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Patient Safety

Or patients. Such incidents have caused serious harm or even death, and it is almost inconceivable that they would not be reported. They could not be covered up from patients. It would be totally inexcusable, and similar to reporting an infectious disease to the Health Protection Agency but not informing the patient that they have an infectious disease. I am happy to discuss the matter outside the debate. The national reporting and learning system is the largest and most comprehensive anywhere in the world. It is the envy of many other countries, and has been further developed and improved to make reporting easier and learning from it much quicker. Patient safety as a discipline is about 10 years old. It has taken time—perhaps a little too much time—to develop sound principles, but they are now in place, and are part of the curriculum for many health care undergraduates. The Government have frequently stressed that it must be a mainstream, key priority for all NHS staff. It certainly features in front-line care and strongly in patient safety with the deans of all the nursing and medical colleges. Comments were made about civil aviation, and I have been reminded that we have been active in transferring some of the culture and lessons of civil aviation to the NHS. The Committee took evidence from Martin Bromiley, a practising airline pilot. We are grateful for the insight that he is giving us on the human factors in particular. We continue to work with him. On extending and expanding the list of never events, the National Patient Safety Agency is considering adding to the existing list, and any addition will be evidence-based. There have been suggestions in the press recently that the Government are not serious about being open and candid with patients, families and carers when things go wrong, and the subject was raised during the debate. Nothing could be further from the truth, and I want to make it clear today that under the NHS constitution all NHS staff have a duty to be open and honest with patients at all times, particularly in these difficult situations. A statutory duty of candour is being sought by some individuals and organisations, and on the face of it a legal duty on staff to be open looks attractive. I have often said that we must do what we can to ensure that organisations and individuals take their duties in this respect seriously. In my view, a statutory duty, if it could be made workable, is not the key issue to focus on initially; it would be the icing on the cake. Before considering whether a statutory duty is necessary or workable, we must do what we can to ensure that a culture of candour develops, giving staff the confidence to be open, safe in the thought that they will not be scapegoated for an error that might not be of their making. That would close down communications rather than open them up. A lot of work is being done in this area, and we should consider whether more can or should be done. I have asked officials to set up a small stakeholder meeting giving proponents and opponents of a statutory duty the opportunity to put their views on record, and to use that as a starting point for a defensive policy review. I am pleased to say that organisations such as Action against Medical Accidents, the National Association of LINks Members, the Council for Healthcare Regulatory Excellence, the Medical Protection Society, the British Medical Association, the NHS Confederation and the Royal College of Surgeons, together with a number of clinicians with key interests in that area, have already agreed to take part in the initial meeting.