NHS Redress Bill [HL]

My Lords, Amendment No. 24 provides that the scheme may make provision to require proceedings,"““to be conducted within a fixed period of time””." We have made clear that the redress scheme is intended to help to resolve cases swiftly and to ensure that redress is provided to the patient as quickly as possible. We agree on that. Experience from the NHS complaints procedure tells us that setting a rigid time limit for responding to complainants may have perverse incentives. In some cases, a case that might be more quickly resolved is not resolved until the time limit, while other cases are poorly dealt with within the time limit when a little more time may have provided a more satisfactory outcome. There may be cases that, for good reason, take longer to deal with; and it is more important to get the decision right than to meet a target. In many of those cases, the patient will understand if he is involved in the discussions and kept apprised of the situation. The major problem with introducing an overall time limit for a procedure that may, in some cases, be quite complex is that it is in danger of becoming meaningless. For simple cases, it will be unchallenging; while for complex cases it runs the risk that cases will not be properly dealt with simply to meet an overall time limit. To be effective, any time limit should have regard to the time taken by the scheme member and scheme authority to resolve the case. This amendment will not measure that effectively. Under our proposals, it is intended that patients will be given a reasonable amount of time in which to consider an offer of financial compensation. That will enable them to obtain legal advice on the offer and settlement. But an overall time limit will not take into account the time taken by the scheme member and the scheme authority as against the time taken by the patient. In other words, a case that, overall, appears to have been dealt with more quickly than a similar case may, in practice, have taken longer when one considers only the involvement of the scheme member and/or the scheme authority. We would certainly not want patients to be put under any undue pressure simply to enable proceedings to be completed within a fixed period of time. However, I accept that an important aim of the scheme is to facilitate the resolution of cases in a swift manner, ensuring that redress is provided to the patient as quickly as possible. Therefore, it is more appropriate for there to be time limits for some of the stages within the overall process. Those limits should be set only after full consultation with stakeholders, to ensure that practical, appropriate and effective limits are set throughout. There may even be a case for providing an exemption for cases meeting certain criteria relating, for example, to complexity. Those will be set out in the scheme. I appreciate that the amendment seeks to ensure that cases under the scheme are dealt with quickly. However, a single, overall time limit for proceedings under the scheme may unnecessarily constrain the system in a manner that is not to the advantage of the patient.