NHS Redress Bill [HL]

The amendments relate to the provision of assistance for individuals seeking redress under the scheme. The provisions for assistance under the scheme are laid out in Clause 9, and the intention is that patients and appropriate representatives whose cases are being considered under the scheme will be able to access support at any time during the process from patient advice and liaison services, PALS and ICAS-type arrangements. It is intended that the arrangements will resemble those currently in place to support patients through the NHS complaints procedure. I need not explain what PALS and ICAS mean but I note the noble Earl’s views about ICAS. If it were to be ICAS or a similar body, it would be developed to meet the needs of the redress scheme with the appropriately trained resources. Amendment No. 50 provides that such assistance must be provided to such an extent as may be necessary rather than to the extent that the Secretary of State considers necessary. That will create uncertainty because it does not make clear who will decide whether such assistance may be necessary. The current drafting mirrors that which has been thought appropriate in the case of other duties of the Secretary of State under health legislation. For example, Section 3 of the NHS Act 1977 provides for the Secretary of State to provide various services to such extent as she considers necessary to meet all reasonable requirements. We believe that coherence is importance. Amendment No. 51 restricts assistance under the scheme to representation only. The current drafting enables more widespread assistance to be offered; for example, support from PALS and ICAS-type arrangements. Naturally, I would not wish to restrict the types of services that may be offered under the Bill, and ““or otherwise”” means that provision under Clause 9 can be wider than just representation. I note the example cited by the noble Baroness, Lady Barker. I am unclear exactly how wide the provision will be but I shall seek clarification. Amendment No. 52 requires the Secretary of State to consult such persons as she considers appropriate before making payments to those providing assistance to people seeking redress under the scheme. It is our intention to work with stakeholders in the development of all aspects of the redress scheme. I do not consider it appropriate that this particular requirement should be singled out as requiring a specific statutory duty of consultation. No one will be required to enter into arrangements to provide assistance unless they are satisfied with the terms of those arrangements, including arrangements for payment. Amendment No. 53 requires the Secretary of State, in making arrangements for assistance, to have regard to the principle that the provision of those services should be independent of any person to whose conduct the case relates or who is involved in dealing with the case. By contrast, the Bill currently provides for the Secretary of State to have regard to the principle that such services should be independent as far as practicable. The current drafting of the Bill mirrors that of Section 19A of the NHS Act 1977, which deals with independent advocacy services for the NHS but, again, it is necessary to ensure a consistent approach to the provision of such services. The inclusion of the words deleted by the amendment is necessary to reflect that although reasonable arrangements may have been made to secure independence, the circumstances of a case may mean that complete independence cannot be guaranteed; for example, it would not be possible for PALS to be completely independent as they are employed by the NHS trust concerned. They work in an independent way but it would be wrong to claim that they are completely independent organisations. However, the provision of ICAS services under the current arrangements is independent. The organisations that deliver the services to patients are funded by the Department of Health under contract but they are wholly independent and are not tied to either the NHS or any individual NHS organisation. When exploring the contracting of ICAS-type support for those using the NHS redress scheme, we intend to ensure an appropriate level of independence.