---

NHS Redress Bill [Lords]

I beg to move, That the clause be read a Second time. I am delighted to move the motion, and I declare an interest as a trustee of AvMA––action against medical accidents––the leading patient safety charity in this country. I speak to the new clause as a Member of Parliament and not on behalf of that organisation, with which I cannot and do not formally speak. However, I know that, like me, AvMA is grateful to the Minister for having listened to our concerns and those of patients across the country and many other patient and consumer organisations and other stakeholders about the original provisions of the Bill, and for acting on them, as evidenced by not just my new clause but the Government’s amendments, both those that they have tabled today and those that were tabled and made in another place. We are also grateful for the Government’s attitude in Committee, which I think Members will agree was, broadly speaking, most of the time a very constructive and cooperative place. I mentioned the other Government amendments because my new clause makes sense, and has the force that I believe it can have, only if it is viewed in the context of the other amendments tabled, here and in the other place, by the Secretary of State. Collectively, I hope that they represent a tangible and real response to the three big calls that have been made: first, for measures of independence to be brought to bear where necessary to resolve disputed cases within the NHS redress scheme; secondly, for specialist legal advice or representation to be available, where appropriate, to empower patients—I use the word ““empower”” rather than ““entitle””, which I know, in the context of this NHS scheme, the Minister does not like—within this NHS process; and, thirdly, for measures to ensure that patient safety lessons are learned and implemented and seen to be learned and implemented. By placing a general duty to promote resolution under the scheme, my new clause seeks to ensure that all the provisions already made possible by the other amendments will have to be considered before proceedings can be finalised. The new clause appears to be quite general, bit I think it can be very powerful, because it is an enabling measure that gives force to all the other amendments that have been made, here and in another place. Crucially, it would mean that where the NHS scheme member’s initial conclusion is not to offer redress but the patient feels, having received independent, specialist legal advice to that effect, that they should be eligible, consideration would have to be given to the use of joint instruction of medical experts as a means of seeking resolution, because—the Minister looks at me quizzically, but I know he will agree with my ““because””—all possible instruments within the scheme would have to be examined and eliminated before having recourse to civil proceedings. In some disputed cases, that might well result in bringing independence to bear on the assessment of eligibility for redress, rather than just establishing the facts of what happened, as others, not least on the Opposition Benches, have sought. In some such disputed cases, it would mean that the patient was empowered through specialist legal advice and representation jointly commissioned from independent sources, but within the scheme. If an independent medical expert assessed that there was negligence and causation, the expectation would be bound to be that there would be an offer of redress. The new clause and the amendments—largely the Government amendments—made here and in another place would help to ensure that patient safety lessons were learned and implemented if the independent medical expert identified in the report the salient risk management issues. In other words, the positive experience from the resolve pilot in England and the speedy resolution pilot in Wales would be put to good use, just as I argued—with some sympathy across the House—on Second Reading and throughout the Committee stage. The crucial point is that the original ethos of the scheme—putting the emphasis on the NHS itself and recognising where it has been negligent, and the NHS proactively putting things right and offering redress within its own owned NHS scheme—would be safeguarded, empowered and furthered by the new clause. The process that I have described of joint instruction would be necessary only if and when the NHS’s assessment did not tally with that of the patient and the legal adviser. That is my interpretation of the overall effect of this enabling new clause and of the combined effect of my new clause with the various Government amendments that it seeks to enable. I would be grateful for a few words from the Minister—I have no doubt that they will be forthcoming—about how that tallies with his interpretation. Kindly, he has already written to me about that so I have an idea what he might say. Given the effect of the new clause and the amendments that it seeks to enable, I believe that we have the framework of a scheme that could enjoy public confidence and deliver real benefits to patients and the NHS.