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5.15 pm
Amendments Nos. 301 to 304 are necessary because they remove clauses 107 to 110—the current complaint clauses—so that they may be replaced by new clauses 30 to 32.
I shall briefly touch on the other amendments in the group and explain why the House would be well advised to resist them. Clause 107(1) sets out in general terms what a complaint may be about. However, amendment No. 40 would broaden that provision by detailing who may make a complaint. The amendment is unnecessary and would put too great a level of detail in the Bill.
Amendments Nos. 41 to 43 and 52 should also be resisted. I understand the effect that they would have but they are unnecessary. I assure the House that we have every intention of using the regulation-making power provided by clause 107 and the other clauses relating to complaints procedures.
Amendments Nos. 44 and 47 should be resisted. They would remove the ability to make regulations to set parameters for the complaints procedure in terms of what, who, how and when, which is not sensible. It is right that the procedure has always allowed patients, or a person acting on their behalf, the right to complain if they are not happy with the service or treatment received from the NHS. Of course, other people who use or are in NHS facilities, such as visitors and contractors, should be able to raise concerns, but not necessarily under the NHS complaints procedure.
Amendment No. 45 is unnecessary because the existing wording of the Bill is sufficient to provide for the time scales and deadlines that it would create. Amendment No. 46 should be resisted because the powers in the Bill and Government new clauses 30 and 32 are sufficient to ensure that the complaints procedure
will apply to all manner of services and treatment provided, subject to any exceptions thought necessary. The amendment would add too much detail to the Bill.I understand the motives behind amendment No. 48. However, it is important for there to be a time limit so that people are encouraged to make complaints as quickly as possible while events are fresh in the memories of those involved. I appreciate that there might be extenuating circumstances if people suffer trauma or distress, so it is right and proper that there should be discretion to waive the time limit, if appropriate. Sensitivity must be used and I promise that we will consider the matter carefully when drawing up the regulations.
Hon. Members should resist amendment No. 49. I do not understand the point of accepting an amendment that would restrict the range of options available for the successful resolution of a complaint. Amendment No. 50 should be resisted and although I understand the thinking behind it, the Bill adequately covers the proposed provision.
Amendment No. 51 is unnecessary. NHS bodies are already allowed to make ex-gratia payments if a claimant has suffered a financial loss, such as expenses incurred as a result of a complaint. NHS organisations will continue to have such flexibility after we have made regulations under the Bill. Again, I understand the thinking behind amendment No. 53, but it would add too much detail to the Bill.
The provisions suggested by amendment No. 54 are already covered by the Bill. Amendments Nos. 26 and 27 are undesirable because they would provide that regulations would be subject to affirmative resolution. Opposition amendment No. 28 deals with things that are usually addressed under the negative procedure. Amendment No. 55 should be resisted because clause 111 provides for an effective, speedy and fair process. The clause, and other provisions, also cover the measures proposed in the amendment. Finally, I recommend amendments Nos. 305 to 319. They are technical, clean up the wording and are consequential on other amendments.
Mr. Burns: I assure the House that I shall not speak for long. As my hon. Friend the Member for South Staffordshire (Sir Patrick Cormack) rightly explained, the vagaries of the Government's programme motion mean that we have only 45 minutes to discuss a key part of the Bill, bearing it in mind that we were unable to debate 50 clauses in Committee because of the programme motion Upstairs. In addition, the Government have tabled four new clauses and 18 amendments, which have eaten into that time.
I shall concentrate on amendments Nos. 26 to 28. It is clear from the Government new clauses that they will once again rely on regulations to flesh out the fine detail of how the Bill will operate in practice. That has happened with many of their measures and reflects their approach to the crucial subject of social care. We all know that negative procedures are about as relevant as an ex-MP. It is difficult to find opportunities to hold the Government to account and debate such measures in detail. We can pray against them, but that is not the same as insisting on affirmative resolution, which triggers an automatic debate before measures become law.
Imitation is apparently the greatest form of flattery. My amendments try to imitate what the Labour Opposition did for 18 years when they sought to hold the Government of the day to greater account by insisting on secondary legislation that was subject to affirmative resolution. On reflection, we were probably wrong to use the negative rather than the affirmative procedure. However, having researched primary health legislation during the Thatcher-Major years, it is clear that we were prepared to make far more of the secondary legislation in our primary legislation subject to affirmative resolution rather than to negative resolution.
The Minister is new, so my speech will be novel to him. It would not be novel to the Minister of State, the right hon. Member for Barrow and Furness (Mr. Hutton), and I must apologise to my hon. Friends who heard it numerous times when we discussed three primary health Bills in Committee. I think that it gains in stature with the telling, and I am pleased that the Minister is hearing it for the first time. He kindly and uniquely for a Minister in this Government assured us in a Standing Committee last week that he was the sort of thinking man—again, unusual for this Government—who was prepared to consider the Opposition's valid points. To the utter horror of his Whip, he said that if the Opposition had a good point, he would be prepared to change the legislation.
I challenge the new Minister—a so-called thinking Minister, if that is not a contradiction in terms for this Government—to give an instant response to my concerns. I know that that is unlikely because he responded to my amendments before I had a chance to explain what they would do. However, there is time in another place for him to show how reflective—the word he used last week—and intelligent he is. He should realise that it is right that we hold the Government more to account and save them from themselves if they make mistakes in secondary legislation. He can table amendments in another place to include affirmative resolution. Much of the detail is important because it fleshes out the Bill.
Mr. Paul Burstow (Sutton and Cheam): I shall speak briefly to the principles behind the amendments, without elaborating on the detail, as the Minister kindly outlined the purpose of our amendments for us. I entirely subscribe to the view expressed by the hon. Member for West Chelmsford (Mr. Burns) about the need for the affirmative procedure in respect of this important subject, not least because the House will not have the opportunity adequately to scrutinise this part of the Bill. We did not debate it at all in Committee and we have a minuscule amount of time in which to try to do it justice today, yet there is no doubt that independent complaints procedures that are transparent and easily accessible, and which ensure a good flow of communication between the body that is the subject of the complaint and the complainant, are an important part of improving patients' experience and the quality of care that they receive.
I shall raise a couple of points with the Minister. Can he say whether, in the regulations that the Government plan to introduce, they will stipulate training requirements for NHS and social services staff to make them aware of the complaints procedures that they have
to operate, and to enable them to provide the informality that he mentioned, before a more formal complaints process begins?Amendments No. 41 to 43 deal with whether there should be a discretionary power to make regulations, as implied by the use of the word "may", or an explicit mandatory duty for the Secretary of State to introduce regulations to establish clear complaints procedures. The Liberal Democrat view is that that should not be at the discretion of Secretaries of State, but a requirement. There should be a complaints procedure. That should not need the assurance of a Minister that powers will be exercised. It should be for the House to write into the Bill that we expect Ministers to exercise those powers, consult and introduce regulations.
The Minister says that our amendments to deal with time scales are a level of detail too far. That argument is regularly deployed by Ministers to rebut any amendments to regulation-making powers, but can he explain to me and perhaps to those outside, why it is appropriate to impose a time limit on complainants for making a complaint, but reasonable for the Government not to set time scales for each stage of the complaints process? Amendments Nos. 45 and 53 try to concentrate the minds of NHS bodies and social services departments to ensure that they do not just hit their target by responding by letter within 20 days and say that they have dealt with the complaint, but go about dealing with it meaningfully.
That brings me to a couple of questions that I raised in Committee but which, because of the vagaries of the process, never received a reply from the Minister with responsibility for these matters at the time. Where a complaint has been made—for example, where a poor assessment is made in an acute trust, which leads to an inappropriate discharge to intermediate care provided by a primary care trust, which itself fails to realise that the discharge is inappropriate and fails to readmit the person to the acute trust—is it for the complainant to navigate their way round the system, complain to the PCT and the acute trust, and work out where the complaint should be directed? Should it not be for the bodies that are the subject of the complaint to work together co-operatively so that they provide a seamless approach to dealing with complaints? Should there not be regulations to that effect?
The same applies in respect of health and social care. Increasingly, where services are integrated and provided seamlessly, it becomes less clear whether complaints should be addressed to social services or health departments. The regulations need to clarify that. I hope the Minister can give us some reassurance on those matters. We shall return to some of the amendments at later stages of the Bill. Hopefully, in the other place, there will be sufficient time to ensure that we get adequate responses to our concerns.
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