Health and Social Care (Safety and Quality) Bill — House of Lords, 2015-02-06
Topic: Health
Bernard Francisco Ribeiro (Conservative, Centre-right): My Lords, I thank all noble Lords who have taken part in this interesting debate. I very much hope that the Minister has addressed most of the questions that have been raised. I know that the concerns of the noble Baroness, Lady Pitkeathley, have been addressed. She made a clear case on the confusion about the role of the PSA as an auditor as opposed to a regulator. That needs to be borne in mind The noble Lord, Lord Willis, was clear that this Bill is proportionate, logical and deliverable. That is the point—it is deliverable. We have heard a lot about the Berwick advisory group, which has flown the kite of zero harm. It probably has not helped that in the immediate period after Mid Staffs we were keen on some sort of zero harm. Earlier, I referred to Mr Ken Lownds and his interest in patient safety. He has been one of the champions of zero harm. As a surgeon, I know that it is an aspiration that ultimately, if the systems are in place, it is possible to head towards. Although the Berwick advisory group says that, "zero harm is a bold and worthy aspiration"— not an intention but a "worthy aspiration", I say to the noble Lord, Lord Turnberg—it is about timing and the pace of change. It is something that we should aim for, but in order to get there we have to make sure that when hospitals are inspected by CQC it finds that the systems are in place to ensure that harm does not occur. That is the whole purpose of the Bill. The noble Lords, Lord Turnberg and Lord Warner, were very exercised by this area and I hope that we have gone some way to address it The noble Lord, Lord Young, raised a good issue. I meant to put it in my speech, but I thought that my speech would be too long—I think that I said to the health team that it might take anything up to 20 minutes, but when I heard what was going on this morning I decided to reduce it. The noble Lord made a good point and I am glad that he did, because those who listened to Dr Atul Gawande, the 2014 Reith lecturer, know that he was the architect of the checklist, which he introduced with the WHO. I remember being approached by Sir Liam Donaldson when I was president of the Royal College of Surgeons to see whether the college could sign it off. I thought that it was something to be used in developing countries, not in the UK, but typically the NHS instituted it. There is a question of whether it should be legislated for. In answer to my noble friend Lord McColl, in surgery it is the recommendation of the college and all the specialist associations that surgeons and anaesthetists should follow the checklist. The difficulty always comes with emergencies, which is where legislation may be difficult—if somebody is bleeding to death, there is not time to sit and have a chat about whether we have everything that we need before we start, which is what that involves The noble Lord, Lord Hunt, referred to Clause 1 and zero harm. We have dealt with that and the near misses and I think that that deals with the point about the checklist, too. As I said, I am chairman of CORESS, which is to do with having confidential reporting of near misses so that we can advise surgeons on how to avoid them happening again, using the airline industry as a template of how to avoid harm. That is what all this is about: avoiding harm Finally, the noble Lord, Lord Hunt, made a point about Mencap. I take on board the fact that Mencap would like see to see an amendment so that the health information of all those who are poor communicators can be taken into account, as we tend to look at people in terms of the information that they give rather than how they give that information. I wonder whether that could be put in guidance when the legislation comes through. Certainly it will be looked at I again thank everyone who has taken part in the debate for their contributions, which have been most helpful. I ask the House to give the Bill a Second Reading.