Schedule 5 - Health Education England

Care Bill [Lords] – in a Public Bill Committee am 3:45 pm ar 28 Ionawr 2014.

Danfonwch hysbysiad imi am ddadleuon fel hyn

Photo of Paul Burstow Paul Burstow Democratiaid Rhyddfrydol, Sutton and Cheam 3:45, 28 Ionawr 2014

I beg to move amendment 134, in Schedule 5, page 136, line 4, at end add—

‘(c) how effectively it discharged its duties under the Equalities Act 2010 or under regulations under that Act.’.

Photo of Andrew Rosindell Andrew Rosindell Ceidwadwyr, Romford

With this it will be convenient to discuss the following:

Amendment 161, in clause 96, page 86, line 33, at end insert—

‘(1A) HEE must exercise its functions with a view to ensuring that there is a diverse workforce, that includes disabled persons, with the relevant knowledge and skills to work as healthcare workers within the health service in England’

Amendment 133, in clause 98, page 87, line 35, after ‘105(1)’ insert—

‘( ) HEE must set out in the document published under subsection (4) the objectives and priorities it has set to meet its duties under the Equalities Act 2010.’.

Amendment 163, in clause 98, page 88, line 10, at end add—

‘(11) HEE’s Education Outcomes Framework must include development and implementation of anti-discriminatory practices within the health-related provisions.’.

Amendment 165, in clause 99, page 88, line 36, at end insert—

‘(k) disabled people who will use health services’.

Amendment 168, in clause 105, page 93, line 12, at end add—

‘(9) When HEE or a LETB are commissioning health education courses, they must be inclusive of disabled students.’.

Photo of Paul Burstow Paul Burstow Democratiaid Rhyddfrydol, Sutton and Cheam

We now move on to Health Education England. The Joint Committee had a chance to scrutinise this part of the Bill and make several recommendations, some of which were about integration. We are grateful that those have been picked up and reflected in the revised Bill. A question that did not particularly surface during our consideration of the draft Bill was about diversity and inclusion, and how HEE would fulfil its obligations under the Equality Act 2010. That has come to my attention, and probably to that of other hon. Members, as a result of representations from such organisations as the Alliance for Inclusive Education.

Through amendments 133 and 134, I want to raise two issues. First, I want to consider how we ensure that medical education frames medical practitioners’ view of the world in a way that is inclusive and respecting of difference. That has an important effect on how medical staff engage with disabled people, how they engage with older people and, particularly in the area of mental health, how they engage with the black and minority ethnic community. Through the amendments, I wanted to raise how we can build that into medical curricula. Disabled people’s experience of health care can be very different from other people’s. Medical education needs to embrace, not just a medical model view of the world, but a social model view of the world. That means, in the context of the Bill, taking a view about the well-being of the individual—not just looking at the group of diagnoses and the prognosis, but looking at the person as an individual. I say this because there are some pretty glaring, horrifying statistics that suggest that that is not quite what happens in practice today.

Some 22% of people with learning disabilities are dead by the age of 50, compared with just 9% of the general population. There is a 20-year gap in life expectancy between someone in the general population and someone with a diagnosable, severe and enduring mental health problem, schizophrenia being just one example. These are intolerable, long-standing flaws in our health care system and, while there is no single cause, one of the causes will be attitudes and the approach to the delivery of medicine. Therefore, there is a case for that being much more visible in the way the mandate is written and the way HEE fulfils its obligations under equalities legislation.

The second bit is about people’s ability to participate in medical education. This again turns around attitudes, aptitudes, what is deemed to be a necessary attitude, and so on, to be admitted to the profession and whether reasonable adjustments can be made. The British Medical Association in its report, “Equality and diversity in UK medical schools” and the Department of Health in its report “Sharing the challenge, sharing the benefits: Equality and Diversity in the Medical Workforce” recognise that widening the net is a big challenge. I very much welcome the references in the mandate that the Minister mentioned earlier, because that says that there has been progress and I very much commend the Minister for what is written in. I look forward to his response to my remarks, because it will give him a chance to say how important the Government consider those matters to be.

The fact that there has been progress on a number of the characteristics covered by the equalities legislation is good news, as is the focus on saying that HEE must monitor and report on recruitment to all NHS-funded  courses against all equalities strands and socio-economic groups. It would be useful if the Minister said how that will be reported, since my two amendments in the group are about reporting. I hope that the Minister will say that, even if the two amendments do not get into the Bill, it would be regarded as strange and out of order if HEE did not, having monitored those things, report on them in its annual report required in schedule 5 and, indeed, in setting out its priorities. I hope that he will say something about that.

Health Education England must also work with the General Medical Council and the Medical Schools Council to develop ways to assess aptitude for medical careers. This is something that ALLFIE, which drew these issues to my attention, has expressed considerable concern about, because the aptitude criteria can exclude people who would be perfectly good clinicians from even being able to get on to courses. I hope that the Minister will be able to say something about the progress there.

The last point I will pick up on is that the mandate splits into two parts in this area—immediate deliverables and longer-term deliverables. On the immediate deliverables, it talks about there being a national framework for action by this spring, but that that was going to be reviewed last autumn. Will the Minister say what that review in the autumn led to and what the current expectation is for the publication of the framework?

Slightly more disappointingly, but I am sure that the Minister will be more than able to reassure us on this point, the long-term deliverables have the very laudable goal of a focus on widening access for people from lower socio-economic groups. I do not want anybody to misunderstand; I think that is a great thing to want to do and we need to see it happen, but there is no reference to a continuing attempt to widen access to people with disabilities and so on. It would be useful if the Minister said a bit about that.

These amendments seek to probe the Government on various aspects of how HEE delivers its obligations under equalities legislation. One of the amendments would add to clause 98 a requirement on HEE to publish a document, and another would make an addition to schedule 5. I look forward to hearing the Minister’s response.

Photo of Grahame Morris Grahame Morris Llafur, Easington 4:00, 28 Ionawr 2014

I rise to support amendments 163 and 165. I do not disagree with the comments and the case that the right hon. Member for Sutton and Cheam has just made. As usual, he was very accurate and forthright in expressing the views of the Joint Committee and subsequent representations made by various disability groups. I do not propose to repeat those arguments.

Amendment 163 would impose a duty on Health Education England’s Outcomes Framework to,

“include development and implementation of anti-discriminatory practices within the health-related provisions”.

Amendment 165 addresses issues surrounding people with disabilities. Health Education England has a vital role to play in linking education and learning to improvements in patients’ outcomes. Setting objectives, priorities and outcomes for education and training could be instrumental in ensuring that all health care workers have the right attitudes and the right values to ensure that disabled people have the same rights and access to  health care as their non-disabled peers. I refer the Committee to my previous declarations of interest, not least as vice-chair of the all-party parliamentary group on learning disability.

It is a concern that the current legislation does not guarantee this equality. Several disability charities and I share a concern that the Government could do more to safeguard disabled people. Disabilities are often misunderstood, even in health care education, as has been highlighted in numerous reports. Change can be effected, but it is very important for it to be delivered on the ground. Traditionally, a kind of negative—perhaps that is the wrong word—or medicalised approach to disability has been taken. An inadequate understanding of the needs and values of disabled people leads to them being discriminated against, not deliberately but as a consequence of organisations’ culture and the lack of training that individuals receive. As a consequence, disabled people receive poorer health care than their non-disabled contemporaries.

Last year Mencap published research based on a confidential inquiry conducted by the university of Bristol and funded by the Department of Health. It estimated that as many as 1,200 people with a learning disability might have died in the NHS because they were not receiving the correct health care. I am pretty sure that the Minister of State attended that launch or a subsequent event, so he is very familiar with the concerns of the community. The inquiry’s research team found that more than a third of the deaths of people with a learning disability were considered to be avoidable.

The right hon. Member for Sutton and Cheam has mentioned some of the statistics on premature death, particularly among women. Women with a learning disability die 20 years earlier than those without one. Overall, more than a fifth of the people with a learning disability who were looked at by the inquiry had died under the age of 50, compared to just 9% of the general population. A contributory factor to the poor health outcomes of disabled patients is considered to be the poor understanding and negative perception of some health care workers. A negative perception may affect a health care worker’s judgment when deciding on an appropriate treatment or service. Judgment of what treatments are worth while or cost effective may be influenced by prejudice, dare I say, or negative perceptions of disability, particularly of learning disability.

Poor communication and assumptions about the quality of life and a lack of understanding by health care professionals often mean that patients with a learning disability get poorer standards of care and, in some cases, die earlier. It is evident that disabled people suffer disproportionately. It is clear that more could be done to lessen the number of avoidable deaths and improve the poor health outcomes of disabled patients.

Health care professionals need support, encouragement and guidance to make reasonable adjustments for patients with a learning disability. I suggest to the Minister that this lack of understanding of disability that contributes to poor health care for disabled people can be countered by placing a duty on Health Education England to have regard to disabled people when exercising its functions.

This is very much an issue of social justice. I do not seek to divide the Committee on party lines. All right-thinking people would agree that health and care services and education must reduce disadvantage, especially for disabled people, as they must aim to reduce all disadvantages. We should not forget that two thirds of NHS clients are aged 65 and over and that group is likely to include high numbers of disabled people. We know about demographic changes; we know about multiple morbidities and the complications arising from them. We know that health care services will have an increasing number of disabled service users.

Disabled people are already disadvantaged, and a increase in the size of the group of those more likely to be disabled will mean that improving the treatment of disabled people will be a significant challenge. It is imperative that challenge is met through the development of health care education and services. The misconceptions surrounding disability that contribute to poor health outcomes for disabled people make a fuller representation of disabled people in the consultation processes of care and education services all the more important.

While there are examples of good practice, many of them are not embedded far enough into health care provision and are often dependent on individual staff members or a local group. As a result, services for people with a disability still vary substantially, not just across regions and localities, but even within a single organisation and service. According to disability charities, it is a lack of proper understanding of disabled people and a lack of proper regard for the needs and opinions of disabled service users that contribute to poor health outcomes.

I am sure that all members of the Committee would agree that disabled people deserve equal health care treatment, and there is a consensus that the Government should do all they can to address the problem. By implementing the correct health-related education and putting a duty on HEE to have adequate regard to disabled people who will use the health service, we can ensure that all health workers have the right attitudes and values necessary to deliver the health care that disabled people need and deserve.

Photo of Jamie Reed Jamie Reed Shadow Minister (Health)

It is hard to follow my hon. Friend’s tremendous contribution. Once again, I rise to thank the right hon. Member for Sutton and Cheam for his amendment. A recurring theme of today’s sitting is that the groups contain significant numbers of amendments. Each is important and needs to be addressed in turn. I am sure all members of the Committee would like to thank the Alliance for Inclusive Education, also known as ALLFIE, and Inclusion London, who have done so much to assist with the drafting of the amendments. The group has immense expertise in the matters that will arise throughout our consideration. It is a national campaigning and information-sharing network led by disabled people, which campaigns on ensuring inclusive access and support in mainstream education. I give particular thanks to Simone. ALLFIE states:

“Education has a fundamental role to play in influencing disabled peoples’ experience of healthcare provision. Traditionally, healthcare education has taken a negative and medicalised approach to disability”— as my hon. Friend the Member for Easington mentioned—

“supporting the idea that disabled people have less to offer than their non-disabled peers.”

Every single one of us in this House, regardless of party affiliation, has a duty to ensure that anything that stands in the way of inclusive health care education practices is rectified immediately. The idea that disabled people have less to offer than their non-disabled peers must be challenged at every level of debate, and I am convinced that the Minister will outline how that will be mandated in HEE by the Secretary of State—or, indeed, by himself, as he seems to be in the engine room.

In practice, that perception of disabled people could not be further from the truth. A 2010 General Medical Council report “Gateways to the Professions” followed by “Advising Medical Schools: Encouraging Disabled Students”, states clearly, in a quote attributed to a medical teacher:

“Disabled people add immense value to the student body. They help any group understand and appreciate diversity. It made a huge difference to the medical school when the first student in a wheelchair was admitted.”

The GMC later expands on that statement, stating that

“Disabled people can make a unique contribution to patient care and, indeed, to medical research by providing direct experience and knowledge of particular health conditions or impairments. Patients often identify closely with disabled medical professionals who can offer insight and sensitivity about how a recent diagnosis and ongoing impairment can affect patients. Such experience is invaluable to the medical profession as a whole, and illustrates the importance of attracting and retaining disabled students.”

All of us, in all parts of the House, recognise the self-evident truth of that statement. It is clear that there is a great need to be inclusive, both for the sake of the person who wishes to access medical education and, incontestably, for the sake of the profession; the social benefits are writ large, too.

The GMC was specifically commenting on the experience of disabled people in medical education, but the point stands that increased diversity increases experience within a cohort of students, and provides a more rounded education—a better education. That is why I welcome amendment 134 and the very similar amendment 133. It is absolutely right that all non-departmental bodies across Whitehall act in accordance with the functions, duties, aims and objectives of the Equality Act 2010, and I believe that those bodies created by the Bill will do an admirable job in exercising their functions in full accordance with that Act, but it is also right that the non-departmental bodies are able to demonstrate how they have done so.

The proposed measure is not intended to be a stick with which to hit HEE; it is a requirement that could benefit it greatly. By demonstrating its credentials as an inclusive educator, it makes the whole profession more attractive to those who may have felt it was out of reach, and improves the knowledge gained by those already within the service. By setting out how it will meet its objectives under the Equality Act, HEE will be an attractive employer, while giving great confidence, security and peace of mind to those who need inclusive support, as they will be given advance knowledge of what they can expect. On the amendments tabled by the right hon. Member for Sutton and Cheam, is the Minister able to give assurances that HEE will be given a duty to demonstrate its inclusive credentials, and how that will be communicated to the wider student body, to make these careers open to everyone, irrespective of their physical ability?

Amendments 161, 163, 165 and 168, which stand in my name and that of my hon. Friend the Member for Leicester West, deal with greater inclusivity. I think it important that I explain the reasons behind the amendments and why they are necessary.

Amendment 161 would place a duty on HEE to ensure that it exercises its functions in such a way as to ensure a diverse work force, which includes disabled persons. HEE should be a champion for a diverse health and care work force, to ensure that inclusive education practices are promoted. Amendment 163 would apply a duty to ensure that one of HEE’s objectives and priorities is to reduce discriminatory practice when health workers are working with disabled health care service users and disabled people in the work force. ALLFIE argues that the amendment is needed because:

“Disabled people have recommended that health-related education which champions anti-discrimination practice is central in order for health care workers to have the attitudes and values necessary to ensure that disabled people have the same rights as their non-disabled peers to access health care services as the general population.”

The amendment is squarely in the same vein as our repeated attempts throughout the Bill’s passage so far and all our considerations to achieve the cultural change that we all know we need to achieve. If the Minister does not believe the amendment is necessary, will he give a robust assurance that the current frameworks and those that will be created under the clause will allay the fears ALLFIE expresses?

Amendment 165 simply puts a duty on HEE to ensure that in the exercise of its functions, adequate thought is given to disabled people who will use health services. Amendment 168 puts a duty on HEE and the relevant local education and training boards to commission only education courses that are demonstrably inclusive of disabled learners. Testimonies that we have received reveal that education providers sometimes lack sufficient experience and the skills needed to work with a diverse range of learners. I am sure we all recognise that.

The amendments make up a package of changes designed to ensure that inclusivity is at the very heart of health education in this country. Why would we want it any other way? They would make sure that every course is open to all and that education courses and training are inclusive of everyone in our society. I understand that the Minister has written to the Alliance for Inclusive Education stating that he does not believe that legislation is the right way to achieve those goals. I hope that he will set out today how we will achieve them.

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health 4:15, 28 Ionawr 2014

Some thought-provoking and important issues have been raised by Members on both sides of the Committee. At this point, it is perhaps worth exploring and laying out for the Committee the role of HEE more generally, as we are about to consider several clauses that deal with HEE’s functions.

It is important to point out that in HEE, we will, for the first time, have a body that is focused and has the specific task of identifying and making recommendations on current and future work force education and training, supported by a £5 billion budget. It covers undergraduate recruitment, undergraduate training and postgraduate training, as well as making sure that there is continuing  professional development for the existing work force, including the health and care assistants we discussed earlier.

Our health and care work force is our NHS’s greatest asset. One of the most important reasons why our NHS and our health care sector work so well and are in many parts of the world held up as a model of good health care is that our health and care work force is properly trained. Of course, to make sure that we deliver high-quality care and will continue to do so in the years ahead, we need to preserve and protect that asset. In that way, we will ensure that our health service remains one of which we can all be justifiably proud. That is why we have put aside £5 billion to invest specifically in the work force, and HEE is placed to oversee that budget. Importantly, this group of clauses also sets out the role of promoting integration across health and care in the training that HEE provides. It is important that we look forward and think about how we need to deliver health and care in the community more proactively and make sure that care is more personalised.

Focusing specifically on the clause, we have heard eloquently outlined a number of health care challenges that face people with long-term disabilities and people with learning disabilities. Emphasis and attention to that issue is long overdue. I know that my hon. Friend the care Minister is particularly focused on ensuring that we deliver the parity of esteem that my right hon. Friend the Member for Sutton and Cheam was so keen to lead on and on which he did so much to begin delivering when he was a Minister. We must focus a lot more on ensuring that we invest in our work force in the right way and on measuring and delivering better outcomes for people with mental health and learning disabilities. I know that all parties agree with that.

There is a clear priority in the first mandate for Health Education England to support people with longer-term conditions and disabilities, but it is important that we build on that. I can reassure Members that when the second mandate is published in the next few weeks, there will be much stronger deliverables—not just a stronger thematic—on supporting education and training and awareness of the needs of people with learning disabilities, as well as greater emphasis on mental health generally. I know that that will reassure my right hon. Friend the Member for Sutton and Cheam, as it builds on much of his excellent work.

I do not wish to create division, but the hon. Member for Easington said that there was potentially prejudice in the work force against people with learning disabilities. I do not recognise that from my own clinical practice or from the hospitals I have worked in. He might wish to clarify that remark in an intervention. It is important to recognise that many health care education and training courses, particularly at undergraduate level, now focus on a more holistic approach to education, recognising that care must be provided in an empathetic and passionate manner. Good communications skills are vital in dealing with people from all different backgrounds, no matter how they present to the health service. I hope that the hon. Gentleman will recognise that.

Photo of Grahame Morris Grahame Morris Llafur, Easington

I do not want to fall out with the Minister, but the point I was trying to make was that people with learning disabilities in particular, but also  disabled people in the round, suffer worse health outcomes and more premature deaths. The statistics back that up. I do not know whether the level of care they receive is an institutional problem, but I am certainly not suggesting that the medical profession is prejudiced against people with learning disabilities. I would not suggest that, but there is definitely a problem with the health outcomes. We do not often have the opportunity to address that, but we do now. I hope that the Minister will take the opportunity, because we might not have another for some time.

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

Indeed. The hon. Gentleman has made a useful clarification. It is absolutely the case that we have unacceptable health inequalities and outcomes for such groups. The Government have clearly recognised that, and bearing in mind what we are doing through education and training, as well as the general emphasis on greater parity of esteem between physical and mental health, I hope we will be in a better place in the months and years ahead.

If we are to get to that better place, it is important that we have a strong emphasis in the education and training framework on the issues that the hon. Gentleman and all Members who spoke have raised. That must not just be at undergraduate level, where many strides forward have been made in better equipping today’s medical and nursing students, as well as other health care workers, to meet the needs of people with learning disabilities. We must also ensure that the continuing professional development is there so that the existing work force can recognise what can be a very vulnerable group. That is very much at the heart of what I am writing into the refresh of the Health Education England mandate, and I am sure that all Members support that.

Amendment 134, which my right hon. Friend the Member for Sutton and Cheam tabled, focuses on the importance of Health Education England’s promoting quality and diversity in exercising its functions, as do other amendments in the group. We can be proud that, generally speaking, we have a diverse health care work force. We celebrate diversity, whether it is ethnic or cultural, because it adds a lot to the care that can be provided in many communities. We are hugely proud of the fact that we have such a culturally diverse work force in the NHS, and we should never lose sight of that.

We do well on medical recruitment. About 55% of medical undergraduates are women, and we have a good representation of ethnic minorities entering medical training. The big challenge is to encourage greater diversity and provide more opportunities in medicine for people from deprived backgrounds. That is a particular challenge. The best route into medicine for people from poorer backgrounds is through graduate courses. However, we still have a long way to go, and a key objective of Health Education England is to support people from deprived backgrounds who enter medicine at undergraduate level. That objective was outlined clearly in Health Education England’s first mandate, and I know we all want to pursue it further.

Former Secretary of State for Health Alan Milburn is the Government’s social mobility tsar, and I have been doing what I can to support his work in the important area of social mobility into medicine. We all want to take that further, though it will take time to  raise aspirations in deprived communities where aspiration has historically been low. That is a key part of the challenge.

My right hon. Friend the Member for Sutton and Cheam talked about helping people with mental health problems to have viable careers in medicine. Recognising that health care professionals often suffer from mental health problems themselves can help to destigmatise mental health. Tragically, dentistry is a profession in which there have been high rates of suicide historically. Supporting people with mental health problems at work will be a priority for Health Education England.

Amendment 134 would require HEE to set out in its annual report details of how effectively it has discharged its duties under the Equality Act 2010 or regulations under the Act. Amendment 133 would require HEE to publish the objectives and priorities it has set to promote equality and diversity. I agree that it is important that HEE, a public body, demonstrates compliance with the Equality Act. The principles of equality and diversity are integral to the delivery of all its functions. However, it is not necessary to amend the Bill to achieve that. Paragraph 35 sets out that HEE must be included in part 1 of schedule 19 to the Equality Act as an authority subject to the public sector equality duty. It is intended that Health Education England will be required to publish information annually to demonstrate compliance with the public sector equality duty, and prepare and publish one or more objective that must be achieved to meet the duty.

The public sector equality duty, set out in section 149 of the Equality Act, requires a public body to

“have due regard to the need to…eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act…advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it”,


“foster good relations between persons who share a relevant protected characteristic and persons who do not share it.”

As HEE is clearly a public body covered by the Equality Act, it is not necessary to repeat such requirements in the Bill in the way that is set out in the Equality Act or in the amendment.

For 2012-13, Health Education England, which is currently a special health authority but will be changing its status when the Bill is enacted, has adopted equality, diversity and inclusion objectives that fall into six broad categories, covering a full employee experience of the current and future work force. The categories cover monitoring recruitment and selection; managing information and governance and equality and diversity; building engagement, support and leadership on equality and diversity; enabling development and progression for all staff; monitoring leavers by protected characteristics; and engaging the future work force. I will write to the Committee and clarify if I am incorrect, but I believe that Health Education England published this on its website recently. This is routinely discussed at HEE board level, which shows the strong commitment at the top of that organisation to the agenda that the Committee is talking about today.

We would also routinely expect Health Education England to repeat these important commitments as part of its annual report. I am sure that it very much has  that in mind. I also reassure my right hon. Friend and other hon. Members that this is a matter that the Government take very seriously. The Government’s mandate to Health Education England, which is currently being refreshed, includes a specific objective for HEE to ensure that the principles of equality and diversity are integral to education, training and development across the NHS and the public health system.

Amendment 168 aims to ensure that HEE supports disabled students seeking to follow a career in the health service. I am pleased to say that the mandate requires HEE to monitor and report on recruitment to all funded courses against all equality strands and includes an objective to improve applications to NHS-funded courses from groups that are currently under-represented. HEE will work with the Office for Fair Access and the Selecting for Excellence group in taking this work forward. Those objectives will continue to apply to HEE when it becomes a non-departmental public body as a result of the Bill.

Amendment 163, which the hon. Members for Copeland and for Leicester West tabled, would require the education outcomes framework to include development and implementation of anti-discriminatory practices within the health-related provisions. The Department of Health, which publishes the education outcomes framework, is subject to the public sector equality duty that we discussed earlier. The Government’s education outcomes framework includes a domain focused on widening participation among the health work force.

This is a specific requirement targeted at the health work force. The domain aims to ensure that talent and leadership flourishes free from discrimination, with fair opportunities to progress, so that everyone can participate to fulfil their potential, recognising individual as well as group differences, treating people as individuals and placing positive value on diversity in the work force. It has two strategic outcomes: to ensure that organisations delivering health care help all staff to meet their potential and meet or exceed their obligations on equality and diversity.

It is also worth highlighting what I specifically wrote into the first mandate for Health Education England, on recruitment into training programmes. This encapsulates much of the discussion that we have had today. In chapter 7, on widening participation and recruiting into training programmes, it states at 7.1.1:

“As a system leader, HEE will ensure that principles of equality and diversity are integral to education, training and workforce development and, as an employer, it will promote equality and diversity”.

As an organisation, it does not just promote its training, it is also an employer where these principles are strongly embedded. The other points, on which I will not detain the Committee, talk more broadly about everything that we have already covered—let me emphasise that strongly—in the mandate itself.

Health Education England has a clear duty in clause 100 to seek advice on the exercise of its functions from the people who use health services or their representative organisations. That covers all patients, including those who may have disabilities. I should add that this clause also requires HEE to seek advice from carers or their representative organisations. I am grateful that what we all consider to be an important issue has been raised in our considerations. As the Minister responsible for  education and training, I am clear that Health Education England must fulfil its responsibilities under the Equality Act and will do so in a way that ensures the delivery of a diverse work force capable of meeting the needs of all patients. I hope that my right hon. Friend and Opposition Members will feel reassured by this and not press their amendments.

Photo of Jamie Reed Jamie Reed Shadow Minister (Health) 4:30, 28 Ionawr 2014

I am grateful yet again for the manner of the Minister’s engagement. We will not seek to divide the Committee on our amendments.

Photo of Paul Burstow Paul Burstow Democratiaid Rhyddfrydol, Sutton and Cheam

On the same basis, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Schedule 5 agreed to.

Clause 95 ordered to stand part of the Bill.