NHS Redress Bill [HL]

My Lords, I shall speak to Amendments Nos. 5 to 7. In Grand Committee, my noble friend Lady Neuberger and I listened very carefully to what the Minister had to say on which services would or would not be covered by this legislation. I have also studied with great care the Minister’s letter dated 18 January, in which he sets out in detail the arguments that he has just put on why ““hospital”” is not narrowly defined. However, as the Minister said, it is right that in the mean time we have had the White Paper—all 267 pages of it—which sets out how and when services will be transferred from their hospital settings into community settings. Noble Lords have listened to various Ministers talking about all sorts of proposals, including the suggestion that consultants be placed in GP practices and the development of practices with special interests. They may even know that there is a unit within the Department of Health which is working specifically on the transfer of NHS staff into other settings and, I believe, is attending to matters such as what happens to staff who are TUPE-ed from the NHS to other organisations. All that suggests the rapid transfer of services which are currently provided within general hospital settings to other places. Therefore, during the next three years, or however long it will be before this scheme is implemented and reviewed, how will people know whether the services which they have received in a primary care setting which have been adverse are within the scope of this redress scheme or not? Why is the scheme such a threat to primary care services? We are talking now not just about GPs, who have their own insurance schemes to which they have to subscribe. Why is it not in their interests as primary care employees and practitioners to have this scheme, the basis of which is to avoid costly and lengthy litigation? It is a phrase that we have not heard for a very long time from the Benches opposite, but the Government were once committed to joined-up government. This seems to be its very opposite. Nothing that the Minister said, either in his explanation of the government amendment or in his letter, has shed any light on which services will or will not be covered by the scheme. He talked about services which are normally provided in a hospital setting but may occasionally be transferred to a community setting. Where, for example, will podiatry services for people with diabetes be—a service which is at the moment carried out within a general hospital setting but which is very rapidly likely to be transferred to community services? Will it be covered or not? I do not think that the Minister has come up with a convincing answer yet as to why there should be such a widespread exemption.