NHS Redress Bill [Lords]

When the chief medical officer undertook his review for the report to which I referred earlier, he looked at a number of other countries and the variety of schemes—often called, sometimes wrongly, no-fault compensation schemes—that exist, for instance, in Scandinavia, New Zealand and so on; but for a variety of reasons, which he spelled out in that report, he felt, and the Government concur, that it would not be suitable to try to introduce a so-called no-fault compensation scheme, not least because people would end up arguing about what caused the damage, even if they were not arguing about where the fault lay. That is why he recommended a scheme along the lines of that provided for in the Bill. We have accepted that recommendation. My hon. Friend the Member for Stafford (Mr. Kidney) raised the question whether the scheme is confined to hospital services. Originally, that was our intention, but we listened carefully to the debate in another place and the Bill, as presented in this House, will enable the scheme to be extended through secondary legislation to services over and above hospital services. For instance, services that fall into the grey area between primary and secondary care can be brought within the scope of the scheme. That is particularly important as changing medical practice and technology allow more of what we think of as hospital care to be delivered in the community. I referred to discussions in another place. One significant change was made there that we cannot endorse. We intend to try to delete clause 12 in Committee. The Bill as originally published provided for a coherent redress scheme focusing on the speedy resolution of cases after full investigation by scheme members at local level, giving full redress to patients through a single-stage scheme, and encouraging and facilitating local learning in hospitals from mistakes that had occurred. What I do not like about the amendments made in the other place is their creation of a two-stage scheme involving two administrative bodies, which we believe will prove too costly and bureaucratic. It allows investigators to act independently of a hospital, which will work against the aim of encouraging local learning and a more open culture. The Healthcare Commission will be charged with supervising the work of the investigators. The commission believes that that would be inappropriate and would not sit well with its current expertise and role.