General and Specialist Medical Practice (Education, Training and Qualifications) Order 2010

My Lords, I begin by thanking the Minister for introducing the order, which I welcome entirely. I shall therefore not spend long in responding. As the Minister said, it was the report by Sir John Tooke two years ago which recommended that PMETB should be merged into the General Medical Council. The reasons for doing this are several, but the chief of them is to bring together a fragmented system of setting and monitoring standards in medical education and training and to create a clear connection between the registration of doctors, their certification and subsequent revalidation. In short, as a result of this order, there will be a single, competent authority responsible for the qualifications and the performance of a doctor at every stage of his or her career pathway. Those arrangements will bring with them clear and obvious benefits. The noble lord, Lord Patel, is currently conducting a review into the regulation of medical education and training, and there was some feeling that we ought to have awaited the outcome of that review before asking Parliament to approve this merger. However, my own view is that this order, which deals merely with the transfer of basic functions, ought not to compromise the noble Lord’s freedom to make recommendations on a more detailed and practical level. I hope that the noble Lord himself does not feel that we are jumping the gun here. The Tooke inquiry set out what it saw as the features of an ideal regulatory authority—that it should be independent of government, which PMETB is not; have strong lay representation; facilitate training that is flexible and which can adapt to change; and cover the whole continuum of medical education throughout a doctor's career. Tooke also said that there should be one authority overseeing medical education and standards and that that authority should work in close partnership with the profession. I do not think that many people disagreed with those conclusions. While there were several ways of delivering some or most of the desirable features which Tooke identified, the option which the Government chose and which we are now considering was the only one that delivered all of them without introducing an unwelcome degree of risk and expense. It was significant, I think, that 82 per cent of the members of the medical profession who responded to the consultation came out in favour of this option. Everything that I have read and heard leads me to think that the GMC is well prepared to implement the merger smoothly, and strongly placed to cope with its expanded role—which, incidentally, should be facilitated by its well established IT systems and support staff. I am sure, too, that the GMC will be in a good position to take in its stride any improvements to postgraduate medical education that are deemed necessary in the future. It is right that we should thank PMETB for the role that it has played over the last few years and to wish the GMC well as it approaches its new tasks. My only query about this order is technical. Could the Minister clarify why the amendments to the Medical Act 1983, which are set out in Schedule 1 to the order, do not have to be effected by means of primary legislation? How satisfactory is it, and how comfortable should we feel, that we are amending an Act of Parliament in a fairly major way by means of a mere statutory instrument? As I understand it, Schedule 1 says that the performance of the functions currently carried out by PMETB no longer have to be specified in primary legislation, but can instead be prescribed in subordinate legislation. That seems a fairly important change to me, and I would be grateful to hear from the Minister whether the gain in flexibility, which this clearly delivers, justifies the concomitant weakening of parliamentary control and scrutiny.