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Baroness Royall of Blaisdon: My Lords, Amendment No. 35 is intended to enable a list of approved providers of legal advice to be held by more than one person specified in secondary legislation, as the noble Earl has explained. In fact, we believe that the amendment is not necessary to achieve this effect because, as a result of the Interpretation Act, references such as "a specified person" in Clause 8(2) are also taken to include a reference to more than one specified person. It would therefore be open to the Secretary of State under the Bill as currently drafted to specify more than one person to prepare the list of those who could provide legal advice in relation to the scheme, if that was what was required.

6.45 pm

Earl Howe: My Lords, I accept that the amendment is, strictly speaking, unnecessary. It was designed as a device by which I could present an argument to the Minister about the Legal Services Commission and perhaps the alternative model that I had in mind. However, I see that my remarks fell on stony ground. I would just like to seed the thought in the Minister's mind that when the Government consult on this issue, they take into account the points that I have made. I have nothing against the Legal Services Commission; I simply do not think that its role lends itself to the kind of outcome that we all want. I understand that the Government may need a little persuading. I hope, however, that they will reflect on the matter. In the mean time, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 10 [Scheme members]:

Lord Warner moved Amendment No. 36:


"( ) require a member of the scheme to prepare and publish an annual report about such cases and the lessons to be learnt from them."

On Question, amendment agreed to.

[Amendments Nos. 37 and 38, as amendments to Amendment No. 36, not moved.]

Clause 11 [Scheme authority]:

Earl Howe moved Amendment No. 39:


 
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The noble Earl said: My Lords, I spoke to this amendment as part of an earlier group, and I beg to move.

On Question, amendment agreed to.

Baroness Barker moved Amendment No. 40:

The noble Baroness said: My Lords, I return briefly to the subject of how the lessons which have to be learnt and the redress scheme which will be operated by individual NHS bodies will be reviewed. The purpose of the amendments is to ensure that the Healthcare Commission has the power to monitor the scheme and to produce an annual review, and that the commission's work will reflect on the independence and the dissemination of training, performance and best practice in individual trusts.

This is yet another way of trying to get to the heart of all this, in that lessons will not be learnt and good practice in developing the culture of learning in the NHS will not happen unless there is a reason for individual trusts to do so. We believe that incorporating that into a review will set up the learning culture which the Minister has referred to before. I beg to move.

Lord Warner: My Lords, Amendment No. 40 seeks to extend the functions of the scheme authority, enabling the scheme to provide that the scheme authority shall not only monitor the carrying out of functions under the scheme by scheme members but provide an annual review of those members.

As noble Lords will be aware, I have taken on board concerns expressed in Committee about the need for an independent check on performance in the operation of the redress scheme. I have proposed that consideration of the effectiveness of the operation of the NHS redress scheme, including investigations carried out under it, be included as part of the Healthcare Commission's annual review of the provision of healthcare by and for NHS bodies. The Healthcare Commission currently carries out an annual review of the provision of healthcare, under powers contained in Section 50 of the Health and Social Care (Community Health and Standards) Act 2003. It takes into account the statement of standards set by the Secretary of State; those core standards are set out in Standards for Better Health. The intention is that when Standards for Better Health is reviewed, the Secretary of State will include a new standard relating to redress.

Similarly, the Healthcare Commission devises and publishes criteria against which annual reviews are carried out. It is intended that the Healthcare Commission would also include new criteria against which the operation of the scheme would be reviewed. Following each annual review, the Healthcare Commission awards a performance rating. The intention is that that will provide an independent overview of the redress scheme process. One element of the annual review would be the provision of the redress scheme.
 
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Amendment No. 40 is therefore unnecessary on two counts. First, the Bill contains powers to provide for the scheme authority to monitor the carrying out of functions by scheme members under the scheme. Secondly, if there is to be an annual overview of performance in the operation of the redress scheme, for reasons of consistency and coherence it would be most appropriate for the Healthcare Commission, rather than the scheme authority, to undertake that role. I am puzzled by the amendment, given that I thought we had gone a long way to ensure that there would be independent overview of the redress scheme's performance—clearly we did not go far enough in the mind of some noble Lords.

Amendment No. 41 provides, first, that the scheme authority may have functions to ensure its independence from the bodies that have liabilities under the scheme and, secondly, that the scheme authority may have functions in relation to improving performance within NHS trusts and issuing guidance on best practice and training. The amendment seems to enable the scheme to provide that the scheme authority should ensure independence from, in effect, scheme members. I am unclear what the amendment does in that respect. Under the Bill, the scheme authority will be a specified special health authority. Its role will be defined by the Secretary of State. Although it would involve close working with scheme members, it would certainly be independent of those members.

I agree that it is appropriate for scheme members to be given assistance to improve their performance under the redress scheme and that scheme members should be given guidance on best practice and training. However, the broad power in Clause 11(2)(c) enables the scheme to provide that the scheme authority shall provide advice or other guidance about specified matters—that could include advice on how to improve performance and on best practice. Clause 10(2)(d) requires scheme members to have regard to any advice or guidance issued by the scheme authority. We therefore have existing powers to achieve this effect.

We also propose to give the Healthcare Commission a specific role regarding the provision of training to scheme members on the operation of the redress scheme. The Healthcare Commission is well placed to do that because it already carries out training on the handling of complaints at local level. It is intended that training on the operation of the redress scheme will emphasise links between handling complaints and handling redress cases, and will cover good practice.

The Healthcare Commission, as opposed to the scheme authority, would be well placed to undertake that role. We are satisfied that the Healthcare Commission can take on both these proposed new roles—the provision of an annual review and training about the scheme—without the need to confer any new functions on it. As I said in my letter of 18 January, when I set out that we proposed to give the Healthcare Commission these two new roles, no amendment to its
 
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existing powers in primary legislation is required. Amendments Nos. 40 and 41 are therefore unnecessary.

Baroness Barker: My Lords, I thank the Minister for that response, which helped to clarify that the important functions of dissemination of guidance on good practice and training have not been overlooked in the rather open wording of the Bill. I should have said earlier that we welcomed the Minister's remarks in his letter about the Healthcare Commission. We believe that the more the Healthcare Commission is involved in monitoring the redress scheme in particular trusts, the better. It would be an added layer of vigilance over the scheme that was perhaps not obvious previously. I have listened to the Minister's remarks and beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 41 not moved.]


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