Health, Social Care and Sport Committee

Meeting date: Tuesday, January 17, 2023

Official Report 633KB pdf

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Subordinate Legislation

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Dentists, Dental Care Professionals, Nurses, Nursing Associates and Midwives (International Registrations) Order 2022 [Draft]

Our third agenda item is consideration of an instrument that is subject to affirmative procedure.

The purpose of the order is to amend the legislative framework underpinning regulators’ international registration routes. In particular, the order enables the General Dental Council to set out and change its processes for international registration more efficiently, including by providing updated powers for the General Dental Council to charge for services that it undertakes.

The order also allows the Nursing and Midwifery Council more flexibility in the range of international testing routes to ascertain applicants’ competence, and changes rules that set out registration processes in order to reduce the time that is taken to process international applications.

The Delegated Powers and Law Reform Committee considered the order at its meeting on 13 December 2022 and made no recommendations in relation to it.

We will now hear evidence from the Cabinet Secretary for Health and Social Care and supporting officials on the order. Once all our questions have been answered, we will proceed to a formal debate on the motion.

I welcome again to the committee Humza Yousaf, the Cabinet Secretary for Health and Social Care. I also welcome, from the Scottish Government, Rachel Coutts, who is a solicitor in the primary care, medicines and treatments branch, and Rebecca Wright, who is a senior policy manager in regulation of health professions in the chief nursing officer's directorate. Thank you for joining us today.

I invite the cabinet secretary to make a brief opening statement.

Thank you, convener. Long time no speak. I am keen to take any questions that the committee might have.

As you heard in the session that we have just concluded, it is so important that the health service is able to meet intense challenges, such as we are currently facing, as they arise. The order gives additional flexibility to the GDC and NMC to help the health service to respond to some of those challenges.

Since the end of 2020, European law on recognition of qualified healthcare professionals from the European Economic Area no longer applies in the UK. Current stand-still arrangements mean that the UK professional healthcare regulators continued to automatically recognise EEA and Switzerland-obtained qualifications for up to two years after the end of the transition period. The period of automatic recognition ends in early 2023, when the Secretary of State for Health and Social Care will review the approach to registering professionals who have qualified in the European Economic Area.

The order is being made under section 60 of the Health Act 1999. It will amend the Dentists Act 1984, and the Nursing and Midwifery Order 2001 and other subordinate legislation. The order will change the legislative frameworks of the GDC and the NMC to allow them to amend their registration processes for international applicants.

Both the General Dental Council’s and the Nursing and Midwifery Council’s governing legislation prevents them from making changes to their registration processes. In the case of the GDC, the legislative structure makes it quite difficult and time-consuming to make changes to its registration process. Likewise, the NMC must follow an overly detailed procedure to carry out assessments for international applicants.

The order makes a number of changes to the legislative framework on the NMC’s and the GDC’s international registration requirements. First, it allows the GDC to apply a range of assessment options to determine whether applicants have the right knowledge, the right skills and the right experience to practise in the UK.

Secondly, it removes the requirement for dental authorities to use an assessment for overseas applicants, such as the overseas registration exam, known as the ORE.

Thirdly, it allows the GDC to charge fees to international institutions for expenses that are incurred in relation to international registration, so that it can cover the costs of recognising international qualifications that meet UK standards.

Fourthly, the GDC will be able to make rules that set out the details of its international registration processes without the need for Privy Council approval, so that that change can be made far more efficiently.

Fifthly, a transitional period for the ORE will continue to apply for 12 months after the order comes into force, at which point the GDC will publish new rules for its international registration processes.

Subject to parliamentary approval, of course, the effect of the order will be to allow the GDC to use increased flexibility to set out two international registration routes based on an assessment of an applicant’s qualifications, skills or training, and completion of an ORE-style assessment, and the recognition of an applicant’s qualifications where the GDC has assessed that qualification and considers that it provides applicants with the required knowledge, skills and experience.

With regard to the changes to the Nursing and Midwifery Order 2001, the NMC will continue to apply its test of competence as the main assessment route for international applicants, which will remain in the legislation as one of the ways that the NMC can ensure that an applicant meets its standards.

However, the order will bring in other pathways for registration. First, there will be recognition of an NMC-approved programme of education from outside the UK. Secondly, in limited situations, there will be a qualification comparability exercise, which the NMC will use to judge whether the applicant’s qualification is of a comparable standard to an NMC-approved UK qualification. In either situation, applicants would still need to meet the NMC’s other registration requirements, such as on English language, indemnity and payment of the registration fee.

I fully support the instrument as a pragmatic solution that will improve consistency and give the regulators much-needed flexibility in responding to the changing circumstances. I am happy to answer any questions that members have.

Thank you. I invite questions for the cabinet secretary.

It seems reasonable that the order provides the GDC and the NMC with greater flexibility to amend their existing international registration pathways. I know that there are challenges with regard to access to NHS dentistry, especially in my region of Dumfries and Galloway. Will the order ultimately help us with recruitment of dentists and dental practitioners, especially with regard to the issues that are a consequence of Brexit?

I certainly hope so. When I have spoken to the NMC and the GDC in my time as health secretary, they have been excited—as excited as regulators tend to get—about the fact that the additional flexibility could really assist with international recruitment. I will not go into the challenges that Brexit has brought in relation to health and social care because those have been well rehearsed, but flexibility can absolutely help with that.

As per the previous evidence session, there is no doubt that health boards want to take maximum advantage and make maximum use of international recruitment. It is not a panacea—I am always keen to say that—but it can provide significant additionality. There is no doubt that the additional flexibilities that I outlined in my opening remarks could help with regard to the dental and the nursing and midwifery workforces.

There are no further questions, so we move to the formal debate on the affirmative instrument on which we have just taken evidence from the cabinet secretary. I remind the committee that members should not put questions to the cabinet secretary during the formal debate and officials may not speak in the debate.

Cabinet secretary, do you wish to say anything further on the motion?

I have nothing further to say.

Thank you. I invite contributions to the debate.

As there are no contributions, I ask the cabinet secretary to move motion S6M-07061, which is in his name.

Motion moved,

That the Health, Social Care and Sport Committee recommends that the Dentists, Dental Care Professionals, Nurses, Nursing Associates and Midwives (International Registrations) Order 2022 be approved.—[Humza Yousaf.]

Motion agreed to.

Thank you. That concludes consideration of the instrument. I thank the cabinet secretary for his time and his officials for attending.

At our next meeting, we will take evidence from Cricket Scotland and sportscotland to get an update on their response to the independent review of racism in Scottish cricket. We will then take evidence from representatives of Food Standards Scotland. That concludes the public part of our meeting today.

11:46 Meeting continued in private until 12:06.