My Lords, this proposed new clause, which would implement one of the most important recommendations in our report, First Do No Harm, is about the independent patient safety commissioner. I am conscious that you cannot change history, but you can plan for the future; that is what we seek to do through the independent commissioner.
I thank noble Lords from all sides of the House who have put their names to this amendment, particularly the noble Baroness, Lady Jolly, and the noble Lords, Lord Hunt of Kings Heath and Lord Patel. I also thank the noble Lords who spoke in favour of the commissioner at Second Reading and have done so often since then.
Many people outside Parliament have also voiced their support. It really gladdens my heart, when we live in such troubled times, to have a rock-solid consensus. Of course, I await the response from my noble friend the Minister but I really do hope that he will choose not to stand apart but to be instrumental in improving safety and the lives of thousands of people by supporting this amendment, even if it requires a bit of redrafting.
I think that noble Lords will be grateful that I will not go through the amendment subsection by subsection, paragraph by paragraph, because that would take all night and it is all there for noble Lords to see. First, though, let me put a question. Why do we need this independent patient safety commissioner? It is quite simple: because there is no one person whose task it is to listen to the voices of patients, to stop the trends and patterns that give rise to safety concerns, and to encourage or require the healthcare system to act on those concerns when they are not being recognised and realised.
The healthcare system has failed to listen to patients’ concerns. Our review vividly and tragically illustrated that. Thousands of people have suffered. Lives have been ruined. I am absolutely convinced that, had we had a patient safety commissioner—that is, if that person had existed—much of the harm done could have been prevented.
It is not only what we found in our review that proves the need for this. Think of the recent Paterson inquiry. Its findings echoed ours, with patients voicing concern but their voices not being heard and avoidable harm going undetected. Sadly, we all know that there is a long line of similar examples; indeed, Essure, a contraceptive device that has caused many women terrible suffering, was reported on by the BBC last weekend.
We know our own bodies. We know when something is not right. We know when a treatment is causing a problem. We are the first to know, yet patient voices and experiences are all too often simply referred to as anecdotes and written off. They are not; they are serious research. We think that a patient safety commissioner would put an end to that—an end to anecdotes simply being written off.
There have been suggestions that existing organisations are already responsible for patient safety so we do not need another one. I want to tackle that fallacy head on. If it is true that organisations in the healthcare system are performing this task and doing it effectively, why has so much avoidable harm occurred?
The system simply is not working. Yes, the organisations within the healthcare system are doing their job; people are working very hard as individuals, and in the organisation, but they are disjointed and siloed, and patient safety is not their overriding purpose. They did not prevent the avoidable harm that we discovered. While some organisations have elements of safety within their remit, not one has patient safety as their total focus, and not one considers that they have the responsibility to listen, spot trends, raise concerns and get the system to act.
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When as a review team we worked together in July, in the early days when we first met, we heard from patients the enormity of their suffering, and we said, “Come on, we must act now.” But we were only a review team and could only recommend. Sir Cyril Chantler, my vice-chairman, and I went to talk to NHS England, to Professor Keith Willett and to the department’s then Chief Medical Officer, Dame Sally Davies. We asked them for these mesh operations to be paused until six safety measures were introduced. I have to say that those individuals were amazing and, to their credit, agreed to halt operations immediately. Today, more than two years later, those safety measures still have not been delivered.
I have heard some people say that we could nest a patient safety commissioner inside an existing body in the healthcare system. Quite frankly, that troubles me. The commissioner needs to be independent of the system—a person who is outside the system looking in, not somebody being in and looking out. We want someone who is independent, outside the system
looking in. The commissioner must have an uncluttered and single-minded focus on patients and patients’ needs, and that person needs to hold their trust. The notion that such an important and major role should be nested within something else is practically flawed. Rather than being subsumed by an existing body, it would amount to a reverse takeover.
Similarly, the answer is not to set up another regulator within the system. We do not need another regulator; the space is too crowded already, as it is. No, we need a new voice, one which will talk and act from the patients’ perspective and encourage the system to do what needs to be done and hold it to account. Crucially, the commissioner must have statutory powers; he or she must have their powers established in legislation, which is why I am proposing this amendment today.
We have looked at other commissioners—certainly the Children’s Commissioner, who has proved herself so effective. She speaks for children. When I looked at her job description, I thought, “Yes, that’s what we want from the patient safety commissioner.” I was really interested to hear her on Radio 4 when there was a lot of controversy about children going to school or not. Parents were worried, as were the trade unions and the teachers—as were the children, to some extent. The Children’s Commissioner said, “Stop your squabbling. These children need to get back to school.” And I thought, “That’s great—that’s what we want from our patient safety commissioner.”
We need a person of standing, independent, accountable to Parliament and with the Cabinet Office as their sponsor, within government but avoiding conflicts of interest with other departments. This new voice will continue the work we started in our review, pressing the healthcare system to take timely action, where action is needed to minimise harm.
The remit of the patient safety commissioner as set out in the proposed new clause extends to medicines and medical devices. I have been asked whether the remit should not be wider, to cover all forms of treatment or even all patient experiences, not just those linked to safety. My answer is this: let us get to first base. The remit could be extended in future beyond medicines and devices, but this is where I believe the need is most urgent and we should address it.
Our healthcare system is very good. It is full of wonderful people, working hard to treat illness and to help people live healthy lives. But we discovered in our review that something is missing. We need something—no, we need someone—to be the patients’ port of call, their listener and their advocate. We need a person who holds the system to account, monitors trends and requires it to act. We need this person to be the golden thread tying this disjointed system together in the interests of those who matter most: the patients. Quite simply, we need an independent patient safety commissioner. I beg to move.