New Clause 11
Health Bill [Lords]
3:45 pm
Sandra Gidley (Romsey, Liberal Democrat)
I need to declare an interest, being a pharmacist by profession. This proposed new clause is well meant, and I do not envy the Minister having this issue on his desk. It is useful that so many Members have signed EDM 1561, showing general support for this. Elizabeth Lee now has a suspended sentence; she did not go to jail. She made a single error; the problem was not so much that it was catastrophic but, more fundamentally, that having discovered that she had made an error, she got in touch with the patient and found that they had been taken to hospital.
The court case found that there was absolutely no interrelationship between the dispensing error and the patient’s ultimate death. Nevertheless, due to existing legislation, the judge felt duty-bound to give the woman a suspended sentence. Not to put too fine a point on it, Elizabeth Lee has withdrawn from the pharmaceutical register and will never practise as a pharmacist again. Her career is in ruins.
However, at the heart of the matter is also a patient safety issue. When a mistake is made or nearly made, that mistake can be learned from. Mistakes are often picked up before they do any harm or the patient takes the medicine, and most chemists have some mechanism for reporting such errors. I can recall working for a company that introduced error reporting. Everybody was suspicious at first, but it then became apparent that there were a couple of common errors that everybody was making, and changes were made that had a big impact on reducing the number of mistakes.
The problem with the case of Elizabeth Lee is that it has made every pharmacist frightened of admitting to an error, so we stand to lose such learning experiences. There may be occasions in future when products become mixed up. People in such situations are only human. If the current anomaly is allowed to continue, we will go back a stage, because people will not be open and honest. That is ultimately a bigger danger to the patient than the potential consequences of amending the legislation, despite the concerns in some quarters about doing so.