Hansard

I begin my closing remarks by returning to parts 2 and 3 of the bill. I grew up in a paternalistic NHS, at a time when patients expected and received little information about the treatment that they were given and accepted without question that health professionals, particularly doctors, knew best and did their best, even when things went wrong. No one would ever have thought that such people might apologise for a mistake, even if they admitted making one.

I am thankful that we live in a very different world, in which information is widely available. It is only right that patients are as involved as they wish to be in their treatment plans and progress, and it is only right that when something happens that has or could have been harmful to them patients have the right to know about it. Of course, not everyone wants to know the detail of the event that went wrong, which is also their right, but patients or their carers and families should be made aware that information is available to them.

A culture of openness, whereby health and care organisations and their staff feel able to admit mistakes and learn from them, and in which staff can inform service users or their carers and families when treatment has resulted in harm, can only lead to an improvement in patient safety. That, of course, is paramount in a well-run health and social care system.

For that to happen, staff must be supported to learn from mistakes and make improvements, so that errors are less likely to recur. Staff will require proper training in the knowledge and skills that they will need if they are to comply with a duty of candour in a more open climate in the service that employs them. In the past there has sometimes been a tendency within health and care organisations to cover up mistakes. It should be possible in this day and age to be open about those and to apologise to service users when they happen.

Of course, a duty of candour already exists for many health and care professionals, but it does not cover all professions and there can be resulting inconsistencies in the application of such a duty in health and care organisations. I hope that the bill will eliminate those inconsistencies and allow organisations to follow best practice and learn from incidents of unintended harm, with a resultant improvement in the care that they provide, so that such harm does not arise again.

The new offence of ill treatment and wilful neglect is intended to apply only to the most exceptional cases. We know that, sadly, such cases have been exposed. Even when the neglect or ill treatment is proved, however, the perpetrators have on occasion been able to find other employment within the care sector. That was highlighted by Mary Scanlon in an example that she gave at stage 2, and the minister’s stage 3 amendment to deal with that was very welcome indeed.

The RCN still has serious reservations about the introduction of the new offence and genuinely feels that it could have the opposite effect to that which is intended in introducing a duty of candour, with the threat of criminal proceedings militating against the building of a culture of openness and transparency. Given the comments and concerns about parts 2 and 3 of the bill, it seems clear that the education, training and support of health and care professionals will be crucial in developing the desired culture of openness in our caring professions and organisations.

I hope that all aspects of the bill will produce the outcomes that are sought, but it will be very important to scrutinise them in a few years’ time, so that the accumulating evidence on the uses of NVPs, the practical application of the duty of candour and the use of the new offence of wilful neglect and ill treatment can be revisited and assessed for their effectiveness.

We all accept the need for post-legislative scrutiny of the statutory provisions that we make in this Parliament and, where there are evolving situations, or reservations expressed by respected bodies such as the RCN, it is particularly important that the provisions are reviewed in the future. I hope that this will be undertaken by future members of the Parliament. As I said in my opening remarks, however, Conservative members are overall content with the bill as amended and will give it our support.