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NHS Redress Bill [HL]

My Lords, I consider that we do have a just conclusion. I am sorry that I did not get my points across clearly. I shall reiterate briefly one or two of the points that I made and challenge the amendment’s intellectual basis. In my opening remarks I mentioned the number of elements in this scheme which have a fair degree of independence. I mentioned independent legal advice and independent medical advice. There are provisions in the Bill that you can make requirements on the experience and qualifications of the investigator. There is the ombudsman waiting in the wings for complaints. There is the Healthcare Commission, which I think everyone will agree is very independent, and it is overseeing the functioning of the scheme. Let us examine what the Commons actually rejected. By a majority of 95 votes, it rejected a proposal from this House, which was passed by one vote, that there should be a panel—I am not making this up; this is what was passed—of patient redress investigators. It has rejected that idea of a panel of independent investigators. We are now coming back, as far as I can judge from the amendments, to a panel of independent overseers. Some would cynically say, ““What’s in a name?””. Let me explore what the overseer does. I am not altogether clear on it. Does he or she sit on the shoulder of the investigator? How far do they follow through the investigation? Are they a duplicate investigator? Is that what this House is providing in the Bill? That provision was rejected by the other House. I have not heard any answers in any of the speeches that have been made to the questions that I raised about this proposal in my opening remarks, yet people want to place this in the Bill. I am going to repeat those questions, because they are relevant. What if the member carrying out the investigation and the independent overseer do not agree about the investigation report? That is not fanciful; that is quite possible. Who resolves that conflict? Who provides support to the overseer? Does the overseer just come along and decide whether they like the look of the draft report at the end of the process? Do they track the quality of the investigation by the investigator? How do they monitor and carry out their oversight arrangements? Those are the practical things that would determine whether the scheme works well. The scheme has been introduced at the very last knockings of the Bill without any explanation of how it would work. If the Government come along and have a go at making a general provision, rightly we are interrogated in Committee about the details of those schemes. Here are the opposition Benches coming along and trying to put in the Bill a set of proposals that have not previously been discussed, for which they can give no explanation of how they would work or how much they would cost. I am charged with exaggerating the costs; I do not know what the costs are. I cannot see how it would work in a very clear way if we do not know exactly what the overseer would do or how much detail they would have to give to the investigation. The noble Earl, Lord Howe, said that it is said that patients will have no idea whether their claim has been investigated fairly. However, the Government have tabled an amendment to explicitly require the redress scheme ordinarily to provide an investigation report to be prepared and provided to the individual. That is a new approach. The individual sees that investigation of the facts, and they are then in a position to challenge that report if they think it is unfair, using legal advice and independent medical advice. We have put things very clearly in the Bill that support the independence of the investigation and will ensure that patients are properly supported. We have learnt from the past; we have introduced changes here that make it much more likely that patients will get a fair shout on this issue. I come back to the point that we really do have to know how an overseer system would work, because it looks remarkably to me like the panel of investigators by another name, which was rejected by 95 votes in the other place.