Select Committee on Science and Technology Minutes of Evidence


Examination of Witnesses (Questions 440 - 459)

WEDNESDAY 21 JULY 2004

MS ANGELA MCNAB, MS TRISH DAVIES, MR CHARLES LISTER AND DR CHRIS O'TOOLE

  Q440  Chairman: In relation to Warnock, which is 20 years old now, where should we start afresh, do you think? Or is it good enough?

  Ms McNab: As we have outlined to you, in terms of the act I think there are some key areas where there is the potential for us to think again. One of them is the scope of regulation that we have in the current act. There are some treatment services that currently fall outside of legislation and our own regulation, and I think that is an area of risk. So fresh sperm and eggs, for example, the internet services which I am sure the Committee will have read about, fall outside. I think that is an area that would be very important to—

  Q441  Chairman: You have provided us with a list. How long has that list been in existence? We did a report in 2002. Was that list there before then?

  Ms McNab: I am not conscious that the authority particularly sat down and considered where there was potential for review of the act at that time, but I can say that over the last 18 months this has been an area where we have been thinking very hard and we have concentrated our minds on what we think the priority areas would be for review.

  Q442  Chairman: We asked for that in the report, if you remember. We said these things should happen. You have not communicated with anybody, you have not moved on as a result of our report.

  Ms McNab: We have addressed the areas that were listed in the report. I think I am misunderstanding your question. Are you saying that we should have given a list to government earlier regarding the areas where there was potential for change?

  Q443  Chairman: Yes, that is right. When did you give the Department of Health your list?

  Ms McNab: Verbally, we have been discussing this for some time—certainly since I have been with the authority, which is nearly two years.

  Q444  Chairman: Two years.

  Ms McNab: I have been with the authority nearly two years and certainly over that time—

  Q445  Chairman: Did you have the list drawn up when you came to the authority?

  Ms McNab: I did not physically draw up a list of where I felt the act could be amended, but it is certainly the areas where there were vulnerabilities we have been discussing for some time.

  Q446  Chairman: Do you think you need to regulate as much as you do? In terms of starting afresh, do you think you over-regulate?

  Ms McNab: I do not believe that we over-regulate, although I do think we need to be flexible in the way that we regulate. I think that something we should continue to discuss, both with the professionals and also with the patients, is what form of regulation would be the most well-balanced and the most certain. I would like to bring Trish in for a minute to talk about regulation and how it works now and what she thinks the balance could be, but could I make one opening remark before she comes in. I think there has to be a balance in regulation between absolutely ensuring patients' safety—and we have heard from Professor Toft's report that the public and patients want to be assured that there is a real rigorous scrutiny of what goes on in clinics, that there is not the potential for things to go wrong—with not being so bureaucratic or so burdensome on clinics that, frankly, we hold up their work or we are very resource heavy. I believe we are constantly looking at that issue. We have made changes which Trish will tell you about; we have more to look at. But that is a balance that we are very acutely conscious of.

  Chairman: We will ask Trish later on. We are going to take about over- and under-regulation and what areas you might devolve to somebody else.

  Q447  Dr Harris: Why was there a delay of several months between the submission of Professor Toft's report and its publication?

  Ms McNab: That was a matter for the Department of Health. I cannot tell you what the reasons for that would be.

  Q448  Dr Harris: Did you not ask why a major report about your functions, which was going to be very helpful to you, was sitting on a shelf or a desk somewhere in the Department of Health? You must have been interested to know the publication date and why it was delayed.

  Ms McNab: Absolutely. I was very much involved with Professor Toft, certainly in the latter stages of the report, and the review that he was carrying out—he has already talked to you about the cooperation we gave him. In conversation with him, therefore, I was aware of the key areas where there were recommendations that he was making, so I can guarantee to you or reassure you that a delay in the publication was not delaying anything that we should be doing. From that point of view, the frustration was not a great one for me because I was already working on the improvements that needed to be made.

  Q449  Dr Harris: So it did not concern you that it was not being published and might not be published. You had the inside information, and, as long as you knew—

  Ms McNab: No, no. I am very sorry if I have misled you. I was totally reassured that it was going to be published. I was aware that there was a process to be gone through to get it to publication. I did not have doubts that it would be published in full.

  Q450  Dr Harris: Why was there this delay?

  Ms McNab: I cannot answer that.

  Q451  Dr Harris: Did you ask the Department of Health why there was the delay?

  Ms McNab: My understating was that there were amendments being made, tidying up being done, printing arrangements being made, that an appropriate date was being found. That is not my business; my business is to make sure that the recommendations are put in place and that the changes that need to be made are made, and also to make sure that when the review was going on that the information that is required by that review was given promptly. I am satisfied that I did that.

  Q452  Dr Harris: The reasons you understood for the delay were amendments—presumably typographical amendments—and finding a suitable publication date.

  Ms McNab: As far as I am aware, administrative communication issues. As I say, that is not my main sphere of business; my sphere of business is to make sure the improvements have been made.

  Q453  Dr Harris: What opportunities were there for witnesses to Professor Toft's inquiry to view the report before its publication?

  Ms McNab: In line with due process, any of the members of our organisation who had contributed as witnesses were asked to look at an early draft and to comment on any inaccuracies that there might be. They were not asked to comment otherwise, but, clearly, as with other reports of this nature, they were asked to correct any inaccuracies.

  Q454  Dr Harris: This was well before publication.

  Ms McNab: Yes, after a first draft.

  Q455  Dr Harris: What about other witnesses who were given an opportunity to review the report before publication? Are you aware that they were given an opportunity the day before publication?

  Ms McNab: I am sorry, Trish, do you want to say something?

  Ms Davies: No.

  Ms McNab: No, I am not aware, "the day before".

  Q456  Dr Harris: We understood that one witness received an e-mail, in the afternoon at five o'clock, telling him that if he wished to view the report before publication he would need to visit your offices between nine and eleven the next morning.

  Ms McNab: I do not recall that, but I am very happy to look into it and to come back to the Committee to clarify that point. If I have forgotten something, then I will be very happy to put the record straight.

  Q457  Dr Harris: Was there a media briefing from the HEFA to witnesses and other interested parties before the publication of the report, giving information to people who might be asked following the publication—

  Ms McNab: We certainly shared with members of staff who had acted as witnesses and prior members of staff the response that we would be issuing. We felt that that was courteous, that they would know what we were going to say publicly, and that was no secret.

  Q458  Dr Harris: These other reports that have not been published, which you heard the discussion about earlier with Professor Toft, is that a concern to you?

  Ms McNab: My concern is to make sure that since I have been working at the Authority we have implemented a system of absolute openness of reporting of any adverse incidents, and that we act as a conduit, therefore, for learning, to prevent any further incidents of that kind occurring. Since I have been with the Authority, I very early on started discussing this issue. We have introduced this brand new Alert system. It is the only one of its kind across the world. My concern is to make sure that works well, that we get the highest possible reporting that we can, and that we learn from every event and share those recommendations very swiftly across the whole of the UK. Again, I would like to bring Trish in here because she has the responsibility for regulation and for the management of those kinds of issues and I think what she could say would be very helpful.

  Q459  Dr Harris: I think there are other questions that other members will have on the Alert system, so, as the Chairman said, you will get your chance. I am interested in this issue of publication, of confidentiality. Professor Toft referred to other reports that have been commissioned less formally on other adverse incidents that have not been published.

  Ms McNab: No, I think there may have been a misunderstanding. To my knowledge—and I am very happy to go back and check on this and to correct it if I find I am wrong—there have been no previous inquiries or investigations of this kind, of an external nature, such as Professor Toft's, into previous events.


 
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