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Health and Social Care Bill

Amendment No. 142 would place a requirement in the Bill for responsible officers to be registered with the General Medical Council. Let me be clear from the start: I agree with the principle of this amendment and I am happy to confirm that the regulations will include a requirement for a responsible officer to be a registered medical practitioner. Proposed new Section 45A(5)(a) of the Medical Act 1983 provides the power for regulations to set out the requirements for a person to be appointed as a responsible officer. An expert group is advising on what those additional requirements will be. In my view, in order to provide greater clarity, the regulations should set out all the conditions that must be met for appointment as a responsible officer and not just some of them. I hope that the noble Baroness, Lady Finlay, will accept my public commitment that her amendment will be reflected in these regulations. Amendment No. 143 would provide that regulations requiring the appointment of responsible officers may include provision for evaluating their performance in the role. I agree that it is important that we ensure that responsible officers have the ability and capability to carry out their duties and I am glad that this issue has been raised. I can reassure the noble Earl and the noble Baroness, Lady Cumberlege, that responsible officers will already be evaluated, because they will be registered medical practitioners. The noble Earl asked who the responsible officer’s responsible officer will be. We have been clear that every doctor in the United Kingdom will relate to a responsible officer. We are also clear that responsible officers will have to be registered medical practitioners. Responsible officers will therefore have to relate to a responsible officer. In our view, it would be appropriate for the responsible officer to relate to one in another organisation. Details will be set out in regulations and guidance following advice from the expert working group that is currently sitting. Under Amendment No. 144, designated bodies would have to provide an individual with an alternative responsible officer if they were requested to do so. If the amendment’s intention is to ensure that a doctor’s career is not damaged unfairly when there is conflict of a personal nature between the doctor and the responsible officer, I fully agree with the principle. However, the amendment as drafted would enable individuals to change responsible officers every time they thought that they might be in trouble. At the very least, this could result in delays in handling cases and, at worst, it could result in a failure to protect patients in cases where the alternative responsible officer was less familiar with the overall context. We should perhaps look instead to the document Maintaining High Professional Standards in the Modern NHS, which already provides guidance for the NHS on handling cases of poor performance for employed doctors. I think that Amendments Nos. 147 and 148 are intended to ensure that, when a concern is raised about a doctor, any underlying issues are identified and addressed, not just those that directly relate to disciplinary action. Amendment No. 147 would make responsible officers responsible for ensuring that action was taken when a system failure was identified. I have some sympathy with this proposal. It is certainly our intention that, where investigation of a concern about a doctor’s performance reveals an underlying problem with the system, the responsible officer should have a role in ensuring that appropriate action is taken. That is why we have said that the responsible officer should be a senior doctor, either at board level or reporting directly to a board member. That will ensure that he or she is senior enough to do something about any system failure. However, this amendment would require the responsible officer to ensure that appropriate action was taken in every case of system failure, whether it stemmed from concern over individual doctors or not. Although in some cases healthcare organisations may wish to combine the roles of responsible officer with wider clinical governance responsibilities, we believe that that is a decision for individual healthcare organisations rather than for the Department of Health. Amendment No. 148 would ensure that appropriate action under Clause 115(1)(c) was timely and included support and consideration of training and remediation. I can assure the noble Baroness, Lady Finlay, that, although this is not set out in the Bill, we will set out in guidance that responsible officers will have to ensure that support is provided to help doctors to undertake their role efficiently and effectively.