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Church Commissioners
The hon. Member for Middlesbrough, representing the Church Commissioners, was asked—
Youth Workers
26. Mark Pritchard (The Wrekin) (Con): How many youth workers are employed by the Hereford and Lichfield diocese; and if he will make a statement. [99171]
The Second Church Estates Commissioner (Sir Stuart Bell): Most youth worker posts are funded not directly by the diocese, but by parishes or clusters of parishes. Two youth workers are currently employed in the Hereford diocese and 20 in the Lichfield diocese, and there are plans for more to be employed.
Mark Pritchard: Does the hon. Gentleman agree that youth workers do an excellent job in both Shropshire and Herefordshire, and will he assure me that there will be no institutionalised “Christianophobia” when those parishes want access to public funds?
Sir Stuart Bell: I am not entirely clear whether I can enter the domain of public funds, but in recent years there has been considerable growth in the number of young workers employed by local churches, and the commissioners and the general Church welcome and support that.
Michael Fabricant (Lichfield) (Con):
Will the hon. Gentleman pay tribute to the bishop’s growth fund in the diocese of Lichfield, which has been used to
encourage new youth workers and leaders who in turn encourage young people to take part in church services throughout the diocese?
Sir Stuart Bell: I am grateful to the hon. Gentleman for mentioning the bishop’s growth fund. In fact, part of that funding comes from the parish mission fund set up by the commissioners and the archbishops’ council to resource all kinds of innovative parish work. I am glad that Lichfield diocese is using that money so wisely and increasing young people’s attendance. That is a very good model for others to follow.
Electoral Commission Committee
The hon. Member for Gosport, representing the Speaker's Committee on the Electoral Commission, was asked—
Appointments
27. Mr. Andrew Tyrie (Chichester) (Con): What recent steps have been taken on the appointment of a new chairman of the Electoral Commission; and when such steps were taken. [99172]
Peter Viggers (Gosport): The chairman of the Electoral Commission, like the other commissioners, is appointed by Her Majesty, following an address from this House. The appointment of the current chairman, Sam Younger, expires on 18 January 2007. I can announce that on 18 October Mr. Younger was offered a further period of office, to expire on 31 December 2008, subject to the statutory consultation required of the registered leaders of certain political parties and the agreement of this House. Mr. Younger accepted that offer on 27 October and the statutory consultation of party leaders was initiated on 30 October.
Mr. Tyrie: I am heartened by that reply and to learn that Sam Younger’s appointment has finally been sorted out. It is in the interests of all of us that such appointments are made in good time, and I was a little concerned that this one might not have been. Will the Committee consider examining the procedure for appointing the chairman with a view to ensuring that such appointments are made in good time in future?
Peter Viggers: Approaching first reappointments on the basis of a satisfactory performance appraisal reflected the approach of the code of practice for ministerial appointments to public bodies and Cabinet guidance on making public appointments. You, Mr. Speaker, invited Sir William McKay, a former Clerk of the House, to carry out an appraisal and consulted the Speaker’s Committee. As a result, it was unanimously decided that Mr. Younger should be invited to accept a further term. I note the other points that my hon. Friend has made.
Point of Order
3.32 pm
Michael Gove (Surrey Heath) (Con): On a point of order, Mr. Speaker. I ask for your help as the guardian of the rights of this House against the Executive. Earlier this year, I asked a parliamentary question of the Department of Health, which was answered by the Minister of State, Department of Health, the hon. Member for Leigh (Andy Burnham), who is in his place. I asked specifically about the amount that the Department and its constituent units were paying under the EU emissions trading scheme. I was told that the figures were not held centrally. A subsequent freedom of information inquiry showed that the NHS Purchasing and Supply Agency had that information. An e-mail revealed under the Freedom of Information Act 2000 said:
“In light of the above we...have a complete picture of the exact amount of carbon emitted in 2005.”
That was the year about which I asked. Can you help, Mr. Speaker, when inquiries under the Act reveal that the Government have given misleading answers to the House?
Mr. Speaker: I thank the hon. Gentleman, who has become expert at raising points of order about late parliamentary questions. If information is available under the Freedom of Information Act 2000, it should be made available to this House. I hope that Ministers will take note of that point.
The Minister of State, Department of Health (Andy Burnham): Further to that point of order, Mr. Speaker. I wish to assure the hon. Member for Surrey Heath (Michael Gove), through you, that I will look into how the information was supplied in that written answer and get back to him with a full and complete reply.
Mr. Speaker: I thank the Minister for that.
NHS REDRESS BILL [ LORDS] (PROGRAMME) (No. 2)
Motion made, and Question put forthwith, pursuant to Standing Order No. 83A(6)(Programme motions),
That the following provisions shall apply to the NHS Redress Bill [ Lords] for the purpose of supplementing the Order of 5th June 2006 (NHS Redress Bill [ Lords] (Programme)):
Consideration of Lords Message
1. Proceedings on consideration of the Lords Message shall (so far as not previously concluded) be brought to a conclusion one hour after their commencement at this day’s sitting.
Subsequent stages
2. Any further Message from the Lords may be considered forthwith without any Question being put.
3. The proceedings on any further Message from the Lords shall (so far as not previously concluded) be brought to a conclusion one hour after their commencement.— [Huw Irranca-Davies.]
Orders of the Day
NHS Redress Bill [ Lords]
3.34 pm
The Minister of State, Department of Health (Andy Burnham): I beg to move, That this House disagrees with the Lords in the said amendment, insists on Commons amendments Nos. 5 and 16, and proposes amendment (a) in lieu.
I think that it is with some surprise that we find ourselves discussing this amendment. I say that not with any sense of arrogance but because I genuinely feel that the House had a good-natured and constructive debate on the matter. We adopted a reasonable approach in response to concerns raised in another place and in this place in Committee and, as the listening kind of Government that we are, we proposed changes to the Bill, which responded to those concerns and which were passed by a considerable majority of the House.
For the avoidance of doubt, I shall set out what we believe we are trying to do in the Bill and the NHS redress scheme. We want to create a fast-track settlement scheme that provides a better experience for patients—that has the patient at its heart. We want to facilitate a learning culture at local level where complaints are dealt with openly and transparently. By doing that, we want to bring down the costs to the NHS of clinical negligence claims and create a better culture for the handling of complaints and claims. I am clear that our policy is both workable and right, but I readily acknowledge that the process we went through helpfully focused the Bill for the benefit of patients, and I pay tribute to Opposition Members who helped in that process.
Keith Vaz (Leicester, East) (Lab): May I take my hon. Friend back to a point that was put to my right hon. Friend the Member for Liverpool, Wavertree (Jane Kennedy), his predecessor as Minister of State, when she appeared before the Select Committee on Constitutional Affairs during its proceedings on the Bill? We asked that the Government encourage local health authorities to settle matters locally. Many problems arise because local people do not understand the nature of the procedure and in the initial letter of reply there is no clarity about how matters can be resolved. Resolving matters locally is much better than litigation.
Andy Burnham:
I quite agree. It may be helpful to explain again the point that my right hon. Friend raises. In parts of the NHS, there is an unsatisfactory culture for the handling of complaints, so because patients do not receive a satisfactory response when they first make a complaint, they are pushed towards considering options such as a second stage complaint to the Healthcare Commission, or even legal action. However, as I have said before, I do not believe that
anybody who makes a complaint does so with the intention of taking the NHS to the cleaners, or to make significant financial gain. In the overwhelming majority of cases, the reason why people pursue complaints is “to stop it happening to somebody else”, as they tell us in our surgeries. I am sure that my right hon. Friend has heard that in his surgeries, as I have in mine. If the NHS was better at engaging with the patient at the point when the complaint was made, the outcome would be better all round. It would certainly be a better outcome for the individual but, ironically, also for the NHS, in that it could learn from patients’ experience and try to improve it, from the point at which a complaint was received. However, I entirely take my right hon. Friend’s point that the process should be clearer and simpler for the patient.
Keith Vaz: I am most grateful to my hon. Friend for giving way a second time. Will the Government be issuing fresh guidance about how to deal with complaints, to accompany the new statutory provisions for local health authorities? Practice varies according to local health authorities, so if the Secretary of State or my hon. Friend the Minister were to give guidance locally, it would help the process.
Andy Burnham: The Bill deals with complaints of negligence where there is a liability in tort and when—as we hope—it is passed, secondary legislation will underpin it, setting out the structure under which we envisage that the scheme will operate. I feel strongly that a rethink is needed about how the NHS handles complaints in the round—not necessarily only complaints where there is a liability in tort. On Friday, I visited a trust that has adopted a much more interventionist approach, by engaging with the individual bringing the complaint to improve the patient experience and so that the trust can learn quickly what is not going right.
In an era when there is more choice in the NHS, and patients can move around the system, the clever trusts are those that engage with complaints in that way. They are looking closely at the quality of the patient experience and using every bit of information they can get hold of to improve it. I very much go with the grain of what my right hon. Friend says. The scheme will facilitate a better culture, but I want to build on it, so that complaints are handled better.
I was describing how we improved the Bill, and I was paying tribute to Opposition Members. I should particularly mention the hon. Member for Romsey (Sandra Gidley), who made some very helpful suggestions during the Bill’s passage through the House. To take one example of the improvements made, we included a measure that allowed investigation reports to be provided to individuals on request. It is partly on account of that amendment that I am surprised to be back discussing the Bill today; it does not appear to have been appreciated in the other place. Earl Howe spoke about the measure in the other place:
“What have we got? We have a scheme that will see a patient’s application for redress disappear into a closed process, one that is the very opposite of transparent. The patient has no idea whether the facts of his case have been looked at fairly or fully.”—[ Official Report, House of Lords, 25 October 2006; Vol. 685, c. 1240.]
Earl Howe is a reasonable and fair-minded man, but on the basis of that comment, I am not sure that the import and effect of the amendments agreed to in the Commons were fully appreciated by their lordships. At the instigation of the hon. Member for Romsey, we made a concession and allowed full investigation reports to be made available to the individual, so it seems impossible that such comments could be made.
We want a scheme that has transparency and accountability built into it, so today we have tabled an amendment that will further improve the accountability of the NHS redress scheme by allowing the naming of the responsible person who could be answerable if a further complaint was made to the health care ombudsman. They would have to be a person of experience and seniority, and that provision will further strengthen the scheme. Not a great deal separates the Government from the Opposition on the Bill, but our differences seem to come down to the issue of independence and independent investigation.
Mr. John Baron (Billericay) (Con): Will the Minister confirm that the responsible person that he describes may be of senior rank, but will nevertheless be from within the trust that is being investigated? An investigation into a trust will be carried out by the trust itself, and that cannot add to the credibility of the scheme.
Andy Burnham: I will deal with that point later, but I tell the hon. Gentleman that we have built into the Bill elements that will strengthen the transparency and accountability of the process for the patient. There is genuine disagreement between the Opposition and the Government, but it is important that we see the scheme for what it is—an in-house, first-stage process. Under the scheme, trusts need not go through the long process to which my right hon. Friend the Member for Leicester, East (Keith Vaz) alluded, but can rather engage with the complaint from the first. They can learn from what happened to the patient, and can then provide speedy redress, thereby improving the experience for the patient and saving the organisation a great deal of time. That is the right thing to do. If the first stage of the scheme included an independent investigation, the scheme would have the same qualities as the process that is available to patients who choose not to pursue their complaint through the redress scheme, or who proceed to litigation because they did not receive satisfaction through the scheme. That is a different proposal, and it would make the scheme entirely different.
I have to turn the subject back to the hon. Member for Billericay (Mr. Baron). The ideas on independence put forward by the Opposition Front Benchers, both in this House and in another place, have varied considerably during the parliamentary passage of the Bill. When the Bill was first sent to the Commons from another place, it required the Secretary of State for Health to make provision for the appointment of patient redress investigators. There was to be a panel of independent investigators, who were to conduct investigations. The Healthcare Commission was to maintain a list of those investigators, and to oversee them. That model gave rise to problems of cost and practicality, with the Department’s own economist estimating a cost of £41 million a year.
3.45 pm
On Report, the hon. Member for Billericay pointed out some of those problems and presented a variation in which the person overseeing the investigation was independent of the scheme member in question. We were told that there would be the same administration, but it would operate under the direction of an independent person, so there would be no new bureaucracy.
Mr. Baron: The Minister is slightly disingenuous, as I tabled probing amendments. The principle remains the same—we believe that whoever investigates the facts should be independent of the trust under investigation. That has been a constant theme throughout. I tabled a probing amendment on redress investigators, but it was never pressed to a vote—it was simply a question of exploring alternatives. We want independence—that is the bottom line—but the Minister has admitted that he will not provide it.
Andy Burnham: I agree that the Opposition have called for independence throughout the passage of the Bill, and various models have been submitted to suggest how that independence could be achieved. On Report, I asked the hon. Gentleman who would employ the independent individuals who would provide oversight. Would they be employed within or outside the NHS? In another place, Earl Howe made it clear that he did not wish to be prescriptive, saying that
“as one idea, I would propose that where the actions of a particular trust were the subject of a redress claim, a non-executive director of a different trust could be brought in to provide the necessary element of independent scrutiny and oversight.”—[ Official Report, House of Lords, 25 October 2006; Vol. 685, c. 1241.]
We simply do not believe that that is a workable model. Non-executive directors could not be expected to have the necessary skills, experience, investigation techniques or time to provide a meaningful overview of investigation under the redress scheme, particularly if required to review investigations by a neighbouring trust.
Mr. Graham Stuart (Beverley and Holderness) (Con): We are puzzled by the Government’s refusal to engage with the proposal to introduce more independence, as are many outside bodies. We have tabled many probing amendments and proposals, but it is the Minister who is backed by thousands of civil servants and the Government machine. Has he genuinely tried to find a workable, cost-effective way of introducing more independence? The current scheme does not have the confidence of Opposition Members or many outside organisations.
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