NHS Redress Bill [Lords]

The right hon. Gentleman is correct in saying that there is not a closed mind here, but we shall review the position in due course. The important thing is to get a scheme that works for hospital care and then to see whether the will or consensus is there in the future. Such an extension would significantly widen the ambit of the scheme and significantly increase its cost. At this stage, it would not be right to go in that direction, but as I have said, that is not to say that the position is closed. The hon. Member for Romsey made some important points. She said that there is an unwillingness to own up early in the NHS and that we need a change in culture, which would save so much time and effort. On hearing that, I thought that she was about to support what we are doing, because those things need to be internal to the NHS, not externally imposed. The only way to get internal culture change—she rightly drew attention to this—is to encourage the NHS from within to adopt a different culture. There are issues of independence, which I shall come to, but I want to stress to the hon. Lady that most trusts have a lay non-executive on the board who is specifically charged with dealing with matters relating to complaints. That is true of my local trust. There is already independence within the arrangements, and it is important not to ignore that fact. The hon. Lady also mentioned the value of compensation and people not being short-changed, but there could be no incentive under this scheme to short-change people or to give them a value less than they would get in the courts, because that would simply encourage taking a claim further to the legal level, duplication of effort and further cost to the system. I do not believe that it is in the interests of the NHS knowingly to offer less than would be obtained in a legal setting. I hope she is reassured on that point. My hon. Friend the Member for Cardiff, North (Julie Morgan), who has apologised for being unable to be present, made an extremely important point. She welcomed clause 17, particularly its permissive and deliberately broad powers to enable our colleagues in the Welsh Assembly to develop their own redress scheme that meets the needs of the Welsh health service. She rightly drew attention to the speedy resolution scheme and the various aspects of it, which we can learn from. We will seek to draw from them as we take our proposals forward. The right hon. Member for Berwick-upon-Tweed (Mr. Beith) raised the West Lothian, or the Borders, question. It is obviously a fair question, but it is often one that vexes legislation of this kind. The statement of policy on NHS redress states:"““Where hospital services are commissioned as part of the NHS in England from a healthcare provider outside of England and Wales, the commissioning body””—" the PCT, in the normal run of events—"““will run the scheme and coordinate the investigation, and where appropriate make the offer of redress.””" The liability as I understand it, not being a lawyer, is of a different kind, but I believe that there is protection for the right hon. Gentleman’s constituents should they choose to be treated in Scottish hospitals. That is something that we would want to encourage, rather than take away. The right hon. Gentleman drew attention to the costs of the scheme, but as the hon. Member for Romsey said from the Liberal Democrat Front Bench, the costs can vary from year to year, so it is difficult to give any precise costs for the scheme. Cases can vary and it is important that we all accept that. We cannot plan with absolute certainty on those matters. My hon. Friend the Member for Crawley spoke passionately and authoritatively, as befits someone of her standing in the NHS. She was right to talk of the effect on staff of the pressure that such complaints can bring. That aspect was missing from our debate until she rightly introduced it. I am sure that those complaints place huge distress on the members of a clinical team who have been involved in an incident where something has gone wrong. She drew attention to one herself. Things are obviously extremely difficult for people in such circumstances, which, again, makes the point for the Bill, in that those people should be supported. People will make mistakes, so we must consider how the system supports someone through that process and encourages them to be able to make redress through their employer or organisation. We must produce a more satisfactory result than a finger-pointing culture and neither the patient nor the staff feeling satisfied. My hon. Friend was right to draw attention to that issue, and she also said that we need a simple scheme that creates confidence in the NHS that it will work. Again, she was right to make that point. The hon. Member for Broxbourne made a similar point, drawing attention to a particularly distressing constituency case. He spoke well, and also spoke kindly of my predecessor, who would thank him for that. We offer our sympathies to the individual involved in that case and would want to learn from it. My hon. Friend the Member for Worsley (Barbara Keeley) raised the case of Mr. Stanley Collins, who sadly died at Bolton hospital, and the difficulties encountered by his daughter, Mrs. Dawn Smallman, in getting the system to face up to the clear inadequacies in his care. My hon. Friend described them in a measured and compassionate way. She was right to say that such injury can be compounded by the process of trying to get redress through the system. I am sure that her comments will have been heard by others outside the House today in relation to whether we can, at this stage, get the hospital to take those issues up. My hon. Friend also raised an important issue of communication by clinical staff with patients at a distressing time. It is my experience of patients who come to my constituency surgery that they recall every single word of what was said to them, as well as the manner in which those words were imparted. They are seared on people’s minds for the rest of their lives. Receiving such news can be the single most important event in people’s lives. There is great professionalism in the service, but people would always do well to remember the point that the way in which people hear difficult news can be extremely important. My hon. Friend made a significant point in drawing our attention to that. Before I close, I want to deal with the main point of substance between us—that is, the measure of independence in our proposals. Our remarks have drawn out the fundamental differences between how we and Conservative Members in particular see the scheme. Let me say quite clearly that this is the NHS Redress Bill. The Bill relates to the NHS itself; the NHS has ownership of it. It is about getting the NHS to face up to mistakes when things go wrong, take ownership of them and make proper redress to people who are on the receiving end of inadequacies in care. There is a crucial difference, in that this is an internal system that the NHS will feel it owns and has control of. As I understand the proposals tabled by the Opposition in relation to clause 12, the same process would effectively be created twice, but there would be a more adversarial system—a finger-pointing culture— whereby people would feel under pressure, which is not the purpose of the Bill we are introducing. That takes us back to my comments to my hon. Friend the Member for Crawley.