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9.45 am

Mr. Philip Hammond (Runnymede and Weybridge): Will my right hon. Friend clarify a point about his new clause and his understanding of the new clauses grouped with it? Is the three-year time limit--or whatever limit is proposed--to be understood as starting from the moment when a complaint is made to the health service commissioner or from the moment at which a formal complaint is made in the overall national health service complaints system? If a complaint had been laid within the three-year time limit at the lower entry point, would it be possible, after that limit, to make reference to the health service commissioner, if the earlier stages had taken a long time?

Mr. Forth: That is a fair question. At a glance, I am not sure whether it is answered by my new clause, nor--at an even briefer glance--by the Minister's new clause, although that is for her to say.

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However, my hon. Friend makes an important point. We face a dilemma: should we be tempted to get bogged down in details so as to cover all eventualities, or do we want to keep matters simple? I readily concede that simplicity has many virtues, but one of the problems with a simple--although not simplistic--approach is that it may not deal with all eventualities. In new clause 4, I was trying to deal with the problem that I thought had been identified on Second Reading by the Minister and in Committee. I wanted to try to limit the period during which people were vulnerable to a complaint, following either their natural retirement or their deliberate resignation from the health service or other employment. That was my focus.

Mr. Andrew Miller (Ellesmere Port and Neston): I have listened with interest to the debate as to whether there should be a three-year period. If, within the period, the commissioner decided that there was a prima facie case to answer, one would think that the process would automatically allow for the continuation of an investigation of the complaints. I need to be satisfied that the right hon. Gentleman's new clause would provide for that.

Mr. Forth: My new clause states:

I would interpret that as meaning, literally, that the complaint should be made, laid or initiated within that period. Within that are subsumed several questions, such as how long it might be reasonable for the commissioner to deal with a complaint before an expiry of the process. I do not know whether we need to get involved in that issue, but we should properly debate whether the elegance--as I would claim--of my new clause or the Minister's even more comprehensive new clause deal sufficiently with that point. We must tease out the answer.

I confess that I am already starting to doubt whether my elegant new clause will meet all the requirements. We shall have to consider that in the debate. Given what my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) and the hon. Member for Ellesmere Port and Neston (Mr. Miller) have just said, we may be able to identify circumstances that will not be adequately covered by the simple approach and may, therefore, require a more complicated one. I shall wait until I hear the Minister and more of the debate before I make up my mind. I am known to be legendary for my flexibility and reasonableness, so I do not want to stick to my new clause for any longer than is credible in the light of our debate. I want to ensure that the Bill emerges from that process in the most viable and effective form possible. That is why we are here and that is our shared objective.

The questions that have already been raised illustrate the surprising complexity of the issues. It may be that, on Second Reading and in Committee, we thought that it would be a relatively straightforward process and, when I framed my new clause, I thought that too. We thought that we were dealing with one dimension of the problem--the protection of the person complained against in the light of his or her resignation or natural retirement from the service.

It has already become apparent that other possibilities will inevitably arise. For example, will there be subsidiary time limits within the time limit stipulated? Will they start

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from the point at which a complaint is made, run through the initial stages of the complaint being dealt with by the commissioner and then come into conflict with the matter of retirement or resignation from the service? Those issues must be considered and that is why we shall have to examine closely and positively the Minister's new clause. Unsurprisingly, it is an attempt to deal with such dimensions and it emerged from a process with which many of us are familiar. A debate took place, the Minister acknowledged a difficulty, signalled that point fairly and gave an undertaking in Committee that it would be dealt with. The problem then went to the Department where the Minister set a challenge to her officials. They resolved it to their satisfaction and the parliamentary draftsman has provided his or her solution.

Mr. Tim Collins (Westmorland and Lonsdale): I apologise for not being able to be present for the beginning of my right hon. Friend's speech, so I do not know whether he has covered this point. However, there is at least one respect in which his new clause is significantly superior to that tabled by the Minister. His does not exclude those who have been struck off in the NHS whereas the Minister's does.

Mr. Forth: I hope that that is so, and I am grateful for my hon. Friend's support. New clause 4 contains the words

and I now wonder whether they would cover someone who has been struck off. Retirement has one meaning and resignation another. The implication of my hon. Friend's comment is that someone who has been struck off has not retired or has refused to resign; he is forced to leave. I am now worried. My hon. Friend was generous in suggesting that my new clause covered such an eventuality, but I now doubt whether it does. I leave that question hanging for the moment, because the Minister might have to deal with it if we are to receive a satisfactory answer. In a sense, I am glad that my hon. Friend raised that issue.

Mr. Dismore: When the right hon. Gentleman hears the argument in favour of my new clause 7, he will find that it deals with that issue.

Mr. Forth: The hon. Gentleman hints that he believes that his solution will be more effective than mine. Admiring him as I do, I do not necessarily have much doubt about that. I do not want to delay the House or prolong my little contribution to the debate unnecessarily. However, at this stage, we can be fairly clear what the problem is, because it was elegantly set out. I hope that we shall have answers to it. I am confident that the Minister will answer. Whether the hon. Member for Hendon (Mr. Dismore) can persuade us that his solution is superior to the Minister's remains to be seen.

My new clause deals simply, elegantly and comprehensively with one part of the problem. Subject to what the Minister and my right hon. Friend the Member for Wealden say, we may not need to make a choice between the new clauses. A battery of new clauses may prove to be the best answer to the problem. Not least among those new clauses may be that of the hon. Member for Hendon, shrouded as it is in a legalese that is designed--whether by parliamentary draftsmen or

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lawyers--to force us to pay for or, as in this case, to listen at length to the legal advice necessary to untangle it. There is nothing wrong with that, especially as such advice is free in this place.

We believe that we understand the problem, but the solution may not be as simple as we thought. It should be dealt with and I hope that my right hon. Friend the Member for Wealden will guide us as to whether he thinks that the Bill requires what is suggested in the new clauses. I gained the impression from what he said in Committee that he believed that the problem must be dealt with, and our job is to decide which of the solutions on offer is the best. I submit mine and I look forward to hearing from the proponents of the others.

Mr. Dismore: It is a great pleasure to follow the right hon. Member for Bromley and Chislehurst (Mr. Forth). I listened to his explanation of how complicated the issue is. I agree that it is much more complicated than people might have originally thought when we discussed it on Second Reading.

The starting point for considering the time limit is to return to first principles and ask what the purpose of the ombudsman is when he deals with complaints in the national health service. Two issues need to be considered. The first is that the ombudsman is part of an on-going process, as the hon. Member for Runnymede and Weybridge (Mr. Hammond) suggested when he asked about the time frame in which a complaint in the NHS system develops. Secondly and more important, we must find an alternative remedy to legal proceedings.

There is probably cross-party consensus in trying to minimise the number of legal actions that the NHS has to defend. The figures for the cost of such actions are astronomical--about £2 billion a year, which is more or less equivalent to a penny on income tax. Therefore, we should try to minimise the need for legal action by providing alternative remedies. One of the most important of them is the power to take a case to the ombudsman to obtain another form of redress.

On Second Reading, I tangentially made the point that the ombudsman's powers need to be strengthened in several different ways. However, we need to produce a time limit that is not weaker than the one that a complainant would have through the courts. We do not want to cut off one avenue and force people to go to law because the ombudsman cannot entertain their complaint as a result of the cut-off imposed by the time limit. That is where my new clause is relevant because it would equate the time limit for a complaint to the ombudsman with that which would apply in the case of someone wishing to sue the NHS. I shall develop that point at greater length shortly.

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