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Mr. Hutton: First, I should like to express my appreciation to all those who have spoken in this short debate for having lent their support to the motion. I am sure that everyone shares my sense that it is the strong will of the House that the inquiry be established and allowed to get on with its work as soon as possible. The House will know that that is conditional on the other place approving a similar motion, but I am sure that that will happen soon, enabling the inquiry to start. I shall respond briefly to one of two of the points made in the debate.
I shall certainly draw to the attention of the inquiry secretariat the remarks of my hon. Friend the Member for Calder Valley (Ms McCafferty), especially those relating to access to the tribunal. The hon. Members for Woodspring (Dr. Fox), for Congleton (Mrs. Winterton) and others have expressed their concern about the use of controlled drugs by Dr. Shipman. I am sure that they are aware that that matter is specifically included in the terms of reference for the inquiry that we are establishing today. We expect Dame Janet Smith to give careful consideration to that aspect of the case, which has given rise to the concern voiced in the House tonight and elsewhere.
The right hon. and learned Member for North-East Bedfordshire (Sir N. Lyell) expressed concern about the work of the NCAA. I assure him that it will not work as a police force. However, as many right hon. and hon. Members will know from their constituency work, when concerns have arisen in the past about questionable or poor performance by GPs, there has been a lack of clarity about where to take those concerns and who is responsible for dealing with them. We think that the NCAA will provide a useful focal point for dealing quickly and effectively with such concerns, which does not happen at present.
On a point of information, concerns were expressed early on about the work of Dr. Shipman. One of the things we want the NCAA to do far more systematically than has been done in the past is put in place a proper set of procedures whereby such concerns can be addressed promptly and effectively and, if necessary, GPs can be provided with more effective support, which is an important part of the process. When serious concerns arise, we should act quickly and effectively, but that has not happened.
Dr. Fox: Does the Minister agree that, regardless of the measures adopted, the more exceptional the case--to use the word of my right hon. and learned Friend the Member for Sleaford and North Hykeham (Mr. Hogg)--the less likely it is to be picked up by any authority, especially if the case involves, not incompetence, but wilful harm to
Mr. Hutton: I agree in part. However, we think that the NCAA provides the best possible chance of our being able to intervene more effectively in such cases in future. That is what we want to achieve and we have been clear about setting out our objectives for the NCAA.
Mrs. Ann Winterton: Would that authority, had it been established, have been able to respond to relatives who after reading newspaper reports suspected that something had gone wrong with the treatment of a family member and were concerned, but did not know where to turn and, because they had such great respect for doctors, were inclined to think that they were only imagining a problem? Does the Minister think that ordinary patients and their relatives will be able to approach the new authority if they suspect that the care that they or their relatives are receiving is not as they would want it to be?
Mr. Hutton: Yes, that is precisely what we think. We are also trying to establish other mechanisms to ensure that patients' voices are effectively heard at all levels of the national health service. That is what the independent statutory patients forums will allow us to achieve.
I tried to deal with the concern expressed in an intervention by the right hon. and learned Member for Sleaford and North Hykeham (Mr. Hogg) about legal representation in the tribunal. However, I shall write to him about that matter and draw his remarks about criminal injuries compensation claims to the attention of my right hon. and hon. Friends at the Home Office.
(a) after receiving the existing evidence and hearing such further evidence as necessary, to consider the extent of Harold Shipman's unlawful activities;
(b) to enquire into the actions of the statutory bodies, authorities, other organisations and responsible individuals concerned in the procedures and investigations which followed the deaths of those of Harold Shipman's patients who died in unlawful or suspicious circumstances;
(c) by reference to the case of Harold Shipman to enquire into the performance of the functions of those statutory bodies, authorities, other organisations and individuals with responsibility for monitoring primary care provision and the use of controlled drugs; and
(d) following those enquiries, to recommend what steps, if any, should be taken to protect patients in the future, and to report its findings to the Secretary of State for the Home Department and to the Secretary of State for Health.
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I made a prediction on 4 July last year, when we had a serious debate--on the Conservative Benches, in any event--on the sort of changes that the Government were trying to make in access to information in local government. The Government had brought out draft regulations and were sending them out for consultation. I said then that
This is all part of the process that the Government call local government modernisation. However, too much of it amounts to being anti-democratic and anti-local government. Because the new structures of cabinets or executives will in effect give little or no choice to councils, I said on a previous occasion that the Minister was the Henry Ford of the local government world--we could have any colour we liked, as long as it was black. In this instance, we can have any type of structure we like as long as the Government wish to impose it. I appreciate the Minister of State's sensitivity on these matters, but if she interrupts her conversation with the Whip briefly to listen to some of the arguments, she might be in a position, just for once, to answer the points raised in the debate.
We are not the only ones, by any manner of means, who have expressed concerns about the overall effect of the changes on local government. They encourage the sort of one-party states that we see in some Labour-controlled councils, and encourage a culture of secrecy and exclusion. No wonder that Councillor Brendan Bird of Hammersmith and Fulham, a leading member of the Labour Campaign for Open Local Government, said of the Government's proposals:
The Government's structures would have applied to every council in the country, save that it was conceivable that they would have been defeated in the House of Lords. It was only a last-minute deal between the Government and the Liberal Democrats that exempted some smaller shire districts from the regulations but imposed them across the great majority of local government in England and Wales.