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Health and Social Care Bill

Rarely in proceedings in your Lordships’ House do I ever find myself in disagreement with the noble Earl, Lord Howe. I have to declare an interest as a past president of the General Medical Council. I admit that my seven-year presidency ended in 1989 before I became a Member of this House, so the GMC and its responsibilities have changed substantially since that time, but surely the White Paper and its proposals that related to some of the recommendations of Dame Janet Smith in her important report were designed to remove from the GMC the final jurisdiction over doctors who were being accused of serious professional misconduct, and whose fitness to practise was in some respect impaired by reason of either conduct or health. It is for that reason that—although I have some reservations about many aspects of the White Paper—the OHPA was so designed to stand in the Bill as being the final court, taking away from the General Medical Council the responsibilities for the legal proceedings against any doctor whose fitness to practise was regarded as being impaired. Surely, that independence would now be prejudiced if the OHPA were to be invited not only to be the final court of judgment but to lay down the criteria on which issues of professional unfitness to practise were defined. The GMC has made it clear in its letter that its core guidance in Good Medical Practice, "““sets out the principles and values on which good practice is founded and describes medical professionalism in action. The guidance describes what is expected of all doctors registered with the GMC””," and has always made it clear that doctors may be disciplined if they show, "““serious or persistent failure to follow the guidance””," because that failure can put their registration at risk. The letter goes on: "““Good Medical Practice not only describes how doctors should behave, it sets the standards against which their behaviour is evaluated in any investigation and informs the criteria against which a fitness to practise panel should consider whether their fitness to practise is impaired””." I am very sad, having talked on Monday about the purity of the English language and correct phraseology, to find that an official letter from the GMC goes on to say, "““this criteria for panel decision””," which should be ““this criterion””; being singular and not plural. I pass that over. I quote: "““These amendments would change responsibility for the production and ownership of Indicative Sanctions Guidance from the regulator to OHPA””—" In other words, from the body that is setting the standards to the body that is determining whether those standards have been breached. It would mean that if fitness-to-practise panels were to make decisions, "““without taking into account the GMC’s guidance, then OHPA would be in a position where it was, de facto, setting the standards for medical regulation and usurping the role of the GMC as a standards setting body for the medical profession. It would also generate confusion for patients and the public if it appeared that two separate bodies appeared to be responsible for setting standards for doctors””." I could say much more, because there should be that separation between the standards-setting body and the body that is concerned with the decision as to whether those standards had been breached. In the GMC’s briefing several quite important decisions by learned judges appear to clarify that situation. For that reason, with deep regret to my colleague the noble Earl, Lord Howe, I cannot support the amendments.