Regulation of Health and Social Care Professionals Consultation

in practice is delegated to the Appointments Commission, and in the future the
administration of appointments will be delegated to the regulators. In our view,
the involvement of the Appointments Commission has been a positive step which
has ensured the appointment of high calibre members appointed against
competencies in a fair and transparent manner, and it is important that these
factors are not lost. We have considered whether Council appointments should
be subject to external approval, such as approval by the Council for Healthcare
Regulatory Excellence, Health Committee or Government. But on balance, we
think that the regulators should be given overall responsibility for appointments.
The Council for Regulatory Healthcare Excellence would continue to have
responsibility for providing the regulatory bodies with guidance on good practice
in appointment processes and setting agreed standards. Appointees would still
be expected to commit to the Nolan principles of public life, which would provide
some safeguards. 27 Any individual appointments could also be investigated by
the Health Committee.
4.45 We welcome views on whether any additional form of oversight is needed, and in
particular whether the Government should have powers to remove members in
grave or extreme circumstances. This may be a useful way in which to ensure
effective leadership and to prevent organisational failure occurring. An example
of how this could operate is Monitor’s proposed power to remove, suspend or
disqualify board members from Foundation Trusts and appoint interim or full
members. 28
4.46 As set out in Part 12, the regulators would have powers to enter into partnership
arrangements with others to recruit and appoint Council members, such as a
recruitment agency. Alternatively, they could enter into arrangements with other
regulators to establish an external body to carry out this role, similar to the role
performed by the Appointments Commission.
4.47 The proportion of lay members and registrant members on Councils and arguably
the size of Councils are matters which affects public confidence in, and therefore
the effectiveness of, the regulatory system. We therefore do not think that these
matters should be left entirely to the regulators. Instead, we wish to test three
options at consultation.
4.48 First, the statute could specify a ceiling for the size of the Councils of for example
12 members. In addition the statute could specify that a majority of members
cannot be registrants. It would then be left to the regulators to make rules on the
size and composition of their Councils within these general parameters. This
approach has the advantages of legal clarity while also affording the regulators
some degree of discretion.
4.49 Second, the Government could be required to specify in regulations the size of
Councils and the proportion of lay and registrant members on Councils. This
would be a broad power whereby the Government could for example set the
same size for each Council or place a ceiling or range for the size of Councils.
Furthermore, the Government could require that a majority of Council members
27
Committee on Standards in Public Life, The First Seven Reports: A Review on Progress
(2001).
28 Health and Social Care Bill 2011, cl 114(4).
61