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Health and Social Care Bill

My Lords, I thank my noble friend for that clarification. I wish to speak to Amendment No. 54A, moved by the noble Earl, Lord Howe. This amendment is linked to a question that I raised in Committee regarding American doctors practising in this country. I asked whether they would be covered by the rules under which they practised in the United States or whether they would be subject only to the jurisdiction and rules of the General Medical Council. Since then, I have received a letter from my noble friend Lady Thornton, for which I thank her. It states: "““I can confirm that American doctors who wish to practise in the UK must be registered with the General Medical Council. American doctors are therefore subject to the same statutory requirements, rules and regulations as all other doctors on the medical register””." I believe that this could cause a problem for American doctors practising here. As I pointed out in Committee, in most American states doctors have a mandatory duty to report suspected child abuse to the authorities and are protected from liability if they report in good faith. Our Government’s guidance, Working Together to Safeguard Children, recognises the role of health professionals and paediatricians in stating: "““They are uniquely placed to notice possible signs of abuse and it is essential that they follow up any concerns they have in line with locally established procedures. Their first duty is to the child whose safety and well-being is paramount””." Any reasonable person would consider that all this amounts to the same thing, but does it? Not according to the Minister’s letter, for the GMC does not seem to recognise protection for paediatricians reporting in good faith. To be the voice of the child who has no voice can be a risky business, as paediatrician Dr David Southall found to his cost when he did just that and ended up fighting for his professional life. When paediatricians move a vote of no confidence in the GMC and a paper signed by 53 paediatricians complains that the GMC’s action is contrary to child protection work, something should be done. The General Medical Council has to recognise that it needs to change its approach. Until that day, we must do what we can, however small. It would indeed be helpful—the amendment calls for this—to have a balance between lay and professionally qualified members on any fitness-to-practise panel. One hopes that they would have an understanding of and indeed might have met the problems and that they would be able to react correctly to the lower standards of child protection that the GMC seems to require. This amendment would go some way towards redressing the balance, as such knowledge and understanding on a panel are always helpful.