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Health and Social Care Bill

moved Amendment No. 127: 127: Clause 95, page 47, line 18, leave out ““in specified circumstances”” The noble Earl said: In moving the amendment, I shall speak also to Amendment No. 128. Both are probing amendments, and they bring us to an issue that has prompted a good deal of debate both inside and outside Parliament: whether the chair of a fitness to practise adjudication panel should on every occasion be legally qualified. At the moment, the Bill specifies that the chair may be legally qualified and furthermore that rules may provide for pilot schemes under which legally qualified chairs are or are not selected for certain sorts of proceedings. I find it difficult to envisage how pilot schemes will work in practice. How, while ensuring fairness and consistency between cases, do you select which cases are going to be chaired by a lawyer and which are not? You could not do it by random selection, because that would open up the prospect of legal challenge. Will it be done by agreement between the parties? If so, one has to ask what doctor would agree to a hearing of their case being chaired by someone other than a lawyer if they believed that this was the best way to achieve a legally secure and fair outcome. I would be glad if the Minister could tell me how she envisages the pilots will be organised. The more substantive issue is one of principle. There is a strong argument that says that what really matters in any adjudication process is the quality of the chairman; in other words, whether he or she has good chairing skills—not whether he or she has a legal qualification. Because the Bill is drafted as it is, I take it that that is the position of the Government, and I know it to be the position taken by the GMC. The contrary position is to say that only someone with a full understanding of the legal process is fit to chair the panel. Adjudication is a legal process; it is not a medical process. The skills and experience that are needed to conduct such proceedings are legal. To take one issue of many, the introduction of the civil standard of proof brings with it apprehensions about fairness and consistency between cases and concerns about how the sliding scale is to work. Those apprehensions and concerns would be considerably allayed if it were known that a lawyer with experience of applying the civil standard had to be the chair of the adjudication panel. In general, applying the law properly and consistently, summing up a case fairly and composing the final judgment thoroughly and clearly are all tasks that, prima facie, are better done by a lawyer. I believe that legal chairs are the norm with the Family Health Services Appeal Authority, which can make decisions that have consequences for a doctor’s future career that can be every bit as profound as a fitness to practise judgment. If it really is the Government’s intention to allow the OHPA to decide which cases should have a legally qualified chair and which need not, it would be helpful to hear from the Minister what criteria should govern those sorts of decisions and why. I beg to move.