have received a number of assurances which the professions and all those involved in self-regulation will regard as being most welcome. In the light of those assurances, I beg leave to withdraw my amendment.

Amendment, by leave, withdrawn.

[Amendment No. 203 not moved.]

The Deputy Chairman of Committees (Lord Strabolgi): I should point out to the Committee that if Amendment No. 204 is agreed to I cannot call Amendment No. 205.

[Amendment No. 204 not moved.]

Lord Monkswell moved Amendment No. 205:

Page 52, line 3, at end insert ("nor abolish that part of the register continued by section 7(1) of the Nurses, Midwives and Health Visitors Act 1997 which relates to midwives").

The noble Lord said: In moving this amendment I shall speak also to Amendment No. 212, which stands in my name and also the names of the noble Lord, Lord Clement-Jones, the noble Baroness, Lady McFarlane, and the noble Earl, Lord Howe.

The amendments are by way of a marker to show our respect for midwives--a respect felt by all sides of the Committee and demonstrated by the names of the supporters. I pay tribute to the Royal College of Midwives, which has provided invaluable advice.

Midwives are a separate and distinct professional group; in fact, one of the oldest professions serving humankind. They provide invaluable services to expectant mothers at the time of birth and ensure the good health of both mothers and babies. In the context of this debate, midwifery is a separate and distinct profession from nursing. Therefore, Amendment No. 205 seeks to ensure that there will continue to be a separate and distinct register of midwives.

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Amendment No. 212 is a little more complicated. My understanding of the Government's proposals in this part of the Bill--namely, Clause 47 and Schedule 3--is that the order-making power to vary the legislation affecting the self-regulation of the healthcare professions will be brought into play when the professions approach government with proposals for change that previously would have required primary legislation. However, in the cases of nurses, midwives and health visitors, the Government have initiated a review and we have the report of J.M. Consulting before us. The report recommends a new council of nursing and midwifery with equal representation of nurses and midwives on the basis that health visitors are a specialist branch of nursing and would be represented by the nursing side, while midwives as a distinct profession--not all of whom are nurses--would be represented by the midwives side.

However, in their response to the report the Government suggest that nurses, health visitors and midwives should be represented equally on the new council. This would mean midwives being a minority. There is a feeling that their professional integrity and distinctiveness would be subsumed over time. Therefore, Amendment No. 212 seeks to ensure that safeguards are written into the Bill to protect the professional integrity of midwives and ensure effective self-regulation of their profession.

Although these amendments are presented in good faith, I accept that there are drafting flaws. However, they run counter to the general thrust of the Bill in trying to introduce specific details. I advise the Minister at this stage that they are probing amendments. However, I hope she can provide assurances to midwives, and those of us who are keen supporters of midwives, that their professional integrity is recognised and that their fears that their professional self-regulation may be weakened will be allayed. I beg to move.

6.30 p.m.

Lord Clement-Jones: I speak briefly but emphatically in support of the noble Lord, Lord Monkswell, in putting forward these amendments. The Minister has made us aware of discussions and consultations that have yet to take place. I certainly do not wish to pre-empt them. If the Government have not yet taken a view on these matters, so much the better. It would be helpful if the Minister can at least indicate the state of thinking in this area. As the noble Lord, Lord Monkswell, made clear, one of the problems is that the recommendations of J.M. Consulting in respect of health visitors have not been accepted by the Government, and therefore in a sense the balance on the new body is not to the liking of midwives.

As regards the retention of the midwifery committee, I am not sure what the Government's thinking is. But clearly midwives feel strongly that it must be retained. We have talked about control over education, training and standards of practice. Midwives believe that they constitute a separate profession and that they are best regulated by a committee under the overall council, as the noble Lord, Lord Monkswell, made clear. The

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retention of the midwifery register, if nothing else, goes absolutely to the heart of the matter. Midwives feel strongly that it should be retained.

I realise that it is easy to view many of the debates we have had as representing the professions pleading their own self-interest. However, I do not believe this is simply a matter of self-interest. I believe it is a matter of public interest. I have a huge regard for the midwifery profession, not least because my wife has been a consumer of their services in the past year. We need to maintain standards in this area. We do not want midwives to be subsumed into the generality of a much bigger profession. That must be seen as a threat to them. I hope that the concerns of midwives will be accommodated in the course of the discussions which the Government will pursue.

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