Food Information (Miscellaneous Amendments) (Scotland) Regulations 2015 (SSI 2015/410)
Item 3 is subordinate legislation. We have one negative instrument before us today. There has been no motion to annul and the Delegated Powers and Law Reform Committee has not made any comments on the instrument. Given that committee members have no comments to make, do we agree to make no recommendation on the instrument?
Members indicated agreement.
General Dental Council (Fitness to Practise etc) Order 2015 [Draft]
Item 4 is also subordinate legislation. We have one affirmative instrument to consider. As we usually do with affirmative instruments, we will have an evidence-taking session with the Government. Once we have had all our questions answered, we will move to the formal debate on the motion. I welcome the Cabinet Secretary for Health, Wellbeing and Sport, Shona Robison, and her officials, who are Ailsa Garland, principal legal officer, from the legal directorate; and Jason Birch, senior policy manager in the regulatory unit, from the health directorate. Do you wish to make opening remarks, cabinet secretary?
Yes, if that is okay, convener. The Scottish Government and the health departments in the three other nations in the United Kingdom are committed to making legislative change in healthcare regulation to enhance public protection. That is why changes are being made to the General Dental Council legislation through the order, which is made under the Health Act 1999.
In the past three years, the GDC has had a 110 per cent increase in its fitness-to-practise case load, which has put a significant strain on its resources. To ensure public protection, the GDC needs to be able to expedite the fitness-to-practise complaints that it receives. It is also clearly vital to prevent the GDC from developing an unmanageable backlog of cases.
Currently, the GDC legislation can make it difficult for the GDC to act swiftly when a complaint is received that a registrant’s practice presents a risk to patient safety. In order to maintain patient safety, generate efficiencies and ensure confidence in dental regulation, changes require to be made in GDC fitness-to-practise processes at the investigation stage.
The order will make five key amendments to the legislation governing the GDC’s processes. The first is to enable the GDC to make rules to allow decision-making functions that are currently exercised by its investigating committee to instead be exercised by officers of the GDC known as case examiners. Currently, if a complaint is taken forward, the GDC must convene an investigating committee. If case examiners are used, a full investigating committee will not be needed for each case, which will lead to the swifter resolution of cases. Given that case examiners will deal with a larger volume of cases than the investigating committees, there is the potential for greater consistency in decision making, which will further enhance patient safety.
Secondly, the proposals will enable the investigating committee and case examiners to address concerns about a registrant’s practice by agreeing appropriate undertakings with that registrant, instead of immediately referring the matter to a practice committee. For example, if a case involved an allegation that a registrant’s health was affecting their fitness to practise, an undertaking could address any public safety risks, avoiding costs and saving time. However, the GDC’s policy is that rules will ensure that a registrant must not be invited to comply with undertakings if there is a realistic prospect of their being erased from the register at a practice committee.
Thirdly, the GDC will have the power to make rules so that the registrar can review a decision that an allegation should not be referred to the case examiners or the investigating committee. That power also extends to review of a decision that an allegation should not be referred from the investigating committee or case examiners to a practice committee.
The GDC’s policy is that its rules will provide that a review can be undertaken by the registrar only if the original decision was materially flawed or if new information has come to light that might have altered the decision and a review is in the public interest. Such a review can only occur within two years of the original decision to close the case.
Fourthly, a power will be introduced to enable the investigating committee, which will be extended to case examiners through rules, to review their determination to issue a warning. At present, a registrant can appeal the issue of a warning only by judicial review which, of course, is a lengthy and costly process.
Finally, it is proposed that registrants will be able to be referred to an interim orders committee at any time during the fitness-to-practise process. That amendment removes ambiguity in the current legislation and ensures that those who are potentially unsafe to practise have their registration restricted while inquiries and investigations are made.
It is estimated that those proposed changes will delivered approximately £2.5 million in annual savings for the GDC, which will no doubt help to reduce future pressure on registrant fees.
It is also worth noting that the General Medical Council, the General Optical Council and the Nursing and Midwifery Council already use case examiners. All three regulators have seen positive benefits from the introduction of case examiners on the speed of completing cases and ensuring public protection. The detail governing the operation of the proposals will require the GDC to amend the procedural rules governing its fitness-to-practise procedures. The GDC has consulted on its proposed rules changes and the negative procedure instrument on those will be laid in the Scottish Parliament this year.
The Scottish Government considers that the best way in which to improve consistency, create greater efficiency and simplify professional healthcare regulation would be to introduce a single United Kingdom bill covering all professional groups, which builds on the work of the law commissions. I have written to the Department of Health on five occasions to ask for confirmation that such a bill will be progressed, and I understand that I will finally receive a response in the near future.
At this stage, I am happy to answer any questions that members might have.
Thank you for that opening statement. Do members have any questions?
What training will the case examiners have? What is in place to ensure that they have the competence to meet the standards that you have laid down?
The case examiners will be given full training by the GDC—we have been reassured on that point—and there will be a case review team that monitors their performance as the work progresses.
What length of experience will case examiners have to have?
Of the case examiners, there will be one registrant and one layperson. The detail will be in the GDC’s guidance, which will be put into the rules in due course. We do not have the absolute detail, but we have been assured that it will be substantial.
Will this change bring the GDC into line with the GMC and the other regulating bodies that you have mentioned? How long is it since those other bodies changed their regulations?
It will. There will be greater consistency of approach. The other regulators have moved in that direction for the same reason, in order to have a more efficient process. The other regulating bodies have had the system in place for a number of years—the GMC has had it for quite some time; I am not sure about the exact dates, but it has operated well over that time.
I thought that the system had been in operation for some time; I was just checking that it had operated well. I think that it is a good idea for the professional regulating bodies to come into line with each other across the country.
I am sure that everyone supports the proposed approach, but there are interesting issues about the things that we formally regulate and the things that the UK formally regulates. Are the processes identical for, say, a dentist and a dental technician? Is the wording of the order identical to the equivalent UK order?
Yes.
Yes, the regulation is UK-wide and applies to all groups that are regulated by the GDC.
The regulation is UK-wide but must be approved by us in relation to certain groups—is that the procedure?
Yes. The situation will be the same in Wales and Northern Ireland.
Four groups are regulated by the GDC: dental nurses, orthodontic therapists, clinical dental technicians and dental technicians. Under the Scotland Act 1998, the approval of the Scottish Parliament is required for any legislation that includes them.
So that is how it is done. It is not formally a legislative consent motion, but it is like that. Is that what you are saying? You have agreed that it should be done at the UK level, but we have to lay separate regulations.
No. The regulations are consistent UK-wide but, because they mention the four groups, the Scottish Parliament needs to be content for the regulations to go ahead.
So it is like a legislative consent motion.
In essence, yes. It is similar to that.
That is interesting. I thought that we had to lay separate regulations.
No. There is just one set of regulations that cover the UK.
As there are no other questions, we move to the formal debate on the affirmative statutory instrument on which we have just taken evidence. I remind you all that members should not put questions to the minister during the formal debate, and that officials cannot take part in the debate. I invite the minister to move the motion.
Motion moved,
That the Health and Sport Committee recommends that the General Dental Council (Fitness to Practise etc) Order 2015 [draft] be approved.—[Shona Robison.]
Motion agreed to.
I will suspend at this point to change the witness panel.
10:56 Meeting suspended.