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Health and Social Care Bill

My Lords, Amendment No. 54A would require the same number of lay members and professionally qualified members on OHPA’s fitness-to-practise panels on all occasions. This is an issue that I would expect OHPA to consider when drawing up its procedural rules. I hope that I can persuade noble Lords that we need to give OHPA the opportunity to consider the advantages and disadvantages of different approaches before it decides how to run its fitness-to-practise panels. Existing best practice is for panels to comprise three people, with the flexibility for more panellists to be added for more difficult and complex cases. The Bill, as drafted, mirrors these arrangements. My noble friend Lady Golding outlined one such difficult case. There are always odd numbers on such panels in order to allow a majority vote. As the noble Baroness, Lady Cumberlege, helpfully pointed out in Grand Committee, lay magistrates almost always sit in threes. This amendment would prevent a simple majority decision by the panel where there is a lay or professional chair. In order to have an equal number of lay and professional panellists, the panel would need to be increased to four people. With a panel of four people, there is obviously no inbuilt mechanism for a majority decision, so there is a genuine mathematical problem. OHPA might also consider that such a restriction on the composition of its panels does not reflect the role of panel members. Lay and professional members are there to listen to the evidence presented and to come to an impartial decision on the basis of this evidence. Having lay and professional members on the panels is not to ensure equal representation but to demonstrate that professional regulation is a partnership between professionals and the public. While I recognise that OHPA may well want to adopt the approach set out in this amendment, I urge the noble Earl, Lord Howe, to give OHPA the independence to make up its own mind. The Bill requires OHPA, in drawing up its procedural rules, to consult the regulators, the professions and CHRE. The rules are also subject to parliamentary scrutiny via the negative resolution procedure. Amendment No. 56 would prevent the move to fully appointed councils of regulatory bodies and would impose a requirement for at least two council members to be elected from the registrants of the relevant regulatory body. It would also—I am not sure that this is an intended effect—delete the provision in the Bill that would enable councils that wish to do so to move to a lay majority via a Section 60 order. While this amendment would allow the majority of the council to be appointed with a minimum of two elected members, the Government feel strongly that the principle of elections among registrants for positions on the councils of their regulatory bodies is wrong. Therefore, I regret that I cannot support this amendment. I am sure that noble Lords will agree that, if the people who are being regulated elect the people responsible for regulating them, this potentially creates a perception that they are there to do the bidding of their electors because they are representatives. As I said in Grand Committee, professional members on a regulatory body should not be representatives of the practitioners who have elected them. Elections create a situation where patients and the public are entitled to question whether the professional member, elected by his peers, sees his first duty to those who elected him or to the patients whom the regulatory body exists to protect. I state clearly for the record that the move to appointments is in no way intended to diminish the role of professional members on councils. Instead, it will add more weight to the professional perspective, as appointed professional members will be free from any doubt that their views are coloured by a responsibility to represent the interests of their electorate. Through the creation of a system of independent appointments by the Appointments Commission, the public and the professions can be assured that people are being appointed because of their abilities, their successful track record of achievement and their commitment to patient safety. The registrants who have these qualities and this experience will be able to apply for appointment through a transparent process and be assessed against competences developed by the commission alongside the regulators. Finally, I emphasise that none of the regulatory bodies is asking to keep its elected members. They have accepted the principle of moving to fully appointed bodies as the best way of securing public confidence in the impartiality of the system of professional regulation. On that basis, and in light of my explanations, I hope that the noble Baroness, Lady Gardner, will feel able not to press her amendment.