I agree that the provision of apologies where appropriate will form a key part of the response of scheme members where something goes wrong with a patient’s healthcare. It is worth bearing in mind that a MORI survey carried out for the Making Amends consultation indicated very clearly that patients who had been harmed by their healthcare predominantly sought an explanation, an apology, and that the NHS should learn from its experience to improve patient care in the future.
The NHS redress scheme will provide the apologies and explanations that patients say they seek, and put in place better mechanisms to prevent occurrence of those mistakes.
Amendment No. 9 would require the scheme to provide for an apology to be given in appropriate cases. I am willing to consider further the possibility of amending Clause 3(2) to provide that apologies must be given where appropriate under the scheme. I reassure the noble Earl on that point. I accept that if the scheme is to be effective, it is vital to develop a more open and honest culture, and the provision of apologies where appropriate will be key to achieving that culture change. It is just as well the Committee was reminded of the printing error as I was about to give the noble Earl a lecture on the inappropriateness of the rest of his amendment. However, I shall not do so.
Amendment No. 10 would require the scheme to provide for the giving of an apology and, in addition to an explanation—for example, of what had gone wrong—the giving of an explanation of the steps to be taken to prevent a recurrence of a similar incident. I have some doubts in that regard. As I indicated, the provision of apologies where appropriate will form a key part of the response of scheme members where something goes wrong with a patient’s healthcare. However, I wonder whether it is appropriate to be prescriptive on the face of the Bill regarding the detail of how scheme members should involve the patient in the process. Scheme members will want to tailor their response to the individual patient and the individual circumstances of each case. To be effective in driving culture change, scheme members will need to have flexibility to take ownership both of how their own clinical governance systems work and of the detail of how to respond to individual patients when things go wrong.
As I say, I shall certainly consider further the possibility of amending Clause 3(2) to provide that apologies must be given where appropriate. However, I believe that it would be overly bureaucratic to provide for the giving of an explanation of the steps to be taken to prevent a recurrence of a similar incident for every case under the scheme. For example, recommendations in certain cases will be relatively minor. Further, it may be inappropriate to go into detail on all aspects of action taken. An effective redress process would be for responses to be tailored to the needs of the patient. Some will want only an apology. I consider this is best left to good practice and local discretion on an individual case basis.
Amendment No. 33 would allow the scheme to make provision for the making of recommendations at the end of a case under the scheme as to how to prevent the recurrence of similar events. I certainly agree that one of the important benefits which the scheme is intended to achieve is to improve the ability of the NHS to learn from its mistakes. However, I do not believe that this amendment is necessary to achieve that. Clause 10(2)(h) already allows the scheme to impose a new duty on scheme members requiring them to charge a specified person with responsibility for overseeing the carrying out of specified functions under the Act and advising the member about lessons to be learnt from cases that are dealt with under the scheme. We intend for that investigation to be undertaken by the scheme member specifically to ensure learning from mistakes that happen at local level. Scheme members are best placed to identify mistakes made and to correct them to prevent similar incidents occurring in the future. In light of the requirement under Clause 10(2)(h) I therefore do not believe that Amendment No. 33 is necessary to achieve the desired effect.
NHS Redress Bill [HL]
Proceeding contribution from
Lord Warner
(Labour)
in the House of Lords on Monday, 21 November 2005.
It occurred during Debate on bills
and
Committee proceeding on NHS Redress Bill [HL].
About this proceeding contribution
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2005-06Chamber / Committee
House of Lords Grand CommitteeSubjects
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