Government: Draft Legislative Programme

My Lords, I welcome this opportunity to help the process of improving the Bills that will come before us and to comment on aspects of them. I will address three Bills very briefly and raise issues of concern. In doing so, my views are based also on those expressed by many others outside. In that respect, they are evidence-based and worth incorporating into changes. I start with the Coroners Bill. The Governance of Britain—The Government’s Draft Legislative Programme states: "““The purpose of the bill is to deliver an improved service for bereaved people””." That important service is not the only one that can be improved. Particularly in coroners’ cases that arise as a result of healthcare issues, there are often wider lessons to be learned. In that respect, the lessons are important for delivering safer healthcare and designing safer health systems. Such information is currently not available from coroners, which is a pity. It should be available to a national organisation such as the National Patient Safety Agency. I declare an interest as chair of that organisation. I hope that the Bill will address that issue. It should also address the problem of long delays in coroners reporting. The Health and Social Care Bill incorporates the White Paper on professional regulation, Trust, Assurance, Safety: the Regulation of Health Professions in the 21st Century. As a preamble, that White Paper has prepared the way for a package of legislative reform aimed at strengthening healthcare regulation. That is to be welcomed. However, the Government must ensure that their legislative proposals deal with principles and not operational details. They should focus on what is to be achieved not the details of how it will be achieved. For example, I accept that the GMC's role is to regulate me and to inform me about what good medical practice should be and how I should maintain it. In the evidence that I must produce to demonstrate that I do so, I should be obliged to follow the GMC guidance. It is not necessary to have such guidance in the legislation. Healthcare and healthcare regulation operate in a dynamic and changing environment. We need to be confident that the legislation that we put in place today remains fit for purpose and allows operational systems the flexibility to develop ways that reflect our experience and changing needs in the years ahead. I hope that the legislation will address that. I support the strengthening of clinical governance. There is a need to review the clinical governance framework as it applies to the acute services sector and, more importantly, the primary care and community care sectors. I hope that legislation establishing Ofcare addresses safety and quality assurance through a robust clinical governance mechanism. I agree with the plan for legislation to use the civil rather than criminal standard of proof for all healthcare professional regulatory bodies. I know that there is opposition from health professionals who believe that the standard of proof should be criminal not civil. I disagree. I know some noble Lords have spoken against having the civil standard. According to the draft legislative programme, we will not now have a GMC affiliate but a ““responsible officer””. I look forward to finding out what that is. Finally, I turn to the Human Tissue and Embryos Bill. We await the report of the scrutiny committee, but I hope that the Government will abandon the idea of incorporating the HFEA and the HTA into one authority entitled RATE. The two authorities’ functions are quite different. The HTA is currently having great difficulty fulfilling its task, and it would be completely wrong to add another task, the HFEA. I hope that the Government will seriously think again about that. We should bear in mind that we already have legislation that allows human embryo research only up to 14 days and does not allow implantation of that embryo. Any future legislation should be based on the existing framework. The term ““inter-species embryos”” is difficult to define, and I hope that any definition used will not cut across our current research on animal models. For example, we already have a mouse model with a complete copy of chromosome 21 of Down’s syndrome to allow us to study why human beings who carry that chromosome have certain deformities. We should ensure that the legislation that we draft on inter-species embryos does not stop that sort of research. I hope that that briefly highlights some of the issues that I have with these three Bills, and I look forward to a longer debate in due course.