Considered in Grand Committee
My Lords, the order being debated today makes provision for the transfer of the register of hearing aid dispensers from the Hearing Aid Council to the Health Professions Council and makes provision connected with the abolition of the Hearing Aid Council after it has completed its affairs. The primary benefit of this legislation is to enhance public safety and we believe that it will bring real benefits to hearing-impaired people.
I am sure noble Lords will join me in thanking the Hearing Aid Council for the work it has done in regulating the private hearing aid profession for over 40 years, but now is the time for change. The framework legislation that sets out the powers and duties of the Hearing Aid Council in respect of the regulation of private hearing aid dispensers is outdated. To deliver high-quality services, change is needed and modernisation will prevent gaps in patient safety from occurring.
Noble Lords will be very aware that the background to the proposed transfer of functions stems from the Hampton report in 2005 on regulatory inspections and enforcement. This report called for the merger of the Hearing Aid Council into a new body. After considering the Hampton report’s recommendations, the Government reached the view that, in fact, the Health Professions Council was best placed to regulate private hearing aid dispensers.
The Health Professions Council, established in 2001, has a modern legislative framework. It already successfully regulates 14 other health professions. It has more comprehensive powers and duties than the Hearing Aid Council, which will enhance protection to patients and the public.
The transfer of the register of private hearing aid dispensers to the Health Professions Council will deliver real benefits for everyone concerned. Private hearing aid dispensers will benefit from a considerable reduction in their annual registration fee, from £695 to £76. Employers of private hearing aid dispensers will no longer need to register, as they currently do with the Hearing Aid Council. This will reduce the regulatory burden on businesses and bring them into line with other employers that are regulated under consumer protection legislation, such as the Unfair Trading Regulations 2008. Employers will also make savings as they will no longer have to pay an annual registration fee. The Health Professions Council has significant economies of scale, with over 200,000 registrants, compared with only 1,700 on the Hearing Aid Council’s register.
The abolition of the Hearing Aid Council will also achieve the Hampton report’s aim of reducing the overall number of regulators. This will result in a small reduction in public expenditure as we will no longer need to support the Hearing Aid Council’s running costs. Most importantly, hearing-impaired people will be better protected by a well organised and highly respected regulator with enhanced powers.
At present, the Hearing Aid Council can take action against a practitioner only once harm has actually occurred. However, the Health Professions Council will have the power to remove a practitioner from the register before any harm takes place, on the grounds that a person is likely to present a risk to the public.
The Health Professions Council sets standards of education and training, performance and conduct and is overseen by the Council for Healthcare Regulatory Excellence. The Council for Healthcare Regulatory Excellence provides external assurance that the Health Professions Council is undertaking its duties effectively through its annual performance review process. In its most recent report, the Council for Healthcare Regulatory Excellence described the Health Professions Council as a transparent, well organised, efficient and cost-effective regulator.
The content of the draft order itself transfers the register of private hearing aid dispensers held by the Hearing Aid Council to the register held by the Health Professions Council; it creates a new offence relating to the dispensing of hearing aids by unregistered persons; it makes provision connected with the abolition of the Hearing Aid Council and the cessation of its functions; and it makes transitional arrangements in respect of uncleared Hearing Aid Council casework at the point of transfer.
The Health Professions Council will, for the first time, protect function as well as title. The title “hearing aid dispenser” will be protected, as is currently the case, but in future, any person not registered with the Health Professions Council who performs the functions of a hearing aid dispenser will also commit an offence. The protected functions will be assessing or testing an individual’s hearing, or prescribing a hearing aid for an individual, with a view to supplying a hearing aid for retail, sale or hire to, or for the use of, that individual.
The proposed transfer of the register of private hearing aid dispensers from the Hearing Aid Council to the Health Professions Council will take effect on 1 April 2010. All private hearing aid dispensers on the Hearing Aid Council’s register on that date will automatically transfer to the register held by the Health Professions Council. Both the Hearing Aid Council and the Health Professions Council fully support this transfer and are working closely together already to ensure a smooth transition. The Health Professions Council has worked with the Hearing Aid Council to develop standards of proficiency that the dispensers will be required to meet after the transfer.
The Department of Health has undertaken a full public consultation exercise on the draft order as required by the Health Act 1999. There were 32 respondents to the consultation and the responses were, in general, overwhelmingly supportive of the proposal. In particular, 97 per cent of respondents—noble Lords can work out how many that is—supported the proposal to transfer the functions of the Hearing Aid Council to another body and supported the Health Professions Council as being the most appropriate regulator.
During the debate on this order in another place there was widespread consensus that the policy of the Health Professions Council regulating private hearing aid dispensers was entirely appropriate. A question was raised about the position of retailers of hearing aids who were not traditionally performing the functions of a health professional. This group of people will not be regulated by the Health Professions Council but are covered by normal consumer protection regulation.
We are grateful for the support given to these proposals by the councils, the professions and all the bodies which have an interest in supporting hearing-impaired people, including the voluntary organisations. These changes bring benefits to everyone and, in particular, the measures will provide improved protection for the hearing-impaired. I commend the order to the Committee.
My Lords, the Committee will be grateful to the Minister for introducing the order, which is politically uncontroversial. Indeed, my understanding is—and she has just confirmed this—that it has the full support of all principal stakeholders, including the main voluntary organisations representing deaf people. I am not, therefore, going to spend time talking about it at any length except to welcome its provisions in the round and, more especially, the consequences which will automatically flow from the transfer of regulatory powers from the HAC to the HPC, such as improved public protection, the introduction of fitness-to-practise procedures and the significantly lower retention fees for practitioners. The HPC has proved its worth and its quality as a regulator and the transfer we are approving today has been the subject of considerable thought and consultation.
Besides bringing the regulation of hearing aid dispensers up to date, the order also opens up over the medium term the prospect of regulatory simplification in that it should one day be possible to bring both public and private dispensers on to the same professional register, which they are not at the moment. Indeed, I understand that some NHS audiologists are not regulated at all and that those who are are subject to a mix of statutory and voluntary regulation. That situation cannot be anything other than confusing to the general public. It would be helpful to have the Minister’s confirmation that unification of regulation in the sense I have described is, indeed, the Government’s intention. I should also be grateful if the Minister would comment on how the Government plan in the future to regulate hearing aid assistance.
Finally, I join the Minister in paying tribute to the Hearing Aid Council for its diligent and conscientious work over the years.
My Lords, I, too, thank the noble Baroness for introducing the order to the Committee in such a clear and comprehensive way. Like the noble Earl, Lord Howe, I do not intend to trouble your Lordships for long. That said, I have indicated on previous occasions that I have a personal interest in this subject, being the child of someone who has been reliant on National Health Service hearing aids for approximately 70 years. Consequently, it has long been my concern that people who are losing their hearing have sometimes gone to the private sector in desperation. There has always been concern about the level of service; by that I do not mean just issuing a prescription but the service provided to people in that situation.
There is real pressure in this area. That pressure may be unique to the field of hearing aids; it does not apply to, for example, optical services. That pressure arises because much of the innovation occurs in the private sector. New technology comes to the private sector long before it comes to the NHS. Therefore, there is a commercial interest behind that. I do not for a moment want Members of your Lordships' Committee to think that I consider private dispensers do not have the interests of their clients at heart, as that is not the case. However, in view of what I have just said, I welcome this measure. I also pay tribute to the Hearing Aid Council for the work that it has done. It is commendable that a body should work so assiduously towards its own demise; that is very generous of it. It is right that the Hearing Aid Council, which did not have fitness to practise powers, should transfer its functions to the Health Professions Council. I noted what the noble Baroness, Lady Thornton, said about the challenge that this presents to the Health Professions Council. It has previously protected titles, not functions. The functions that it will have to regulate in future were listed by the noble Baroness: assess, test and prescribe hearing aids. Does that definition include screening? Screening for the hearing impairment of children and adults is carried out in a large number of places and I want to be absolutely sure that those who carry it out are properly regulated. However, I am not clear whether that falls within this definition.
Like the noble Earl, Lord Howe, I noted that there is an intention that private and public dispensers will be registered on a single register with a single set of standards. In my view that day cannot come soon enough. Everybody who suffers a hearing loss deserves the very best and consistent treatment. When do the Government envisage that that unification of registration will happen? I understand from the Hearing Aid Council that it is unlikely to happen until 2011, at least, even though the transfer will occur in 2010. I wish to see that development occur speedily. Like all the bodies and voluntary organisations that have worked on the unification, I think this is a very good measure and I wish it good speed.
My Lords, I am chair of the Council for Healthcare Regulatory Excellence, which is keen to ensure that public protection issues are properly dealt with. The CHRE seeks an assurance from the Government that the HPC will be required to address, through its appropriate committees, the case of any HAC registrant who currently has a sanction imposed on them. It is important that the HPC committees have the full range of sanctions available to deal with the case appropriately and are not bound to follow the HAC’s decisions. This is vital if a new system of regulation for hearing aid dispensers is to offer improved levels of public protection. I therefore want to put a very specific question to the Minister: can she confirm that it is Parliament’s view that when professionals transfer from the Hearing Aid Council register to the Health Professions Council register—or, indeed, in any similar situation in the future because I think we are talking about a principle here—it expects the HPC to exercise its judgment in reviewing whether sanctions imposed by the Hearing Aid Council on an individual are adequate for public protection? I also offer my congratulations to the Minister for her speedy, but clear, exposition and to the Hearing Aid Council and the HPC for their work on this.
I thank noble Lords for their comments and the fact that there is such a welcome for the order. I have had one of the most comprehensive briefs ever—and all excellent stuff. I think that we have been able to find an answer for virtually every question.
The noble Earl asked whether there were plans to regulate any more professions. Indeed, the Health Care and Associated Professions (Miscellaneous Amendments and Practitioner Psychologists) Order 2009 introduced a statutory regulation saying that we would be looking to bring them under the Health Professions Council. A number of groups of healthcare workers are currently not regulated, and we are considering the need to regulate them, and when regulation is justified, identifying an appropriate model of regulation in the light of the recommendations of the extending professional regulation group. That includes hearing aid assistance. The noble Earl also asked about how audiologists could be regulated as a priority. We are consulting on the proposals for healthcare scientists, and we expect to publish the response at the turn of this year. We published a White Paper in February stating the Government’s intention to introduce statutory regulations for healthcare scientists as a priority, and that is what we are pushing forward.
The noble Baroness, Lady Barker, asked about screening, which was a perfectly sensible question. I think that I touched on that in my opening remarks. The legislation addresses the functions performed by the registry as assessing hearing, testing and prescribing a hearing aid, so it includes screening. Provided that the screener is not carrying out these functions with a view to the sale, retail or hiring of hearing aids, there will be no need for them to register. We would expect the screening to be carried out in the manner in which it is being done.
On the merging of private hearing aid dispensers, and NHS-associated practitioners undertaking a hearing aid practitioner role being regulated as one professional group, the role is just emerging within the NHS and requires further development, including ensuring that it fits within the overall career framework for healthcare scientists. The new arrangements are being proposed as part of modernising scientific careers, so I do not expect that the timetable will be any faster than the one that the noble Baroness mentioned.
I can confirm to my noble friend Lady Pitkeathley that Article 6(7) of the hearing aid dispensers order will allow the HPC to deal with cases where the HAC has imposed a penalty in any way that it considers fit, and indeed, there will be a complete review of cases to do whatever it considers appropriate. When the functions transfer from one regulatory body to another, it makes sense to have a review process on the sanctions imposed by that transfer. The HPC has confirmed that it will review outstanding cases and those with sanctions internally in the first instance, with the outstanding cases then likely to be reviewed by a panel. It is not anticipating problems. It is meeting the HAC to discuss outstanding cases on a two-weekly basis. We expect the number of cases to be very small indeed.
I hope that that answers most of the questions. I commend the order to the Committee.
Committee adjourned at 8.05 pm.