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Out-of-Hours GP Services

Certainly I want to ensure that we learn all the lessons from this, but may I deal with the legal issue last? On the performers list, a report was published last March and officials have been consulting on how all that will be put in place. Where regulations need to be put in place, that will be done shortly, but the hon. Gentleman will appreciate that consultation with the relevant organisations needed to occur and that we wish to move forward with this as quickly as we reasonably can. The hon. Gentleman mentioned holding to account those who have failed in the system, particularly Cornwall primary care trust. The main thing is that we get the system right; that we ensure that those who have failed will no longer be in a situation where failures can take place again; that we are able to examine how the system operates; and that the checks that will protect patients are the ones that occur. I am not convinced about imposing a criminal offence on a PCT. I am not sure who in the PCT the hon. Gentleman wants this to be imposed on—is it the PCT's chairman or its chief executives? I am also unsure as to what the penalty would be. We are talking about a criminal conviction, so does he want these people to be sent to prison? Does he want to fine them? Why would he convict them? These are people who have been employed to do a job, and appropriate disciplinary procedures are in place to deal with them if they do not carry out their job adequately. Boards can be dismissed, and chairmen and chief executives can be removed, so I am still to be convinced about his suggestion that a criminal penalty for these people is the best way of changing behaviour. I am also a bit cautious because we do not want to get into a situation with criminal law, which tends to be absolute in its implications, where people are reluctant to come forward and say that there is a problem in their system that needs addressing because they fear that they might get prosecuted if they were to do so. I am concerned about such implications. As for the GMC carrying out checks, we were aware in 2004 that there was a problem as a result of the Medical Act 1983. That is why we put in place the requirement on PCTs to ensure that English was spoken—that is something that PCTs must do. There may be ways in which PCTs can work with the GMC to ensure that it can be satisfied that people are not only able to speak English, but competent. However, that needs some further discussion between the GMC and the PCTs. In other words, the GMC could act as an agent of the PCTs, but I wish to examine that. My main concern is to ensure that the checks are done—I am less concerned about who does them. I just want them done, because patients deserve safety. As for ensuring that across Europe we have good and competent quality of care, we can discuss with other countries the need for them to improve the quality of what they do. We obviously have a limited amount of control over that, but what we can do is ensure that we have systems in place that enable people to become aware of information about doctors being disciplined or struck off elsewhere. As far as minimum training and induction are concerned, I agree that, as part of minimum standards, we need to ensure that they are included in a national contract. There is a legal requirement now, through the national quality regulations, that those standards be applied, but in this particular case, they were not always applied. That is why I want the model contract, so that there is no doubt on that point. Finally, the hon. Gentleman asked me about extradition and the European arrest warrant. It is indeed the case that an arrest warrant was issued. Unfortunately, it appears that the arrest warrant was issued on 12 March 2009 but the German authorities refused it on 24 March 2009 on the basis that they were already prosecuting the case. I cannot quite work out why they were doing that. It has been suggested that Dr. Ubani asked the German authorities to prosecute him first, so he could avoid extradition on grounds of double jeopardy. The CPS was concerned about that, because it wanted to prosecute him, and contacted Eurojust to query that on 26 March. On 21 April, Dr. Ubani was convicted, received a four-month suspended sentence and made a payment, although it is disputed whether it was a cost or a fine. I hope that that deals with some of the hon. Gentleman's concerns, but we are concerned to engage further with the German authorities on this issue.