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Queen’s Speech - Debate (6th Day)

Part of the debate – in the House of Lords at 6:11 pm on 22nd October 2019.

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Photo of Lord Ribeiro Lord Ribeiro Conservative 6:11 pm, 22nd October 2019

My Lords, I add my appreciation to that of others for the contribution of the noble Baroness, Lady Emerton, to your Lordships’ House. She has been not only a spokesman for nursing but a stalwart in maintaining standards in the profession. We will miss her wise counsel in our proceedings.

The humble Address refers to new laws to establish an independent body to investigate serious healthcare incidents—no, not health service incidents, as in the new Bill. I will come back to that later.

Sir Bernard Jenkin MP, chairman of the Public Administration and Constitutional Affairs Committee, stated:

“There is an acute need for the Government to follow through on its commitment to turn the NHS in England into a learning organisation; an organisation where staff can feel safe to identify mistakes and incidents without fearing the finger of blame”.

The Bill achieves that objective, but its remit needs to be wider. The Joint Committee’s report, in its recommendations 4 and 5, was clear that the legislation should be called the healthcare safety investigation Bill, and consequently should establish the healthcare safety investigation body—the HSIB—in statute. Indeed, it was originally referred to as such. The committee wished the remit of the HSIB to be extended to the provision of all healthcare in England, which of course includes the private sector. The Government in their response agreed to look at that in both the title and the extent of the remit of the new body to investigate independently funded healthcare in England.

I make that point because, in the recent Sellu case, in which a surgeon was sent to prison on gross negligence manslaughter charges and later exonerated on appeal, there was evidence that the root-cause analysis of the surgeon’s work at the Clementine Churchill Hospital, a private hospital, which showed evidence of system failures, was effectively buried and not made available at the original trial. Extending the legislation to the private sector would prevent such failures in future and ensure equal standards between the NHS and the private sector. Can my noble friend confirm whether that recommendation will be accepted? If it is not accepted now, will an answer be provided during next week’s debate on the Bill?

Another area of concern in the Bill relates to the safe space, an approach used for many years by the air accident and other transport safety investigation bodies, which has contributed to improved safety in those industries. This approach has been challenged by coroners and other groups but is strongly supported by the Joint Committee. I am sure we will discuss this at length on the Bill, but assurances from the Government at this stage would be welcome and would give participants in the Healthcare Safety Investigation Branch confidence that information they share candidly will be investigated and protected. I declare an interest as chairman of the Confidential Reporting System for Surgery. We have supported the work of the Healthcare Safety Investigation Branch, and look forward to working collaboratively with the new body in future.

Another area of the Queen’s speech relates to shortages in the workforce and the need for more investment. Nowhere is this more urgently required than in mental health—we have heard much about that already today. It is encouraging to read of the pilot scheme to recruit 1,000 additional staff as part of the £2.3 billion extra investment in mental health in the NHS long-term plan. However, Sir Simon Wessely, previous president of the Royal College of Psychiatrists, in his independent review stressed the need for capital spending to restore the fabric and conditions of many of our institutions. I hope that will be part of the £1 billion boost to NHS capital spending promised for 2020-21.