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Session 2005 - 06 Publications on the internet Standing Committee Debates NHS Redress Bill [Lords] |
NHS Redress Bill [Lords] |
The Committee consisted of the following Members:John Benger, Alan Sandall,
Committee Clerks † attended
the Committee Standing Committee BTuesday 13 June 2006(Morning)[Miss Anne Begg in the Chair]NHS Redress Bill [Lords]10.30
am
The
Chairman: I remind the Committee that there is a money
resolution in connection with this Bill, copies of which are available
in the room. I should also like to remind Members that adequate notice
should be given of amendments. As a general rule, my co-Chairman and I
do not intend to call starred amendments. Please will all Members
ensure that mobile phones, pagers and so on are turned off or in silent
mode during our sittings. It will be in order for hon. Gentlemen and
hon. Ladies to remove their jackets if they so wish. I was going to be
cruel and make them sweat through the summer months. It is a bit cooler
today, but I suspect that it will get quite warm. The debate on the
programme motion may continue for up to half an hour. I call the
Minister.
That— (1)
during proceedings on the NHS Redress Bill [Lords] the Standing
Committee shall (in addition to its first meeting at 10.30 a.m. on
Tuesday 13th June)
meet— (a) at
4.00 p.m. on Tuesday 13th June;
(b) at 9.00 a.m. and 1.00 p.m.
on Thursday 15th June;
(c) at 10.30 a.m. and 4.00 p.m.
on Tuesday 20th June; and
(d) at 9.00 a.m. and 1.00 p.m.
on Thursday 22nd June.
(2) the proceedings shall (so
far as not previously concluded) be brought to a conclusion at 4.00
p.m. on Thursday 22nd
June. May I begin by
welcoming you to the Chair,Miss Begg. It is a pleasure to
serve under you. I am glad that we can get off to an agreeable start
and that it will not get too hot in the room. We had a good debate on
Second Reading. The Bill received broad support from across the House.
I hope that the time we have allotted in this programme motion will
allow members of the Committee to cover the detail in full because we
do need to do that. I also welcome the hon. Member for Billericay (Mr.
Baron) and the hon. Member for Eddisbury (Mr. O'Brien), a fellow
north-west Member. I see the hon. Member for Southport (Dr. Pugh) too,
so it is quite a north-west
triumvirate. I was
grateful to both Opposition Front Benchers for their support on Second
Reading. I think that it indicates broad assent to the principles of
the Bill. That is not to say that there are not issues of substance
that we will want to consider carefully, but I think that we have
allotted sufficient time for our debates. May I welcome particularly
the hon. Member for Romsey (Sandra Gidley)? She and I served on the
Health Committee what feels like many years ago. I am pleased to be
working with her again on this Bill.
I should like to say a word
about Labour members of the Committee, particularly my hon. Friend the
Member for Birmingham, Erdington (Mr. Simon), who works closely with
the organisation Action against Medical Accidents. I am pleased that he
is serving on this Committee. We look forward to his contributions. I
hope that where there may be differences of emphasis between us we can
work through them in a spirit of co-operation and agreement, as is
normally the case with my hon. Friend. I am trying to emulate his
style: I may grow my hair as long his, although it may soon be ruled
out of order. There
are Members on both sides of the Committee who take a detailed interest
in this subject. As I said on Second Reading, Members of Parliament
gain expertise and knowledge of it through their efforts to help
constituents along the difficult road towards a resolution and, dare I
use that word, “closure” of their experience in the
health service. We know how difficult that road can be at times. We
know the obstacles that can be thrown in front of people seeking
redress. I hope that in making our comments we can reflect on the
experiences that all of us have had cause to work through. I hope that
the Bill will benefit from that informed
comment. Finally, I
pay tribute to the usual channels in scheduling our eight sittings. I
was relieved to see that careful attention had been paid to proceedings
in Germany. I am delighted that we should be able to get out in good
time for kick-off on Thursday and then again next Tuesday. I do not
know whether it had more to do with luck or good planning. My hon.
Friend the Member for Ogmore (Huw Irranca-Davies) is a fiery Welshman,
so perhaps he thinks that we will leave the Committee for a dose of
disappointment. He has helped to make me feel happy, relaxed and
without needing one eye on kick-off time, which should aid our
proceedings. We have
an excellent Committee of Members with a broad range of experience
across the health service and in the matters to be considered. We have
given sufficient time to do justice to the complex issues involved,
which are important to our
constituents. Mr.
John Baron (Billericay) (Con): I also welcome you to the
Chair, Miss Begg, and I look forward to your chairing the Committee as
it proceeds. I thank the Minister for his kind words. As for the
football arrangements and whether they were a matter of planning or
good luck, I suggest that they were one of planning on our side, and
good luck on his, but the bottom line is that we have got there
anyway. I shall say a
few words of overview of the Bill. It stands as we like it, as the
Committee knows. I thank their lordships, in particular my noble Friend
Earl Howe on behalf of my party and Baroness Barker and Baroness
Neuberger, who speak for the Liberal Democrats, for their amendments,
as a result of which we have a much improved Bill before us. Our
position is clear: we would like it to be left as it is, because we
believe it to be far improved from when it was first brought to the
House of Lords in
October. The Minister
talked about consensus, of which there was a great deal on Second
Reading. The Government know that the Opposition support their attempts
to
address the problem of clinical negligence litigation. The process is
currently complex, costly and long drawn-out. Most clinical negligence
cases are funded by legal aid, yet most fail, at great expense to the
NHS and the taxpayer. That money could better be directed towards
patient care. However, most people do not qualify for legal aid, so
they want a credible and independent alternative to going to court. The
NHS redress scheme could offer that alternative. The fundamental divide
between us and the Government is that, whereas the Secretary of State
and the Minister envisage a scheme that would effectively make the NHS
judge and jury in its own cause, we believe that investigation of what
has gone wrong in a case ought to be separated from the process of the
NHS assessing its own liability and making an offer.
What is more, the investigative
process must be independent, like the coroners’ courts and the
system provided by the Inquiries Act 2005. As the Government intend to
reverse our key amendments made in the Lords, I shall ask the Minister
to justify removing from the new scheme the essential feature of
independence, which has the support of the Law Society and Action
against Medical Accidents. I shall also ask him to explain both how his
arrangements will create independence and the costs that he has
attributed to our scheme, which seem to be the Government’s only
main argument against it. They suggest that increased costs are the
reason why we should not proceed with the Bill in its present
form. As can be seen
from our amendments, I intend to focus on the key parts of the Bill,
particularly clauses 6 and 12. Their lordships did an excellent job
through their probing amendments, and the arguments that were made are
on record, so I do not see why we should repeat them here. I hope that
the Minister will be generous in taking interventions so that we can
have a meaningful debate, to which I look
forward. Sandra
Gidley (Romsey) (LD): I, too, welcome you to the Chair,
Miss Begg. I also welcome the Minister to the consideration of his
first health Bill. I do not know whether it is worrying or reassuring
that we have a Minister with experience in the field of health, but I
look forward to working with him. I do not intend to repeat what has
been said, but I endorse the remarks by the Conservative Front-Bench
spokesman. Our two parties did work very closely together in the Lords
and we prefer the Bill in the shape it is in. Ultimately we all want to
see a better system for patients. Although we differ on the way
forward, it would be nice to think there was some consensus as I gather
that those in the other place are very keen to keep what they now have.
Any flexibility on behalf of the Government would be very
welcome. Question
put and agreed to.
Sandra
Gidley: I beg to move amendment No. 10, in clause 1, page
2, line 6, leave out subsections (6) and
(7).
The
Chairman: With this it will be convenient to discuss
amendment No. 11, in clause 1, page 2, line 26, leave out ‘or
(7)'.
Sandra
Gidley: On Second Reading we raised concerns that the Bill
deals exclusively with the secondary care sector. Despite Government
assertions to the contrary, there is no good reason why any part of the
health service should be excluded from these provisions. This is
particularly so because over the last few years there have been
significant changes in the way many health services are delivered. Now,
many services that used to be the preserve of the hospital
sector—the secondary sector—are being delivered in
primary care settings or even at home. The latest Government White
Paper endorses the move to care in home-based and community-based
settings. As there is
so much churn in the system, boundaries between secondary and primary
care responsibilities are increasingly becoming blurred. For example,
some treatment could be initiated by a doctor in a hospital but
delivered by nurse practitioners or doctors in the community. The
argument has been made that doctors have professional indemnity
insurance, but it is not quite so clear cut for other members of the
health care team who work across the boundaries of primary and
secondary care. It is difficult to see where they slot neatly into the
picture. The
amendment will make life easier for the Secretary of State if she
decides that the Government have got it wrong because it will enable
the redress scheme to extend to primary care by means of regulations as
opposed to primary legislation. This takes into account the
complications involved in extending the scheme to primary
care. Bearing in mind
the Government’s long-term aim and the churn in the system, it
would seem sensible to facilitate any future change rather than say we
will sit back and review it and in three years’ time think about
whether we need any more secondary legislation. The majority of NHS
care is provided as primary care, and to exclude patients harmed by NHS
primary care from the redress scheme would be unfair and
inconsistent. The
amendment allows the Secretary of State to introduce the redress scheme
in stages. For example, it could at first apply only to hospital care
but be extended to primary care later, without having to go through
primary legislation. If the Government saw that there were problems
with the implementation of the scheme, the amendment would enable the
problems to be redressed fairly
quickly. There would
also be advantages for GPs and other primary care practitioners in
bringing them within the scheme. In the current system, for example,
injured patients have no option if they wish to obtain compensation for
negligent treatment by a GP other than to sue that individual GP. A lot
of patients find it difficult to take action against a GP because the
GP is generally the health practitioner with whom they have built up a
relationship and have the greatest contact. It is also very stressful
for a GP to be sued—more so than if they were covered by an NHS
indemnity, like hospital doctors
are. To extend the
scheme to primary care is also more in keeping with the policy of
moving away from a culture of individual blame to corporate
accountability. There is also an issue about the GPs paying their
premiums to the medical defence unions. Some of the medical defence
unions are against the extension to primary care, and one wonders if
there is a slight vested
financial interest in that objection. In many ways, this is a probing
amendment to extract from the Minister further clarification of how the
success of the scheme will be reviewed and what the likely timetable
for change will
be. 10.45
am
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