---

Health and Social Care Bill

I shall take the issue of the composition of regulatory body councils first. The Bill does not tell the full story of the Government’s policy in that respect. As set out in the White Paper, Trust, Assurance and Safety, the Bill removes the restriction in Section 60 of the Health Act 1999 on lay majorities on the councils of healthcare professional regulators. It is our intention that subsequent secondary legislation will then ensure that all councils have parity of membership between lay and professional members as a minimum. We think it is important that every regulatory body has at least parity, because professional majorities on a council can undermine the perception of its independence from the interests of the profession. I think there is widespread agreement about that. Having parity will remove any doubts that a professional majority can influence a council’s decision-making process in favour of the profession. The intention is that every professional regulatory body will have parity, but the removal of restrictions on lay majorities in the Bill will also allow us to consider, on a case-by-case basis, requests from regulatory bodies to move to a lay majority. We want to make that option available to the regulators because moving to a lay majority is an opportunity for a regulator to send a clear and public signal that the interests of patients and the public are at the very heart of what they do. After all, the very reason that a regulatory system exists is to protect patient safety, and having a lay majority may reflect that purpose. This has been recognised by some regulators, including the General Optical Council. Even with a lay majority, there will be ample professional members on the councils bringing a crucial professional perspective to council discussions. When we talk about a lay majority, it is likely to be simply one more lay member than professional members on the council, as a symbolic acknowledgement that the purpose of the regulatory body is to protect patient safety. With regard to the second aspect of this amendment, which would prevent councils from being fully appointed, the noble Baroness, Lady Gardner, said in a recent debate on dentistry that appointed members are wrong because, "““they will not necessarily be representative of the practitioners in the way that someone elected to that post would be””.—[Official Report, 24/4/2008; col. 1698.]" However, it is for precisely that reason that the Government felt it was crucial to move away from elected members. Professional members on a regulatory body should not be representatives of the practitioners who have elected them. That creates a potential conflict of interest and a situation where patients and the public would be entitled to wonder whether the professional member, elected by his peers, saw his first duty to those who elected him or to the patients that the regulatory body exists to protect. The appointment of all professional members is about resolving very valid concerns that being elected places on professional members a responsibility to the interests of their electorate and their specific concerns. It is also about creating a new transparency within regulatory bodies so that it is clear all members on the council are impartial and independent. Professional members of the regulatory councils are there to provide a professional perspective, but absolutely not to represent a specific group that elects them. In the light of these explanations, I hope the noble Baroness, Lady Gardner, feels able to withdraw her amendment.