NHS Redress Bill [HL]

As we have discussed, there are a fair number of concerns about Clause 8 in general. I return to the question that we have raised time and again as we have discussed the Bill about this being a liability in law. This is a tort-bases system and therefore a great deal more thought needs to be given to patients taking proceedings. If patients are able to start proceedings as well as the NHS trust—I hear what the Minister says on that and I am relieved to know that it is intended that ordinary patients and citizens can start the process—they will need help to do so and to understand the proceedings. We remain to be convinced that what the Minister has said about PALS and ICAS is adequate. Do people not need more specialised advice to enter a scheme which is essentially tort-based? Taking the clause as a whole, one looks at that part, scratches one’s head and says, ““It is really very difficult for the ordinary punter, the ordinary individual””. That is the first point I wish to make. Secondly, the Minister gently chided me and said that I nod my head and smile at the thought that this is all about culture change. It is indeed about culture change and we are all absolutely at one in wishing to see a culture change in the NHS. However, one must reflect on how long it takes for a culture change to take place as a result of legislation. For example, the Sex Discrimination Act and the Race Relations Act were finally introduced at the end of the 1960s, and again in 1975 and 1976, and yet it was 25 years later before young people automatically assumed that race discrimination and sex discrimination was wrong. A whole generation can pass before a culture change takes place. The Minister is shaking his head but it takes a long time to drive culture change. I would like to see more on the face of the Bill which makes it clear that both the NHS trusts and the patients can make the move, and that advice will be made available to patients to enable them to make the move and to understand the scheme. As it stands at the moment, I am not quite certain that we have parity of esteem.