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12.42 pm
Mr. Forth: The Bill is a good, perhaps even a model, example of a private Member's Bill. My right hon. Friend the Member for Wealden (Sir G. Johnson Smith) deserves enormous credit for the skill with which he identified the
need for such legislation, consulted about it and put it together. The Bill's scope is modest, but its potential and, I suspect, actual impact on those whom we are here to serve are significant. Moreover, my right hon. Friend, with his usual courtesy and skill, has drawn on his considerable experience in guiding the Bill through its stages.Let me say to the hon. Member for Basildon (Angela Smith) that I would have thought the reason why the Committee stage was so remarkably short--at least, I hope that this was the reason--was that, while the Minister accepted that there was further work to be done, she and the Government were not yet in a position to give the Committee guidance. The Committee was prepared to accept that, on the understanding--I think--that the matter could be properly dealt with here, on Report. That is indeed the way in which things have worked out--and they have worked out very well, in a co-operative spirit.
Our debate has demonstrated a number of things, including the wisdom of private Members' Bills being modest in scope, and the value that should be attached not only to the opportunities that arise in Committee in normal circumstances, but to the opportunity that legitimately arises on Report to consider a Bill further and, if necessary, improve it. My right hon. Friend can take great pride in what he is, I suspect, about to achieve in securing a Third Reading for his Bill; I am sure that we all wish it well.
I acknowledge the work of all concerned, and I certainly wish the Bill well. I hope that we have managed to improve it today; that is my sense of what has happened, and I am confident that it will be on the statute book before long.
12.44 pm
Mr. David Stewart: I shall not delay the House.
I compliment the right hon. Member for Wealden (Sir G. Johnson Smith) on his excellent private Member's Bill. If I am fortunate enough in my future career to come high up in the ballot, I shall certainly model my Bill on the form and content of this Bill, and learn from the excellent debate today.
I made the point earlier about the range of the Bill. It does not apply to Scotland, but the 1993 and 1996 Acts do. I commend to the Scottish Executive that it takes on board the fact that there is a loophole in the Health Service Commissioners Act. I hope that it will look at that.
We should commend the various organisations that have been involved. Some of the input from the Consumers Association has been first-class. The BMA and all hon. Members have been active in supporting the excellent work that has gone into getting rid of the loophole in the Act.
Sir Geoffrey Johnson Smith: May I say how pleased I am that the hon. Gentleman has referred to the work of the Consumers Association? It is something that I should have mentioned; I intended to do so. I warmly endorse that comment.
Mr. Stewart: I thank the right hon. Gentleman.
I commend the right hon. Gentleman for his work in preparing the Bill. I believe it is sensible, practical and strengthens the rights of patients in the NHS.
12.46 pm
Mr. Heppell: I thought that it was probably wise, as I grumbled a bit about the new clauses, to stress that, while I may have had doubts about some of them, I certainly have no doubts about the value of the Bill.
I, too, congratulate the right hon. Member for Wealden (Sir G. Johnson Smith) on introducing the Bill, which takes forward the complaints procedure for my constituents even more. I suspect that many people out there do not realise how the ombudsman's role has changed over the years. After being set up in 1973, it changed dramatically after the Wilson review and the report by the Select Committee on the Parliamentary Commissioner for Administration in 1993. The clinical judgment element was introduced in 1996, which was a further step forward. The Bill plugs a loophole.
I do not think that it is the end of the story. One of the things that the process has identified is that more changes could be made to make the system even better. In some respects, I can understand the arguments on why private medicine is not covered by the ombudsman, although there are probably arguments to say that the private sector should be part of the process. None the less, I, and, I think, my constituents, find it amazing that someone who is operating as a locum within the NHS is not part of the process.
People must make their choice. If they go to the private sector, they must realise that they will not be covered by the ombudsman, but I would expect to be covered in respect of any locum that took the place of my doctor. I hope that we will re-examine that matter, but, again, I do not want to end on a sour note. My congratulations go to the right hon. Gentleman and to the Consumers Association for their excellent work on the Bill.
12.48 pm
Mr. Miller: I, too, put on record my congratulations to the right hon. Member for Wealden (Sir G. Johnson Smith). He said earlier that he normally gets involved in things to do with the defence of the realm and so on, but the defence of the ordinary citizen, which is at the heart of the Bill, is an important aspect of our work. The way in which the debate has been conducted this morning illustrates the House working at its best. There has been a certain amount of banter, good humour and agreement on both sides.
I congratulate my hon. Friend the Minister on carrying her last amendment as promised. Some of us are still a little confused about the detail. I think that the debate, as my hon. Friend the Member for Nottingham, East (Mr. Heppell) said, will continue to unfold as the function of the commissioner settles down, with the Bill becoming an Act in the near future.
It has been a worthwhile exercise. I hope that the Bill receives a speedy passage in the other place and goes on to the statute book in a very short time.
12.50 pm
Mr. Hammond: I add my congratulations to those already paid to my right hon. Friend the Member for Wealden (Sir G. Johnson Smith) on choosing the subject
and piloting his Bill so expertly through the House. As he himself has acknowledged, it is a relatively small measure to fill a specific loophole. However, it deals with a significant perceived injustice, albeit that that injustice affects a relatively small number of people. The injustice arises from the distinction between the independent status of general practitioners and the rather different status of health authorities and NHS trusts, so that if general practitioners cease to provide services, there ceases to be a continuing entity to be held liable for previous malpractice.On a much broader front than the provision of medical services, there is a growing feeling that people--whether in our police services, health services or in other spheres--should not be able to escape proper scrutiny of their actions simply by taking the easy option and resigning. My right hon. Friend's Bill ensures that, in one sphere, that will no longer be possible.
I tell the hon. Member for Basildon (Angela Smith), in response to her comments, that the Bill deals not only with those who are actively seeking to avoid being held to account or scrutinised for their actions, but with a perhaps much larger number of people whom the ombudsman is unable to investigate--in the example that the Minister gave a few moments ago, simply because of the natural process of retirement. Although they have not sought to evade the ombudsman's attentions, the law prevents scrutiny of them.
On Second Reading, there was a wide consensus in favour of my right hon. Friend's Bill. However, there was also a recognition of the need to balance the proposals with a limitation on the potentially open-ended jeopardy that practitioners might face. Today, with the amendments tabled by the Minister, we have addressed that issue and made the Bill into workable legislation.
The hon. Member for Nottingham, East (Mr. Heppell) was right to say that this legislation is not the end of the story, and I hope that, in a few moments, the Minister will be able to tell us something about the timetable for the Government's wider review of the complaints procedure in the national health service.
I do not agree with the statement of the hon. Member for Nottingham, East that, if people go to the private sector, they have to accept that they will not be covered by the health service commissioner. As we saw yesterday, in our consideration of the Care Standards Bill, the Government are moving towards a recognition that there is a need for unified regulation and registration procedures across sectors, so that, wherever patients choose to go for their medical and social care provision, they can be sure that they are being treated in a properly regulated environment, which includes a proper complaints procedure.
The Opposition are delighted that the Government have acknowledged and taken on board the Secretary of State's responsibility for all patients within the system, not merely those within the national health service. I very much hope that, when the Government consider wider reform of the health service complaints procedure, and possible proposals for a complaints procedure in the private acute sector, they will see the merits of a unified system that allows all patients equal access.
Public confidence requires that the complaints procedure in any body or sphere work effectively. The Bill is a small but important step in dealing with the clear
concerns that a group of people have felt about how the NHS complaints procedure works. It brings those who have felt excluded from the process--disfranchised--back within the net.The Bill leaves the House with two small concerns still hanging over it. On new clause 6, the hon. Member for Hendon (Mr. Dismore) identified a further small group of potentially aggrieved people who may find that the Bill does not extend the improved access and scrutiny to their cases. It would be ironic and unfortunate if a Bill that set out to address the grievance of a group of people who are excluded from the complaints process inadvertently excluded another group. No doubt that will be considered in another place.
The other point is whether there should be different periods of jeopardy for practitioners who resign from the service in the normal way and those who are dismissed as a result of malpractice. As my right hon. Friend the Member for Bromley and Chislehurst (Mr. Forth) said, I suspect that our noble Friends in another place may wish to look at that again.
However, those minor points in no way detract from the achievement of my right hon. Friend the Member for Wealden in piloting the Bill successfully through the House. Congratulations are due to all those who participated on Second Reading, in Committee and today on the constructive and positive way in which the Bill has been made into useful and workable legislation.
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