Part of Health and Social Care Bill – in the House of Lords at 3:30 pm on 25 October 2011.
My Lords, there is nothing like suggesting to a House of Lords Committee that we move on to encourage one to stand up and contribute.
The noble Baroness, Lady Thornton, mentioned the debate that took place at the start of the Committee stage of the Apprenticeships, Skills, Children and Learning Bill, now an Act, in 2009. I remember sitting behind the Dispatch Box next to my then noble friend Lord Young listening to the noble Lord, Lord Hunt of Wirral, make a very convincing case for the Opposition on the need to set out a clear definition of apprenticeships and the importance of a well thought through, principled preamble. I remember listening to my noble friend take the Committee through a detailed and well argued explanation of how all those issues were carefully covered throughout the very long Bill. However, both Her Majesty's Opposition and the Liberal Democrats were united in saying that they needed to be stated clearly at the start of the Bill. They won the day and there that statement is in the apprenticeships Act.
When I saw the amendment of the noble Baroness, Lady Thornton, it made me think about all the important legislation of the past, and it led me to the Children Act 1989, which I am sure the Government are still very proud of. An important aspect of that Act is the principle of paramountcy, whereby the interests of the child are paramount in any decisions taken about their health and welfare.
Listening to debates on this Bill, I have felt genuine concern about how we resolve issues around conflict of interest. The relationship between a health professional -a doctor, nurse or physiotherapist, but principally a doctor-and their patient is based on an extremely high level of trust and is one of the cornerstones of our NHS, and I was wondering how the importance of that trust and that relationship could be incorporated in some principles. Have the Minister or the noble Baroness, Lady Thornton, thought about whether it would be appropriate to have a principle under which the needs and interests of the patient should be paramount when decisions are made about them? Obviously, there are a lot of ways of thinking about that from a legal perspective, but it is something that we need to be very concerned about. How is the conflict of interest to be carefully managed where a GP refers a patient to a service that they own and profit from? How can patients-whether as individuals or a population-be absolutely sure of the decisions being made about them, at every level throughout the system, including commissioning? It is very important that we think about the principles underpinning the health service. This is a very important debate.
Annotations
Anne Jago
Posted on 1 Nov 2011 4:48 pm (Report this annotation)
In her speech, Baroness Morgan spoke about the need for a principled preamble to new Bills to address conflict of interest issues. She spoke about the importance of the principle of paramountcy which underpins the 1989 Children Act. The introduction to this Act says that the welfare of children is of paramount importance.
Given the importance that the Baroness appears to attach to this principle, I find it hard to understand why she disregarded it in my case. I wrote to the Baroness for help when she was Children’s Minister. She took the view then, that the hurt feelings of a failing head teacher were more important than hurt children.
She agreed with her Permanent Secretary that it was reasonable for me to be found guilty of professional misconduct for sharing this information: Child T has a Statement for his violent behaviour which gives him 30 hours of support a week. This was not confidential information; every pupil in Child T’s class knew of his support. I was following education law when I gave this information to the professionals at Bowles Outdoor Education Centre who would be looking after my pupils. I had every reason to do this. Two months earlier, Child T’s foster carers had omitted this information, from the Bowles consent form, in order to deceive Bowles into taking Child T without his support at night, so that they could go on holiday. This was child neglect. I was found guilty of misconduct because Hackney Social Services complained that I had not invited them to change my risk assessment (omit that Child T had a Statement giving him full time support in school) so that Child T would not miss the fun of collective living (miss the opportunity of assaulting unprotected pupils). This complaint was deemed to have undermined my head teacher.
The written reprimand I received said that I had been insensitive and unwise to have shared information, while knowing the wishes of my head teacher. Her wish too, was that Child T should be left in a dormitory without his support (giving him the chance to assault other pupils, when there was no adult present to protect them).