NHS Redress Bill [HL]

My Lords, we are already half way through the list of speakers. Every point that could possibly have been made has been made—certainly every point that I intended to make has been made. I feel rather sorry for the speakers who will follow me. However, I hope that your Lordships will allow me to emphasise one or two of the points that have been made. Any legislation that will allow patients who have suffered adverse incidents in NHS hospitals to avoid the complex legal process and to claim redress in the form of an apology, explanation, further remedial treatment and some financial compensation has to be welcomed. The current system is complex and unfair and suffers from all the defects that have been explained by the Minister and listed in the Explanatory Notes and the various briefings that we have all received. That has been very adequately covered by previous speakers. The medical and dental professions are supportive of the initiative and I know that the defence organisations—I declare an interest as a member of the Medical Protection Society, a past member of the council of the Medical Protection Society and a past chairman of Dental Protection—are in favour of a move away from purely financial compensation towards a more comprehensive package of redress. I know that the other dental Peer, my noble friend Lady Gardner, is also in favour of the Bill. She says that she feels that many hospital disputes will be resolved far more easily under this proposed process. The absence of the threat of litigation will, it is hoped, create a culture of openness within the NHS in which lessons can be learnt and risks reduced. It should ensure much greater frankness in explaining the nature and cause of any mishap and move us away from the present culture, which prevents health professionals being open about mistakes and learning from them. I hope that the Minister will be able to assure the House that this legislation will go some way towards discouraging the increasing national culture of the need to complain—the need to find someone to blame; of no win, no fee litigation. A constant awareness of this threat cannot benefit the NHS, where 99.99 per cent of healthcare workers carry out their duties to the best of their ability and maintain high standards of care. Is it the Government’s intention to continue to measure standard of care by the Bolam test, as already mentioned by the noble Baronesses, Lady Neuberger and Lady Morgan? However, some aspects of the Bill require clarification—in particular, the need to avoid doctors and healthcare professionals being unfairly criticised. The provision of accessible and appropriate redress for patients in a timely and efficient manner, avoiding the need to resort to lengthy litigation cases, would benefit both patients and professionals. It is important that the redress scheme balances quick resolution with thorough investigation. There must be a careful examination of the facts. Any investigation that fails to consider all aspects of the care provided could lead to doctors and other healthcare professionals being unfairly criticised. That might lead to further investigations and disciplinary hearings that could undermine the morale of healthcare professionals, negating one of the core objectives of the redress scheme. The Bill contains little detail, and much of the substance will be determined by secondary legislation. While I understand the need for flexibility to accommodate experience in changing NHS practice, the operational details must be subject to more rigorous scrutiny. Important practical matters, such as raising the qualifying monetary cap for claims, the composition of adjudication panels, the instruction and role of medical experts, the nature of guidance on assessing and awarding compensation, and the appeals process, have not been outlined and will be determined by secondary legislation and by the prerogative of the Secretary of State. I welcome the Bill and look forward to dealing with the detail in due course.