NHS Redress Bill [HL]

My Lords, I take that as an invitation to have another go. As I said in my letter and in my opening remarks, I acknowledged that we could not be absolutely certain precisely which and at what time services would be taken out of a normal hospital setting and made available in a community setting. A good example of this is emergency care practitioners in ambulance services. Different ambulance services at the moment have different ranges of emergency care practitioners doing different duties. The location from which forms of healthcare are delivered is changing quite rapidly, not just in this country but in all countries. In the White Paper, for example, there are six projects in particular specialties—urology is one, ENT is another—where we will look for new clinical pathways for people. We will work with the professions to gauge the safety and feasibility of taking more of the work in these specialties traditionally done in a hospital into a community setting. Given that we know the direction of travel, we think it sensible in this Bill to take provisions to put in secondary legislation, and to communicate with patients which services are to be covered by the scheme. I tried to explain clearly—both in Committee and today—why we did not extend this scheme to primary care. At the moment this scheme is intended to cover hospital-type care only. Primary care would be excluded from the scope of the scheme. Costing of the scheme was made on that basis. I gave in my speech the extra costing of extending this Bill to primary care, even if we could speedily do it. On the estimates available to me, they are of the order of £56 million. However, we have the complexity caused by the fact that GPs and other primary care practitioners have a totally different professional indemnity system from the NHS hospital indemnity system. We cannot simply translate that system into the terms of this Bill. To do that, it would need to be looked at again and there would need to be wide consultations with the primary care interests. In the mean time, we do not want to hold up the Bill until all those consultations in the primary care field have been completed. We do not know where they will take us, so in our view it is better to get on with the redress scheme being provided by the Bill, but to make it flexible enough to deal with a range of services that we know are likely to end up being provided outside the hospital setting in the coming years. On Question, amendment agreed to.