Health and Social Care Act - From a Bill to an Act
The Health and Social Care Bill received Royal Assent on 21 July and became the Health and Social Care Act 2008. From its introduction into the House of Lords on 15 November last year, the 200 page Bill was debated and scrutinised on no less than 20 days in the two Houses of Parliament.
So now the Bill is an Act what will it mean for doctors, patients and the GMC?
First, it is important to recognise that the whole Act is not about the professional regulation of doctors; a significant proportion of it is dedicated to the establishment of a new body in England and Wales – the Care Quality Commission – that will bring under one roof the registration, inspection and quality functions of the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission.
Second, the Act also covers a number of other important topics including public health protection powers and the new Health in Pregnancy Grant.
The part of the Act dedicated to the regulation of health professions falls into two main areas: the establishment of a new separate adjudicator for GMC fitness to practise hearings; and the introduction of ‘Responsible Officers’ working for healthcare providers.
The establishment of the Office of the Health Professions Adjudicator (OHPA), which is expected to take up its powers in 2011, will see the GMC’s adjudication function transfer to this new body. Cases will be considered by OHPA independently of the GMC. The GMC will maintain its current role in setting professional standards and bringing cases when those standards are not being met.
During the debates on the Bill, the GMC argued strongly that OHPA must exercise its functions, not just independently from the GMC, but also independently from the government as the dominant provider of healthcare in the UK. The GMC also supported the continued use by OHPA of the GMC’s guidance when considering what sanction to impose following a finding that the doctor’s fitness to practise is impaired. We argued that it is essential to maintain a clear link between the setting of standards and the penalties for their transgression.
One of the most significant parts of the Act for doctors is the establishment of a network of ‘Responsible Officers’. Responsible Officers will be based within the NHS and have an oversight role, not just for doctors in the health service, but for those in private practice as well. The Department of Health is consulting on whether the posts of Responsible Officer and local medical directors can be combined.
The Act also confirms that in future all healthcare regulators will be required to adopt the civil standard of proof in fitness to practise hearings; the GMC took this step independently of the Bill in May this year.
The detailed implementation of the Act’s provisions will now be rolled out through further secondary legislation which we will continue to report to you through the pages of GMCtoday.
Parliament approves GMC Council changes
While the Health and Social Care Bill was completing its passage through
Parliament, MPs and peers also debated an order implementing the first
proposals contained in last year’s White Paper, Trust,
Assurance and Safety - The Regulation of Health Professionals in the 21st
Century (
pdf).
This order contained a number of provisions including:
- changes to the Council of the GMC providing for a move early next year to a smaller, wholly appointed Council with equal numbers of professionally qualified and lay members
- transfer of responsibility for maintaining the list of approved UK medical schools from the Privy Council to the GMC
- new powers to facilitate the registration of suitably experienced individuals in times of civil emergency, such as an influenza pandemic.