NHS Redress Bill [HL]

As the noble Baroness said, the amendment would result in the redress scheme covering people with qualifying claims in tort arising out of health services provided as part of the NHS in England. That means that the scheme might cover people with qualifying claims in tort arising not only out of hospital services but all healthcare sectors, including primary care, under the phrasing of the amendment. As we currently envisage the scheme, it will apply only to cases involving qualifying liabilities in tort arriving out of hospital services provided or commissioned as part of the health service in England. For reasons that I shall explain, we need to resist the amendment, because the great majority of cases of clinical negligence and breach of care occur in secondary care. Therefore, it is appropriate that the redress scheme be introduced for cases arising for secondary care services initially. Many incidents of criminal negligence in primary care settings would result in very small value claims, which would incur disproportionately high administrative costs to handle. GPs and other primary care service providers have private indemnity arrangements with organisations such as the Medical Defence Union and the Medical Protection Society, which are private organisations that collect insurance-type premiums from their members. We need to have further discussions with those stakeholders to establish how funding flows would work if a significant proportion of their low-value claims were taken on through the NHS redress scheme. After the evaluation of the NHS redress scheme in secondary care we will consider extending the scheme further. Our intention is to review the scheme after three years. One of the matters that will be considered during this review will be whether to introduce further primary legislation to extend the scheme to primary care. There is already a large programme of reforms taking place within primary care and it will be important to ensure, following further discussions with stakeholders, that the introduction of a redress scheme would support any changes and initiatives already or soon to be in place. I think that Members of the Committee know that there has been a wide public consultation and that, at the turn of the year, there is likely to be a White Paper on services outside hospital, which could lead to significant changes in the range of services provided and blur the boundaries between primary and secondary care. That is another reason why we suggest watching, waiting and reviewing the experience in this scheme relating to hospital care and not extending the scheme at this stage in the development of policy thinking. I hope that that will clarify the Government’s position for the noble Baroness, Lady Neuberger.