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

My Lords, I should like briefly to comment and I must declare an interest as someone with her name on the specialist register of the GMC and as an observer at the Medical Schools Council at the time of the Tooke inquiry. This is an important document; it is being welcomed generally and almost without major reservation, although there will always be some minor ones. However, I have a few questions for the Minister. The first is for clarification. Proposed new Section 34F deals with the, ""Removal of names from the General Practitioner Register and the Specialist Register"." That is not absolutely clear, but I hope that that is because of my not seeing the clarity in its wording. Should somebody fall below the level of their specialist competencies, when we get into revalidation and relicensing would they still remain on the medical register during a period of retraining and then re-enter? It looks as if it is written from the point of view of somebody being struck off for a time, then coming back on or having a suspended medical registration, rather than their simply falling below the line as a specialist. That is one question. Secondly, I very much welcome the provision of emergency powers in the event of a national emergency. That fits completely with the report from this House on pandemic flu, with which everyone here is familiar. However, I wonder whether it should also include a provision that, in a dire emergency, those doctors who have ceased to maintain their GMC registration—within the previous 12 months, perhaps—could be rapidly reregistered, so that they could return to provide hospital services. That would particularly be in some of the specialities where not very many other people would be around. I am thinking of highly specialised areas in surgery, cardiology and so on, where a lot of high-tech medicine is going on. One would hate to see those areas fold completely because we have missed a technicality at this stage. Lastly, I have a much more general question. This order is important for protecting patients. It states clearly how training up to specialist competencies will occur and it says that those doctors on the specialist register have the appropriate skills and competencies and are maintaining them. I hope that the other healthcare professions will pick up that example. We recently had the document Post Registration Career Framework for Nurses in Wales, which Rosemary Kennedy, our Chief Nursing Officer for Wales, led on. That lays out the specialist competencies for nurses. I do not wish to sound disrespectful, but the definition of specialist competencies as regards certain healthcare disciplines is long overdue. In some healthcare disciplines, staff may be graded, paid and viewed by patients as specialists but have no specialist register and, by and large, no framework. I urge the Government to discuss taking forward specialist registration with other registration bodies, thereby enabling patients to assess the skills and competencies of everybody looking after them who is a member of a specialist team. We live in an era of multiprofessional teams, not unidisciplinary ones.