NHS Redress Bill [HL]

My Lords, whether or not the amendment is strictly necessary to the Bill, it seems to me to have its heart in exactly the right place. I have no hesitation in supporting a very great deal of what the noble Baroness said. The new clause has a number of things to recommend it, not least its value as a declaratory statement prefacing what follows. I absolutely agree that patients need to be told at the outset of the grievance process that there is more than one way for them to proceed to seek redress and that the NHS redress scheme, envisaged in the Bill, is but one avenue that they can choose. But there is another dimension to this. We will discuss in our debate on a later group of amendments, which I shall not anticipate now, although the noble Baroness has foreshadowed them very helpfully, a key bone of contention between this side of the House and the Government—the need to separate the two halves of the redress process into its functional constituent parts, and to treat them as distinct. What will happen initially is that the hospital whose actions have given rise to the application will carry out a factual investigation. It will examine what was done, by whom, and why. In my very firm opinion, this fact-finding investigation should remain just that. It should steer clear of attempting to lay blame or of ascribing legal liability. All that should be for later. It should confine itself to a factual explanation, and I shall say more about that later. Once the hospital has done this, there is a very strong argument for the patient to be brought right back into the frame. The factual explanation should be presented to him with an apology, where appropriate, together with a clear statement of what lessons have been learnt by the trust to prevent similar errors happening in the future. It will then be possible for the patient to take stock. One option might be to take the matter no further. Another might be to ask the NHSLA to examine fault and legal liability under the Government’s redress scheme. Yet another would be to seek a mediated settlement through a Resolve-type process. And another might be to go to court. One of the things that has consistently troubled me about the Government’s model for redress is that once an application has been made to the redress scheme, and scrutiny of the case commences, the process continues inexorably to its conclusion through investigation, summarising evidence, proposing remedial treatment, assessing fault, and arriving at an offer of financial compensation until finally the NHSLA presents the results as a sort of comprehensive redress package to the patient. I do not think that that all-in-one process is desirable, for reasons I will come on to later. But I also believe it is not necessary, because in very many cases all the aggrieved patient wants is an explanation, an apology, and a real sense that lessons have been learnt. The money, for a lot of people, is very often secondary. But where the money is not secondary, I believe the patient should be able to choose how he wants to proceed on the basis of the factual investigation. It is clearly for the noble Baroness to decide how far she wants to press the amendment, and what importance she attaches to it in the context of the rest of the Bill. The Minister will probably say that, in substance, it is unnecessary. However, I hope he will take on board both the rationale and the strength of feeling that lies behind it.