My right honourable friend the Secretary of State for Health (Patricia Hewitt) has made the following Written Ministerial Statement.
The Government have today laid before Parliament a White Paper on professional regulation (Cm 7013), together with our response to the Fifth Report of the Shipman Inquiry and the related inquiries into Richard Neale, Clifford Ayling, Michael Haslam and William Kerr (Cm 7015). The Government are also publishing today a report which brings together all the action that the Government have taken in response to the six reports that the inquiry published (Cm 7014). Copies have been placed in the Library.
The Government are very grateful to the chairs of the four inquiries—Lady Justice Smith, Dame Anna Pauffley, Suzan Matthews, and Nigel Pleming—and to all those who contributed to their painstaking and thorough deliberations.
Their findings were shocking to patients, the public and professionals themselves. The case of Harold Shipman, the trusted GP who murdered as many as 250 of his patients, is well known. Ayling, Kerr and Haslam sexually abused patients with impunity over many years. Neale's incompetent surgery continued in the United Kingdom although he had already been struck off in Canada.
Even so, people still rightly hold the health professions in the very highest regard and take it for granted that they deliver excellent care as a matter of routine. It is therefore all the more bewildering when that trust is betrayed.
The two documents set out a programme of action on two fronts to ensure that public and professional confidence is sustained. The White Paper sets out measures to strengthen professional regulation. The response to the Shipman inquiry proposes a series of measures to strengthen clinical governance.
The White Paper will ensure that the regulators command the full confidence of both the public and the professions. In future, members of the regulatory councils will be independently appointed, rather than elected; professional members will no longer form a majority on councils; and the accountability of councils to Parliament will be enhanced.
To ensure that all health professionals are safe to practise with their patients, new revalidation arrangements will require them to demonstrate periodically that they have kept up to date. We will introduce in England a system of regional GMC affiliates who will provide support to local employers in acting on concerns about doctors and ensure that their revalidation is carried out rigorously. The arrangements will be piloted, in consultation with the professions and employers, to avoid bureaucracy and ensure that they are proportionate.
In adjudicating on fitness to practise cases, all regulators will adopt the civil standard of proof, with a sliding scale. The adjudication function of the GMC will be made fully independent, to provide further assurance to patients and professionals. Other professions will continue to conduct adjudication panels, but members of those panels will be independently appointed.
As the pharmacy profession undergoes a revolution in its capacity to treat patients, my department will work with the pharmacy profession to establish a General Pharmaceutical Council to regulate pharmacy and agree effective arrangements for the clinical leadership of the profession.
As the Shipman inquiry acknowledged, the NHS has made much progress since the inquiries were established. In particular, new structures and processes to ensure the quality of care, known as “clinical governance”, have put in place systems which will help prevent such abuses continuing undetected again. Further safeguards are needed. This will mean improved support for patients who want to register concerns and measures to ensure they are taken seriously; making more systematic use of information about the clinical outcomes of individual practitioners and teams; ensuring information from different sources is brought together so that a fuller picture about professionals is properly considered and robust action is taken; ensuring more rigorous checks on references and qualifications when health professionals are recruited; providing comprehensive guidance on preventing transgressions of professional boundaries and sexual behaviour with patients; and requiring all primary care organisations to adopt best practice in investigating and acting on concerns.
The department will consult shortly on proposals for a radical overhaul of the processes for death certification. These will ensure a unified system of death certification that provides more effective scrutiny and stronger safeguards for the public. I am also publishing today a report which brings together all the action that the Government have taken in response to the six reports that the inquiry published.
In consultation, all the regulators have acknowledged the need for further reform. The GMC in particular is to be commended for its thoughtful and progressive stance and I congratulate Sir Graeme Catto and the council on the leadership they have shown.
The proposals offer the opportunity for a lasting settlement in the relationship between society and the health professions. Many aspects will require legislation, which we will bring forward as soon as possible.