My Lords, I will come to the Minister’s summing up at the end, but I thank all noble Lords who have taken part in this debate. I have not heard anything really contrary or disturbing against a patient safety commissioner. It has been supported, and I am very grateful for that.
I first thank the noble Lords, Lord Patel and Lord Hunt of Kings Heath, and the noble Baroness, Lady Jolly. I know that the noble Lord, Lord Patel, has been a champion of safety both in Scotland and in this country. I share his impatience. He considered some of the interesting reports that have been produced and we hope that they all have made a little difference—but not enough. He is so right to say that we are searching for independence, as other noble Lords have mentioned. The person who we appoint to this position is so important. We do not want a patsy or someone who is just going to do what the department and Ministers want. We want an independent voice. I thank all those who also talked about a patient safety commissioner and the Children’s Commissioner, who, as we all said, has been outstanding. I also thank the noble Lord, Lord Patel, for his revealing statistics, which were interesting.
I understand the cynicism of the noble Lord, Lord Hunt of Kings Heath, about NHS England. I say just one thing about it, but I should have declared
my interest at the start of the debate because I am employed by NHS England in the context of maternity services. The chief executive took our report, Better Births, and said, “I am giving you five years to implement it”. He gave us the people, resources and everything else. We were making real progress until March. The virus has really knocked us back—we did not expect it. However, in the four years that we have completed, we have changed much of the culture within maternity services and improved the lot of many women. We have not had that response from the Government on this report. They have not said, “We will give you five years and some resources. See what you can do”. No, they have been silent. Today, the Minister told us a bit about what he has been doing. However, none of that was news to us. We know all that already.
Moving on, I refer to what the noble Lord, Lord Hunt of Kings Heath, said about the tension within boards. I chaired the Brighton health authority board when the Grand Hotel was bombed. It was a tragedy—lives were lost—but when one looked at the whole system, it worked. Why was that? It was because we had a good leader in A&E who conducted a rehearsal three weeks before the bombing. That rehearsal paid off. Preparation is extremely important. The noble Lord was of course right about the financial problems that must be weighed up within trusts.
We are so lucky to have in our House my noble and learned friend Lord Mackay of Clashfern, a previous Lord Advocate and Lord Chancellor. I remember working with him on debates about the family and all sorts of matters. If you want somebody with true wisdom, understanding and foresight, you go to him. He has done it all, knows about it and always has such integrity. I thank him very much for his support and his impatience, which I share. We know today that babies are being born deformed. One in two have a chance of having a disabled child if they are on sodium valproate, and they do not know about it. We are impatient. We do not want to see more of that. We want to see safety become a reality.
My noble friend Lord O’Shaughnessy has, of course, been a Minister in the House and he knows the tensions and difficulties. One of the things that I know about him is that he listens to patients: he takes time out to do that. He appreciates, almost more than all of us, how people have waited for decades in terrible conditions, suffering terribly. I know that he has done a lot with sodium valproate and the patient groups there, and I thank him for that. What he was telling us about Jeremy Hunt and the way that this review was first commissioned was really helpful, because Jeremy Hunt set the parameters. He was invited to take on three different areas by the Prime Minister, Theresa May. It was really her initiative first, and then Jeremy worked extremely well. I am of course delighted that he appointed me to chair the team.
I want to say a word about the noble Lord, Lord Blunkett. I am very pleased that he is taking part in this Committee; he apologised for not being at Second Reading. Whenever he comes in on a debate, we welcome him. Again, with him having been a really strong leader in his own area and then in the Commons,
it is really good to have had him join us today. He talked about the Health and Safety Executive and how we have to work with it. He is of course right.
The Minister, in his summing up, asked who this patient safety commissioner is going to work with. We do not know exactly—of course not. He can read the amendment, which sets out quite a lot. He can read the report and see there what we were thinking about, but of course this needs more work. In fact, one of the members of our team said to us, “Do not lose out on the coroners’ courts; you learn a lot from them”. Her husband is a judge, so she knows a bit about it. We are saying that you have to map the whole horizon and see where things are not quite right. Why is something going wrong? That is something we ought to look at more carefully.
It is about listening to patients but, much more than that, it is about working with all the different healthcare systems. My noble friend Lord Sheikh and others talked about the NHS. We are thinking much more broadly than the NHS. We are thinking about it, of course, and we know it has done a fantastic job with the coronavirus, but we are also thinking about private providers. I was very interested that the noble Baroness, Lady Masham, brought in private providers. We need to think about other public bodies and certainly about the royal colleges, the pharmaceutical and devices industries, the manufacturers and of course the policymakers—the politicians. I appreciate that it is a broad area but that is the problem with it at the moment: it is disjointed and siloed, it is unresponsive and defensive. We need some person who is going to get into all of that and call all the organisations to account—encourage them but call them to account when things are not working right.
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I thank the noble Baroness, Lady Ritchie of Downpatrick, for her strong support and what she said about the different stories she had heard. It is shocking that they have been avoidable. Perhaps I could pick up just one. Throughout the report, there are a lot of quotes but this one really struck me. This is a woman who had mesh, and she says:
“This device took everything from me my health my life my job my dignity my marriage my freedom. There are a lot of us suffering.”
That is the impact that some of this has had on thousands of individuals. That is our nation’s tragedy.
I thank the noble Lord, Lord Sheikh, very much for his report. We were working as a very small team and met very often; through Cyril Chantler and others, we were thinking about the patient. We said, “Where is the patient?”. The patient is the pilot, while the clinician is the navigator. We said that often what happens is that the clinician is the pilot and the patient is the passenger. We want to change that. Who is this service run for? It is run for the patients. Who pays for it? The public, who are patients. We were really thinking a lot about that. Of course, we want to trust patients and to have someone who is going to help them and join the dots, as the noble Lord, Lord Sheikh, said.
I thank the noble Baroness, Lady Masham. As I have said, she was on the button with the private health sector. We always have to include it, and we
have, when we talk about the healthcare system as a whole. She mentioned charities, which are also terribly important. We essentially worked with 15 charities and with hundreds and hundreds of individuals. I still have a postbag full of their worries and requests, such as “What is happening to your report? Why isn’t it implemented? What are the Government doing?”—I get all those questions all the time.
I thank the noble Baroness, Lady Bennett of Manor Castle. She is so correct—go back always to the patients’ quotes. That is what this is all about. We have certainly talked a lot about Anne Longfield and the patient safety commissioner. People have spoken glowingly of her, and perhaps we ought to canonise her—I do not know.
I thank the noble Baroness, Lady Thornton, for all her support and the encouragement she has given me. She was also so right to talk about three reports on patient safety, complete with Mid Staffs. The problem with Mid Staffs was that it had so many recommendations; I think it was about 160, but I cannot remember the exact number. That is why we had only nine, but these nine are key. One of them was about an apology, which we asked for and which was given by the Secretary of State, so we have eight. But those eight are key to ensuring that in the future we have a much better system that is totally influenced by patients and their experiences. That is really important and this Bill brings a lot of it in. I am very grateful for that.
I thank my noble friend the Minister for his summing up. He warned me beforehand that it was likely to be long. It was very thorough but for us, there was no news. We know all about special centres, and we have been working with the people there to establish them. Of course, we have worked with the British Society of Urogynaecology. We have talked a lot about consent and how that should operate. Of course, a lot of work has gone on with NHS Digital and NHSX. We have talked to their leaders and listened to what they have to say. As the Minister knows, we asked certain questions of them and we had the replies.
Of course we must listen to patients, but we need to do much more than that. We need some sort of mechanism. We need something that makes this a reality. We do not want warm words; we want action. We have thought about this for two and a half years. What would make a real difference? The eight recommendations would, but the most important, and the one that needs legislation, is that of an independent patient safety commissioner.
I say to my noble friend the Minister that of course we know about the HSIB, the duty of candour, speak up guardians, the MHRA, the CQC and all that. We are trying to promote something and someone different—someone who is not part of the system and is not going to have a vested interest in how it works. We want someone independent. I know that scares the pants off the Department of Health and Ministers. They do not like independence but, my goodness, it is so important, as we have learned with the patient safety commissioner.
I understand my noble friend talking about the fact that it is a big report and the Government will have to think a lot about it. I have done a lot of reports in
my time. The first was to ensure that nurses could prescribe. It took me 20 years to get that to happen. I have not got 20 years. The people suffering now do not have two years or 18 months. Suffering cannot wait. This is important and it is critical that we move quickly because our people are in a terrible state and are suffering. I will talk later about redress and things like that, but that is another amendment.
I thank my noble friend for his summing up. I am disappointed but I am delighted that he said, in answer to questions from the noble Baroness, Lady Thornton, that he will think further. We know that we have something important here. Nobody has countered this in the Lords, the Commons or anywhere else. They have all agreed with it. I have talked to Aidan Fowler, who is newly appointed and has his strategy, and he told me that if we have a patient safety commissioner he would work with him or her.
We need somebody. Perhaps all of us here, with all our contacts, should be thinking about who would be a good person to take on this role. I am not going to be on the appointments commission, but we should be moving this forward. We cannot just sit on it because there are too many people suffering now and who will continue to suffer unless we really get to grips with this.
Finally, on sodium valproate, surgical mesh and Primodos, a lot of these people are very sick. They have nevertheless given their lives to help others and to take forward what they know needs to be done. We have had no opposition at all from those people. On the contrary, we have had a lot of support.
At a time of great difficulty for this country, when we know that it is divided, here is something consensual that we can be proud of as a nation. Yes, we have been managing the coronavirus and that will be part of our legacy, but what a tragedy if that alone is our legacy. We want something more than that. We could go down in history as having made a real difference to the population, to people who would have suffered if we had not made a stand.
I say to my noble friend the Minister: do not be worried about disturbing the pond. I can see that he is worried that this will upset some people, but they have not come to me about being upset. This is the time when we should all be on the side of the angels. I beg leave to withdraw the amendment.