Fifth Standing Committee on Delegated Legislation
Thursday 27 May 2004
Mr. Nigel Beard
Draft Health Professions (Operating Department Practitioners and Miscellaneous Amendments) Order 2004
9.55 am
The Minister of State, Department of Health (Mr. John Hutton): I beg to move,
That the Committee has considered the draft Health Professions (Operating Department Practitioners and Miscellaneous Amendments) Order 2004.
The order will introduce statutory regulation for operating department practitioners. It will strengthen public protection for patients undergoing operations by setting and maintaining in law standards of practice, training and conduct for a group of health care staff that is closely involved in the delivery of patient care. It will bring operating department practitioners in line with their medical and nursing colleagues who work in the same area.
The order was the subject of extensive consultation towards the end of last year, and copies of the consultation document are available. I am glad to say that the proposals have attracted broad agreement. I confirm that the provisions are compatible with the European convention on human rights.
Statutory regulation for operating department practitioners is part of a programme, set out two years ago, to strengthen public protection by extending regulation to all health care staff whose work has a direct impact on patient care. The House has already given the Health Professions Council the power to regulate new professions that are currently unregulated. ODPs are the first new profession to be covered in that way. They will be followed by applied psychologists, health care scientists, and psychotherapists and counsellors. Members of the Committee will be aware that we are now consulting on the regulation of other health care staff without professional qualifications, such as health care assistants and assistant practitioners.
Operating department practitioners provide high standards of patient care during the anaesthetic, surgical and recovery phases of the peri-operative period. ODPs administer drugs to patients about to undergo an operation or during the operation itself, insert catheters or other equipment, close wounds following the operation, and ensure that hygiene and safety standards are strictly observed. It is the ODP's responsibility to check that equipment and disposables such as swabs are properly accounted for after an operation to ensure they are not left inside the patient's body.
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Operating department practitioners are based primarily in the operating department of the hospital, but many work in accident and emergency departments and intensive care units, and they frequently assist cardiac arrest teams. Everyone accepts that those are important functions, which is why I believe we should now make a move towards statutory self-regulation.
The order will bring ODPs within the remit of the Health Professions Council. The council's role will be to set standards of proficiency, conduct, performance and ethics for ODPs; to set standards of education and training that will produce competent, safe and effective ODPs; and to maintain a register of those who meet the standards and are fit to practise. The council will also have a mechanism for investigating complaints and dealing with those registrants who cease to meet standards; it can caution them or impose conditions on their practice, such as removing them temporarily or permanently from practice.
The latter point will be the responsibility of the HPC's fitness to practise system, under which the council can investigate allegations against those registrants about whose practice complaints have been made. If, on investigation, the council decides that a registrant has a case to answer, it will hear the case and impose any necessary sanction to restrict that registrant's practice. That process will ensure that the council's register contains only those who remain fit to practise.
The order will make it a legal requirement that only properly trained and competent ODPs are allowed to practise as such. The order means that article 39 of the Health Professions Order 2001 will apply to ODPs. It will apply equally to all health care providers, in the public as well as the independent sector.
The order includes protection of title by law. That means that those who call themselves by a protected title such as operating department practitioner who are not registered will be committing an offence, which will be subject to summary prosecution and a substantial fine not exceeding £5,000. The offences include falsely representing oneself to be registered, using a title to which one is not entitled, and falsely representing oneself to possess qualifications in the relevant profession.
The order includes transitional grandparenting provisions, which I believe are especially important, as they will allow those who meet the standards of practice despite not having undergone approved training to continue working as ODPs. However, they must apply to the HPC for their competence to be assessed. Those provisions are to be found in article 3 of the order.
Some ODPs are members of the Association of Operating Department Practitioners, the professional body that has brought the profession to the point where it is ready for statutory regulation. I pay tribute to the vision and hard work of the association; without its efforts, we would not have the order before us today. The association runs a voluntary register of about 6,000 practitioners who have approved training and who have satisfied the association that they are fit
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to practise. It is envisaged that such people will automatically be transferred to the new register when the order comes into effect in September.
A further 10,000 ODPs are known to be practising, but they are not on the association's voluntary register. There is no way of knowing how many unregistered ODPs have precisely the same training and, therefore, competences as the 6,000 registered practitioners. Many of them—perhaps even the clear majority—will probably have the same training, and they may apply to the HPC for statutory registration so that they can continue practising as ODPs after the order comes into effect. If they satisfy the HPC that they have undergone approved training, and satisfy HPC requirements as to their good health and character, they may be registered straight away, without the need to apply under the grandparenting provisions. Those issues are dealt with in article 9 of the 2001 order.
Practitioners who do not have such training will need to apply under the grandparenting provisions in the present order. Their training and experience will be assessed by the HPC assessors, and they may be asked to undergo further training and to complete a test of their competence, before being admitted to the register. Those matters are dealt with in article 13 of the 2001 order. In that way, many of the 10,000 practitioners who are currently unregistered will be able to continue providing a safe and effective service. The new arrangements will, however, also weed out those who call themselves ODPs but who are not fit to practise because they do not meet the required standards of competence.
Mr. Paul Burstow (Sutton and Cheam) (LD): I have been listening to the Minister's presentation of the order, which Liberal Democrats certainly support. However, concern was expressed during the consultation that the order could remove the recruitment pool provided by theatre auxiliary staff and deprive them of a clear career path. Has the Department assessed that issue? Is it satisfied that there will be no impact on the availability of such staff?
Mr. Hutton: I am reasonably confident that that will be the case. Of course, it will be the responsibility of local NHS employers, the association, the HPC and the Department to ensure that there is no impact on the availability of such staff, and I assure the hon. Gentleman that we would want to take action if there were.
In the recent past, the association overhauled the standard training requirements for ODPs trained in the United Kingdom, and the required qualification has changed from national or Scottish vocational qualification level 3 to a two-year higher education diploma in operating department practice. That now forms the basic training platform for practitioners.
The new provisions are the result of years of work and careful consultation. They command the complete support of the association and the HPC. The order is a sensible and important measure: it will strengthen public protection, it is fair to those who are affected by
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it, and it is an entirely proportionate response to a recognised gap in the existing system of statutory self-regulation. I commend it to the Committee.
10.3 pm
Dr. Andrew Murrison (Westbury) (Con): The Opposition have no trouble with the order, and we are delighted that the Association of Operating Department Practitioners welcomes it. It marks the coming of age of ODPs, whose profession, with its defined skills mix, has changed beyond all recognition during my professional lifetime. Over two or so decades, the profession has done a huge amount of work to improve the skill level of its practitioners. The order is the culmination of all that hard work, and it brings ODPs up to the level of other health care professionals, such as chiropractors, dieticians, physios and radiographers, who are already governed by the HPC. We therefore broadly welcome the order and have no difficulty with it.
In that spirit, I shall keep my remarks brief, and I have just one or two residual questions for the Minister. It would be nice to know the timetable that he envisages for the handover from the association to the HPC of functions relating to fitness to practise, because it is not entirely clear from the explanatory memorandum. Can he also give us an idea of the residual role that is envisaged for the association after the handover of much of its work to the HPC?
I should also like to be assured that titles such as surgical practitioner and anaesthetic practitioner will be safeguarded, so that those who are not qualified to use them cannot do so. Otherwise, not only the public but potential employers might be confused when faced with people describing themselves as such.
The Minister has addressed most of the significant points that I was going to raise, for which I am grateful. He has also addressed some of the concerns of the association—they were minor ones, as I believe that it is content with its measure. However, I should like the Minister's reassurance that practitioners from abroad who seek to practise in this country, in particular those from EU accession states, will be subject to proper scrutiny. In other health care professions, arguably those that are more easily identified, such as the medical profession, the issue has caused some difficulty and continues to do so. In a profession such as this, which is relatively new and not so well defined, there is potential for a great deal of confusion. I should be grateful if the Minister would say how he envisages dealing with such practitioners under the new arrangements.
The association is, rightly, keen that any practitioner coming from abroad should have a basic competence in the English language—it cites level 7 of the international English language testing system as a suitable gauge. Can the Minister confirm that that cannot be applicable to the European Union? What measures does he envisage using to ensure that practitioners from the EU or elsewhere are at least competent in to hold basic conversations in English?
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