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NHS Redress Bill [Lords]

I support the comments made by the hon. Member for Billericay (Mr. Baron), who has gone into the issues in some depth. It is a good job that I did not prepare such a lengthy and in-depth speech, because I would not have had time to deliver it. There is broad agreement on the general principles of the Bill, which has been welcomed in all parts of the House. It is right and proper that patients are encouraged to complain and that trusts are engaged proactively in that. However, throughout the Bill’s passage, Liberal Democrat Members have tried hard to establish two clear principles: a clear separation between fact-finding and fault-finding, and the independence of the process. It has become gradually more apparent that the Government intend that investigations should be thorough and that all the facts should be established before an inquiry is handed over to the next stage. We would prefer a slightly more rigid separation, but we can broadly agree that everything is moving in pretty much the right direction. However, there remains a problem with the NHS Litigation Authority taking over at that stage, because its job is, in effect, to protect the NHS from over-large claims and often to challenge such claims. Rightly, part of its remit is to protect the public purse, but that seems counterintuitive as regards the stated aim of the Bill, which is to be on the side of the patient. Many patient groups perceive the NHSLA to be on the side not of the patient but of the NHS. However, this is not the place to rehearse those arguments at length. In the time that I have left, I want to concentrate on the outstanding point of difference—independence. During the Bill’s passage, there have been numerous attempts to introduce different mechanisms for dealing with that problem that the Minister could accept. He has been generous in other parts of the Bill, so I hope that he will forgive me for saying that he seems to be bogged down in those mechanisms and has found fault with each idea without recognising the broad principle. When we saw the Government’s amendment, our first thought was that it could represent a concession whereby the Government could introduce independence if they so wished, but sadly that has proved not to be the case. If the Minister will not listen to Opposition Members on this matter, perhaps he will be more persuaded by others. When the Bill was introduced, the Patients Association said:"““The Government has shied away from the Chief Medical Officer’s recommendations, only two years ago, and wants to introduce a system that is unfair, is not independent and less rigorous.””" Dr. Gerard Panting of the Medical Protection Society made a slightly different point when he said that, for the NHS redress scheme to command the confidence of both the public and of health care professionals, it is important that independent advice is available. Most of the patient groups that I have spoken to have expressed concern that an in-trust investigation would not be independent. People with real expertise have been involved with this Bill in the other place, including my noble Friend Baroness Neuberger, who said:"““The Minister will forgive me if I go back to an earlier time in my life, when I was part of the advisory group that worked up the previous complaints system. We all, in good faith, believed that an in-house complaints investigation system could work. He will also know, because this will have landed on his desk now and in previous incarnations, that we were wrong. As an NHS chairman, like the noble Baroness, Lady Murphy, I chaired a community health service NHS trust and had to sign off the letters responding to complaints. Very often, I felt that the trust investigated itself fairly. Sometimes I did not. Either way, it was equally clear that the punters outside—the patients and their families—were dissatisfied because no one outside had had a proper look.””—[Official Report, House of Lords, 25 October 2006; Vol. 685, c. 1243.]" Clearly that is something that we want to avoid. I believe that the Minister is well intentioned, but I hope that he will learn from the experience of others that this provision is potentially flawed. An independent overseer would be in a better position to identify the organisational dysfunctions that we must acknowledge occur in some organisations. I am pleased that the Minister has said that he will review the issue. Will he describe the time scale involved? Will he also consider introducing either a pilot scheme or enabling legislation so that trusts may choose whether to have an independent overseer? Alternatively, there could be a few experimental areas in which independence is tried out, so that when the system is reviewed, we can make a full comparison to determine which method works best in the interests of patients. Question put, That this House disagrees with the Lords in the said amendment:— The House divided: Ayes 285, Noes 187.