I shall speak to new clauses 28, 29, 30 and 33, which stand in my name and those of other hon. Members from both sides of the House.
There is a huge amount to welcome in the Bill, and on Second Reading I welcomed the steps in part 2 to implement many of the recommendations in the Francis report. I said at the time that although there has been good progress, there remains a lot more to do, which is the reason behind the new clauses. I have tabled four new clauses—two on whistleblowing and two on patient safety. Those are both vital areas that we must get right.
I welcome the measures that the Government have taken to improve protection for whistleblowers, including changes to the Public Interest Disclosure Act 1998 and the banning of gagging clauses. Whistleblowers are not only individuals who are able to see where things have
gone wrong when others around them have perhaps gone native and begun to accept the unacceptable, but they are people with the moral backbone and courage to speak out when things are wrong. It is hugely important that we have a culture where people do not need to become whistleblowers, because their complaints are taken up far earlier and they do not need to go down routes outside the usual complaints process. We should have a culture where people are encouraged to speak out, and where raising concerns is seen as a good thing.
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As I have said, there are still far too many whistleblower cases and there is a lot more to do. That is illustrated by the fact that the Secretary of State had to step in last week to intervene in a whistleblower case. The Select Committee on Health was told that the chief executive of NHS England, Sir David Nicholson, will personally intervene in such cases to champion whistleblowers. It is interesting that Sir David is revelling is imminent freedom to mock the Secretary of State and some of his NHS England colleagues when he does not seem to have been that proactive in stepping in to champion whistleblowers previously. I very much hope that his successor proves more effective on that front, but I digress.
There is an awful lot more to do. The key thing about new clause 28 is that it would introduce a report on whistleblowing. That would provide an audit of how the Government’s recommendations and new policy affects things on the ground, which would be welcome to the Government, whistleblowers and hospitals in general. It would also provide a valuable arena in which historical whistleblowing cases can be looked at. That would provide a kind of truth and reconciliation process for many who have not seen justice, including victims of bad care and their families, and whistleblowers who have tried to highlight cases. Crucially, we could look at how those whistleblowers were treated and where they are now. Far too many do not go on to be gainfully employed, but they should be the first people to be employed in their sector—I will say more on that in a moment. We can also look at whether their concerns have been taken up and whether anything has changed. One of the most common complaints is that nothing changes after whistleblower cases, when people have risked their livelihood to speak up against something and try to change things. The proposal would provide an opportunity to look at why those changes are never made and what we can do about it. The report could make recommendations to the Secretary of State on how to ameliorate that.
New clause 33 deals with what happens to whistleblowers and the role of candour. It would introduce a candour commissioner for health and social care to report annually on the culture, which is so damaging to our NHS, whereby problems are hidden as opposed to being brought out into the disinfectant of sunshine. The annual review would give confidence to whistleblowers that someone independent takes them seriously. The measure might begin to deal with the toxic problem of whistleblowers being effectively surreptitiously blacklisted because they are not re-employed in their sector.
One amendment I wanted to table—it was outside the scope of the Bill—would have meant that, instead of a blacklist, there would be a white list of whistleblowers.
If a whistleblower’s complaint were vindicated, a white flag would go up next to their name. Any employer within the sector who did not give the whistleblower a job would have to say why they are not the right person for the job. I was hoping that such an amendment would go some way to working against the unofficial blacklist that so many of our brave whistleblowers face.
My other proposals are on patient safety. New clause 29 is on zero harm. We have learned, tragically, in the past few months of things that happened over the past decade. We would not have expected to have to put minimum requirements of care in law, but they should have been put down in law, because, sadly, on too many occasions, those basic standards and requirements of humanity were breached. New clause 29 would put zero harm—the Hippocratic oath—into law to ensure that they are not breached.
New clause 30 would introduce mandatory incident reporting and patient safety management systems. It would permit the Government to introduce regulations to ensure that all health care providers tell the patient or their family during a patient’s care when death, deterioration of condition or the introduction of a new condition occurs. That is not necessarily for blame, but simply for information. The worst thing is that when mistakes happen—they will; that is natural in something as difficult as health care—families are not told. That is damaging to our NHS. If mistakes happen, families must be told. Even if a deterioration occurs and is not a mistake but a natural course of events, the family should be told clearly what has occurred. The new clause would place a requirement on all providers to publish a patient safety management system, which many good providers do, to describe clearly their procedures for ensuring that patients are kept safe. Good providers already do that, but it should be a minimum requirement for all providers.
Those would be valuable added safeguards to clause 80. As we have seen, with the best of intentions and optimism, minimum humane standards have not been met. I believe that the proposals should be included in the Bill to provide a facility by which those who do not abide by such minimum care standard are held to account.