Health and Social Care Bill

My Lords, I join the noble Lord, Lord Campbell-Savours, as a former Member of Parliament. I am guessing that anyone who was a Member of Parliament for any length of time could, through their constituency casework, repeat the sort of story to which he referred; so I will not burden the Committee by adding similar types of anecdote, other than to say that we cannot all be wrong. Up and down the country, people are going to see their Members of Parliament and saying, ““We have a problem that we can’t get past””. There has to be something in the system that is not working right. Like other ex-Members of Parliament, I have from time to time tried to intervene, but the fact that I was a Member of Parliament made virtually no difference whatever to the health authorities. Maybe you would argue that Members of Parliament were the last people they would tell, but they were not going to tell anybody. Having said that, I also agree with one thing that the noble Lord, Lord Winston, has just said. I hope that the noble Baroness, Lady Masham, will not take this amiss—I will come to my view in a minute—but I do not think that this amendment is the right amendment. Perhaps I may read to her just a few words: "““full information to patients, their carers or representative about any incident or omission””," that may affect their care. That has been taken to refer to a major problem—a life-threatening problem; a permanent disability or disfigurement problem—but, actually, it could also refer to the numerous stories that appear in our national newspapers, week in and week out, about the absence or inadequacy of nursing care to the elderly. Those are incidents and omissions that affect their care. An amendment that is that wide in its potential scope seems to me to require further thought. It might be described, to use my example, as inadequate nursing care—and, incidentally, I speak as the husband of a qualified nurse—but the nurses do not appear to think that it is inadequate, because it keeps on happening. The management does not think that it is inadequate, because it keeps on happening. The boards of the hospitals do not seem to think that it is inadequate, because it keeps on happening. So, identifying at that level what this amendment might mean seems very difficult. I come to the central point. I share the view of those who believe that more candour is required. I hope that my noble friend will take this away and look at it again in the context of reaching out to those delivering NHS services, not just to some of them. The legal point is a real stumbling block. If you are a professional paying a lot of insurance against medical cover or if you are running a big hospital and paying a lot of insurance health cover, then lawyers are important. We can be dismissive of lawyers and say ““transparency reigns, OK””, but in the real world lawyers also reign, OK. If I may say so to my noble friend, your Lordships’ House needs help on this issue. Do not make us pick between the reality of the need for candour and the reality of the professional job that lawyers are doing to protect their clients. Instead, I ask my noble friend to bring forward a more comprehensive view, perhaps with mediation at its heart. Even in this debate we have heard about people who did not want a lot of money or retribution; they just wanted to know. That rings bells in my head about mediation. Perhaps if a mediation type of arrangement was included in all of this, the problems with the lawyers would be so reduced that the NHS could handle it. Let me cheer up my noble friend. I can remember my time in Richmond House, with the escalation of money that we had to set aside year by year as more legal cases went to the courts. That was a genuine problem; it was money that was not going to be available for patient care on a day-by-day basis. There are two real issues here. I think we can solve them not in terms of the Bill, either in the way it is written or, with due respect to the noble Baroness, Lady Masham, in the way that she is seeking to amend it, but rather by asking the Minister if he can come back with a more comprehensive and coherent strategy for dealing with this problem. I hope that he will put mediation somewhere near the centre of it.