Health and Social Care Bill

My Lords, an apology is not, of itself, an admission of liability. I am very grateful to the noble Baroness, Lady Ashton of Upholland, for allowing me to put that into English law, if I can update the noble Lord, Lord Marks, on it. I come at this question from a slightly different angle. My familiarity is with doctors who have blown the whistle and had their careers destroyed as a result. That, too, has its roots in a lack of internal candour. I want to see the health service become more constructively self-critical, and for the mistakes and wrong judgments that have been made to be the subject of ordinary conversations within a hospital or other medical organisations, so that better care is provided in the future. This is the way it is in schools. Teachers are generally pretty open about things that have gone wrong and look to find ways of doing things better, but they do not tell parents about it. You can look at schools that have improved from 20 per cent to 80 per cent of students achieving five GCSE grades of between A and C. The kids are the same and the intake is the same. That school has failed thousands of children but no one has ever admitted that to the parents, which is very hard to do. In fact, it would tend to freeze any kind of internal self-critical attitude, particularly if the duty was drawn as widely as it would be in this amendment. I therefore find myself siding with the noble Lord, Lord Winston, in this, although I am very committed to candour. Candour needs to be there, particularly in something as dangerous as medicine, where you are skiing down the edge of a precipice for half the time. You cannot be blamed when things go wrong because mistakes are bound to happen under those circumstances. Downhill skiers crash; they do not intend to do that and are well trained not to—but it happens. This spreading of blame for every slight mistake or wrong judgment taken in the circumstances of surgery or something with a longer timescale, such as pharmacology, is not the right way to approach the issue. We need to find ways of being open and of encouraging professionals, in particular, to be open with each other in a culture of self-improvement. To expose all this to litigation and in effect to encourage patients to go to law whenever something goes wrong, under circumstances where it is inevitable that a large number of things will go wrong, would be a mistake.