NHS Redress Bill [HL]

moved Amendment No. 27:"Page 3, line 30, at end insert ““any such investigation to be by a person independent of the scheme””" The noble Earl said: In moving Amendment No. 27, I shall speak to Amendment No. 58. The amendments attempt to get to the heart of one of the principal shortcomings of the Government’s proposed redress scheme—that is, its lack of independence. I shall not repeat what I said earlier in the debate, but if we are really to establish a redress scheme that commands confidence among patients and the public, it is simply not acceptable to establish it in the form that we see here. When a patient has a grievance that he wants investigated, it cannot be right to consign the task of investigating the facts behind the grievance to a body such as the NHSLA, which for all its professionalism and experience is justifiably seen as part of the internal machinery of the health service. The Minister will no doubt tell me that the NHSLA operates at arm’s length from the NHS proper. I can accept that only up to a point. Its remit is clearly bound up with the day-to-day work of the NHS, and it is not a body that one could call detached in that sense. The Minister may also say that there are professional standards to which NHSLA employees must work. I certainly do not wish to cast aspersions on the integrity and capabilities of those who work for the authority. I have nothing against them at all. But there is the clearest possible conflict of interest here. The job of the NHSLA at the moment is to defend the NHS against clinical negligence claims. It does so, very often, with considerable effectiveness and success. How therefore can we expect it suddenly to start wearing two hats—one for the NHS and the other for the patient—and to do so with complete impartiality? Even if it were to do so, and even if it were to do so conscientiously, how would it look to the general public? It would look as though the NHS were acting as judge and jury of its own behaviour, which in a real sense it would be. That is not the way to create a scheme that people trust. I have no objection to the idea of the NHSLA acting as the secretariat or the administrators of the redress scheme and as such having the name of ““scheme authority””. There I perhaps part company slightly with the noble Baroness, Lady Neuberger, but I am open to that suggestion. The actual job of investigation and any functions under the scheme that are what one might call quasi-judicial ought to be carried out by someone independent of the scheme authority. Who might that be? The obvious candidate is the Healthcare Commission, which the noble Baroness mentioned earlier. That body has won genuine and widespread respect for its independent stance vis-à-vis the health service. The Minister indicated earlier that the commission was not happy with the thought that it might be charged with these duties, but that does not negate the fact that it is a prime candidate. That is the proposal made in Amendment No. 59, which we will debate. But it need not necessarily be the Healthcare Commission. It could just as easily be a panel of individuals who had the necessary medical knowledge as well as the necessary degree of impartiality to arrive at an outcome that would be regarded as both thorough and fair. I am not wedded to a particular solution at this stage. All I am clear about is that a solution is needed. The Minister will know of the pilot redress scheme that went under the name of Resolve; the noble Baroness mentioned it a few minutes ago. The chairman of the company that ran that pilot, Mr Brian Raincock, has written to me and given me permission to relay the opinions that he has expressed. He writes in his letter:"““For any scheme to work well and to gain the trust of patients it must be truly independent. This came out most forcibly from all those involved in the highly successful RESOLVE pilot, be they claimants, their lawyers, Trust officials or indeed the NHSLA itself””." I must say that I found the mention of the NHSLA particularly interesting. But it is not only the issue of independence that Mr Raincock raises. In addition to that, on the strength of his experience with Resolve, he expresses strong support for the model of redress scheme that I have been advocating—that is, one that separates the business of assessing financial compensation from that of preparing an honest account of a hospital’s performance in relation to a claim. I do not know what reassurance the Minister can really give me on those questions, given the issues that divide us. At the very least, though, this is his opportunity to set out how he believes a necessary element of independence can be built into the redress scheme as he envisages it. I beg to move.