Health: Tuberculosis
Baroness Masham of Ilton Excerpts(10 years, 6 months ago)
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Baroness Masham of Ilton
To ask Her Majesty’s Government when Public Health England will publish its strategy for tuberculosis.
Baroness Masham of Ilton (CB)
My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and declare an interest as a member of the All-Party Group on Tuberculosis.
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)
Public Health England has made TB one of its main priorities, and is leading a coalition of key stakeholders to inform its development of a strategy for tuberculosis. This aims to bring together best practice in clinical care, social support and public health to strengthen TB control, leading to a year on year decrease in incidence and a reduction in health inequalities associated with TB. The strategy will be published by March 2014.
Baroness Masham of Ilton
My Lords, I thank the noble Earl for his Answer, but is he aware that London is now known as the TB capital of Europe? It has some good facilities for prevention and treatment, but are those the same throughout the country? That is why the strategy is so important. There is plenty of tuberculosis—and drug-resistant tuberculosis, which is the big concern—in Birmingham, Bradford, Leicester and many other cities. Will he ensure that the strategy is pushed out as soon as possible? That is vital.
Earl Howe
The noble Baroness is absolutely right about the seriousness of the position, especially in some of our big cities. I can tell her that a TB control board has been set up in London, where about 40% of TB cases occur in the UK. The board is developing a dedicated London TB plan to strengthen measures to prevent, diagnose and treat TB in London. There are similar initiatives in Manchester and Birmingham. However, she is also right to say that we need to focus on the rest of the country, not least some rural areas, and the strategy there will be different to identify cases, diagnose them quickly and intervene early. Work is going on to roll out the plans for that.
NHS: Mid Staffordshire NHS Foundation Trust
Baroness Masham of Ilton Excerpts(10 years, 6 months ago)
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Earl Howe
My Lords, the trust board at Mid Staffs was ultimately responsible, and individuals on it have been replaced. That was the first step in holding the system to account. We are introducing strengthened accountability for the future, including a fit and proper persons test for directors, as well as a single-failure regime triggered by failures in care. We have also appointed a Chief Inspector of Hospitals with power to ensure that the system acts quickly to tackle unacceptable care. In a range of ways I hope that we have addressed the central point in my noble friend’s question, which is very well placed.
Baroness Masham of Ilton (CB)
My Lords, I am pleased to hear about the transparency and the duty of candour, but will the noble Earl give the House an assurance that patients will be listened to? I am thinking about the young man who implored staff for a drink, and even telephoned the police on his mobile, but was ignored by staff. This was not Mid Staffordshire but a London teaching hospital. Further, will staff be protected when they blow the whistle? Will the noble Earl give an assurance that they will not lose their jobs?
Earl Howe
My Lords, I completely agree with the noble Baroness that the voice of the patient is an essential part of maintaining a culture of safety in the NHS. Improving the way in which the NHS manages and responds to complaints will be critical in shaping a culture that listens to patients and learns from them and ending a culture of defensiveness or, at worst, a culture of denial about poor care. That is why we welcome and accept the spirit of the review of the NHS hospital complaints system by Ann Clwyd MP and Professor Tricia Hart and the principles behind their recommendations.
On whistleblowers, the amendments to the NHS constitution have enhanced the protection for whistleblowers, but we are not complacent and we are already considering whether there is a need for more developments both to protect whistleblowers and to ensure that action is taken, where necessary, in response to concerns. We are looking, with the national regulators, at how whistleblowing concerns are dealt with at the moment and, where appropriate, we will introduce improvements to systems in the future.
NHS: Clinical Commissioning Groups’ Funding of Treatment
Baroness Masham of Ilton Excerpts(10 years, 6 months ago)
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Baroness Masham of Ilton (CB)
My Lords, if patients are turned down by CCGs, can they appeal to NHS England?
Health and Social Care (Amendment) (Food Standards) Bill [HL]
Baroness Masham of Ilton Excerpts(10 years, 6 months ago)
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Baroness Masham of Ilton (CB)
My Lords, I thank the noble Baroness, Lady Cumberlege, for bringing to your Lordships’ House this Bill to:
“Make provision for the regulation of food standards in hospitals”.
I feel that the least solution is to have a minimum standard.
I must declare an interest. I have had to spend some time in hospital at various times and can say from first- hand experience that if it had not been for high-protein drinks and blood transfusions, I would have spent much longer recovering. The hospital was Stoke Mandeville; it gives excellent care but is let down by the food, which is so unappetising and tasteless that it is often discarded. I am not surprised that around 30 million hospital meals in England are not eaten each year.
On one occasion when I was doing my visit as a member of the board of visitors of a young offender institution, the inmates were complaining about the food, which happened to be a rather good-smelling macaroni cheese. I said to them, “You should spend a week in the hospital I have just been in and then you would have something to complain about”. There was silence.
This Bill is long overdue. There is a desperate need for regulation of food standards across the country as there is so much variation in hospitals. I am sure that your Lordships will agree with this statement:
“It is crucial that patients receive tasty, nutritious food as part of their care. Although the NHS is spending more on patient meals, there is still too much variation across the country”.
The Government say that the NHS should be a patient-centred health service. Accepting this Bill would help to demonstrate their sincerity and prove that it is not just a matter of words.
Katherine Murphy, chief executive of the Patients Association, of which I am a member, said that the huge disparity between low and high spending on food in hospitals could not be justified and that the best patient meals are often those that are freshly cooked in a hospital’s own kitchen. Patient meals cooked in this way are often also the cheapest to make because they give hospital cooks the option to find the best deals from local suppliers. I am told that the Royal Brompton Hospital falls into this category.
There should be flexibility in hospitals over the availability of food and the giving of medication. This is necessary for people with Parkinson’s disease, when medication should be taken before meals, and patients with diabetes, who should not go without food for long periods. Nurses should learn how important food is for the health of patients.
One of my nephews spent a month in Glenfield Hospital in Leicester after a heart operation and he praised the food. I have not heard such sentiments about the food at Stoke Mandeville Hospital. There, the patients’ food is pre-cooked in Wales and brought to the hospital, where it is reheated and served up to patients in an unappetising and tasteless state, which does nothing for their morale and recovery. An example of that concerns one of our spinal injury members who was very ill. A few days before he died, he telephoned a friend asking for some decent food which he could eat. His friend could not get there but arranged for one of the doctors, who was sympathetic, to bring him something he could eat and enjoy. I dedicate my contribution today to Stephen and all ill patients who need good, nourishing hospital food.
Yesterday, one of your Lordships told me about the time when his mother was in hospital. It was a teaching hospital here in London. When her food was brought in, it was put down and left, but she needed help to eat it. So concerned was her son that he arranged to come in at meal times so that he could help her, but some people do not have friends or relatives who can do this. On one occasion, my husband was in the local hospital, which had just changed over to a housekeeping service. The housekeepers brought the food to the patients. I told the housekeeper who brought my husband’s lunch that he had a problem with swallowing and I explained his condition. She was very interested and told me that nobody had ever told her anything. She wanted to help.
I am sure that the arrangements for feeding patients who need help should be much better organised. Kind, responsible people may be better than nurses, who very often seem too busy to help. There should be a foolproof system so that all patients get fed with care and compassion. Maybe there should be an amendment to the Bill in Committee so that there is a foolproof system for patients who need help with feeding and drinking.
I wish the Bill a speedy and successful journey through Parliament.
Female Genital Mutilation
Baroness Masham of Ilton Excerpts(10 years, 6 months ago)
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Earl Howe
I completely agree with the noble Lord. It is clear that we need to make a step change in the landscape here. We have continued to prioritise FGM, both at home and overseas. The intercollegiate report, however, published this week, adds a very welcome dimension to the work we are doing. It was written by health professionals and FGM experts for health professionals, and the Government will naturally study the report very carefully and consider the recommendations as part of the cross-government programme of work to tackle and eradicate this awful practice.
Baroness Masham of Ilton (CB)
My Lords, is the noble Earl aware that I took through your Lordships’ House the Prohibition of Female Circumcision Act 1985? Is he aware that I, too, am most frustrated by the lack of prosecutions? Why has France convicted people with this horrific condition and not us?
Earl Howe
My Lords, I am aware of that. I was a new Member of the House when that Act went through, and I commend the noble Baroness for the work she did on that issue. She mentioned France. One of the features of the French system is the physical examination of all girls under the age of five. We will not be following that path. We do not think it would be right to do so. We think it raises ethical and human rights concerns. However, all children are routinely seen by healthcare staff in the universal healthy child programme that covers England, and prevention and safeguarding absolutely underpin that programme. It is an important channel for conversations to be held with parents and children, so that they can be provided with relevant support and advice.
Health: Local Healthwatch Organisations
Baroness Masham of Ilton Excerpts(10 years, 6 months ago)
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Earl Howe
I am grateful to the noble Baroness. She is certainly right that some local Healthwatches have got off to more of a flying start than others. I am aware of many that are working closely with their local clinical commissioning groups and indeed with provider trusts. However, others need encouragement and support, and we have created Healthwatch England to provide exactly that kind of support. That is the route for the Healthwatches which find themselves in some uncertainty about their role.
Baroness Masham of Ilton (CB)
My Lords, does the Minister agree that Healthwatch members working in rural counties have extra travelling expenses and will these be considered? Healthwatch members should not be out of pocket.
Earl Howe
I am very much in sympathy with that thought. However, it is up to the local Healthwatch organisation to organise its funding as it sees fit and in the most cost-effective way possible. I would not want to dictate to them what they should do but, clearly, for a Healthwatch to work effectively, one has to have volunteers who are ready and willing to do the work, which might involve the need to reimburse them for some expenses.
NHS: London
Baroness Masham of Ilton Excerpts(10 years, 6 months ago)
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Earl Howe
I can certainly find out the answer to that last question. As regards the appeal, we have only just received the judgment, as the noble Lord will know. But that is only the outline judgment. We have not received the full text. It is important that we read that and inwardly digest it before we finally decide on the way forward. The lessons of Lewisham are very clear. I confirm that we shall not be legislating around Lewisham and the recent provisions in the Care Bill were not retrospective, as the noble Lord is aware. I have not personally visited Lewisham, which is clearly an omission that I should at some point rectify, but it is important for me to put on the record that the concerns expressed by the people of Lewisham are, and have always been, entirely understandable. Ministers greatly respect the wish of local residents to see their hospital thriving, as it always has in the past. Nevertheless, as I said earlier, Lewisham and Greenwich now have a challenge. There is a financial issue that needs to be addressed and I hope that commissioners and providers, acting together, can do that successfully over the months ahead.
Baroness Masham of Ilton (CB)
My Lords, can the Minister say whether, if A&E departments are shut, hospitals will be downgraded? Will the resources of the ambulance service be increased to transport ill patients around, as the ones with A&E departments may not have enough capacity to treat them?
Earl Howe
I do not think that it is appropriate to talk about downgrading in this case. However, it is appropriate to talk about changing the way in which services are delivered to the local population. In the case of two hospitals, we are seeing fully fledged A&E departments becoming 24/7 urgent care centres. That means that the most serious A&E cases, such as trauma and cardiovascular emergencies, will be taken to centres of excellence where patients will have a much higher chance of survival. That is a pattern that we are seeing throughout the NHS and one that has been proved to be successful and in the interests of patients. On ambulances services, we are already seeing in London, for example with stroke care, ambulances taking patients to centres of excellence for stroke care. Eight of these centres now exist compared to 32 some years ago. That means longer journeys in an ambulance but also much higher survival rates for the patients. I do not think that we should look on the kind of reconfiguration that I have described in a negative way. On the contrary, the whole thrust of these proposals is to improve the quality of care for patients.
Care Bill [HL]
Baroness Masham of Ilton Excerpts(10 years, 6 months ago)
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Earl Howe
My Lords, I will begin by making absolutely clear that we agree that all prisons and approved premises should have arrangements for safeguarding the adults in their care. They should have a comprehensive policy that is understood by all staff and which ensures that vulnerable adults are identified and given appropriate support. I hope that we also agree that we cannot relieve prisons and probation providers of their duty of care by imposing a duty on a local authority to make safeguarding inquiries into suspected abuse or neglect in a prison or approved premises.
We need clear guidance for prisons, probation providers and local authorities to ensure that the procedures within prisons and approved premises are informed by best practice and local expertise. My officials will work with the Ministry of Justice and the National Offender Management Service, together with the Association of Directors of Adult Social Services and other stakeholders, such as the Prison Reform Trust, to develop instructions and guidance for prisons, probation providers and their local authorities. Those instructions and guidance will be in place by the time the Bill is implemented and will give improved clarity about the Prison Service and probation providers’ roles and responsibilities in safeguarding adults in their care, including the need to have a whole-institution approach to safeguarding, and cover their relationship with the local safeguarding adults board.
The Ministry of Justice encourages prison and probation staff to be involved with local safeguarding adults boards. The guidance on how safeguarding should be carried out in conjunction with local authority partners can draw attention to the duty in Clause 6 that local authorities and their partners must co-operate in the exercise of their respective functions relating to adults with needs for care and support. The guidance will be consistent with the broader advice and guidance on safeguarding adults in the community to ensure that good practice on safeguarding policies and inquiries is routinely shared.
In addition, the guidance will set out clearly the need for locally agreed relationships with local safeguarding boards, including clear local protocols around the circumstances for involvement of local SABs. The guidance will also make clear how prison and probation staff can benefit from the expertise of social services and local authority safeguarding teams.
For approved premises, the probation provider has a clear responsibility in relation to safeguarding but there is nothing to prevent it seeking advice from either the safeguarding adults board or the local authority safeguarding team. This already happens in many areas. Since a local authority’s duties in relation to safeguarding would not extend to safeguarding adults who are at risk of abuse or neglect by reason of their detention or their offence, a joint approach would be much more effective where there is a particularly difficult safeguarding challenge in an approved premises.
Her Majesty’s Inspectorates of Prisons and Probation and the Prisons and Probation Ombudsman will take account of the guidance and local agreements and make recommendations for improved practice, if relevant, when inspecting services and investigating complaints within the prison and probation services.
I wish to be clear in answering the noble Lord, Lord Patel of Bradford, who said that the document No Secrets said that local authorities have responsibility for safeguarding in approved premises. Local authorities do not have a statutory duty at the moment. It is the duty to conduct inquiries that will not apply—not that local authorities cannot conduct an inquiry if invited to by the probation trust or provider. Guidance and probation instructions will provide further detail on how local authorities and probation trusts, as they currently are, can work together at a local level. The guidance will go to all probation providers who run approved premises. Probation services will be contracted out in due course, so these will be approved premises provided by the probation service and by voluntary or private providers. The guidance will make it clear that the provider running the accommodation has a duty of care and a safeguarding responsibility.
I hope that, with those assurances and clarifications, the noble Lord will feel able to withdraw his amendment.
Baroness Masham of Ilton (CB)
My Lords, how will the Government ensure that the guidance is carried out? Would a report not be useful?
Earl Howe
My Lords, the Ministry of Justice will want to ensure that the guidance is adhered to and the department will have oversight of the way that this works in practice, as the noble Baroness might expect. As I say, there is best practice already out there; we want to build on what we know works, with joint working across the prison and probation services and local authorities.
Care Bill [HL]
Baroness Masham of Ilton Excerpts(10 years, 7 months ago)
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The Lord Speaker
I remind your Lordships that if this amendment is agreed, I cannot call Amendments 129 to 131 by reason of pre-emption.
Baroness Masham of Ilton (CB)
My Lords, it is vital that people with mental illness have adequate aftercare. I ask the noble Lord, Lord Patel of Bradford, if his Amendment 128A would cover such cases as the tragic case of the schoolgirl who was travelling by bus to school and was killed by a person who was mentally ill. There should be more protection for the public, who are at risk from mentally ill people who are let loose in the community without adequate aftercare and supervision. It is vital that people have aftercare, otherwise we will have more and more disasters.
Lord Patel of Bradford
I thank the noble Baroness for her question. I would not like to associate mental health patients leaving hospital with the case that she has outlined, but clearly it is true that if we do not provide good quality aftercare services and encourage people to take them up but rather leave people in hospital anxious about whether they will have to pay for some of these services, then that is a potential result that we will have to live with, in circumstances where people do not have accommodation, health and social services provided or someone coming in and saying to them, “Deal with your accommodation and social care issues as well as your medication”. This is a real anxiety.
Baroness Masham of Ilton
My Lords, what will happen to the protection of the public from those who have schizophrenia?
Earl Howe
My Lords, the protection of the public is of great importance, as I need hardly say; but we are dealing here with quite a narrow point of definition about who should be entitled to free mental health aftercare. To expand the scope of that definition to include others would not be fair on many people, which is why I have argued that I believe we have positioned the definition in the right way. The noble Baroness’s question is a very relevant one in the broader context of how we look after those with mental illness, but I would like to think that this amendment should not affect her concern one way or another.
Care Bill [HL]
Baroness Masham of Ilton Excerpts(10 years, 7 months ago)
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Lord Patel of Bradford (Lab)
My Lords, Amendments 136A and 136B seek to ensure that people in prison and those residing in approved premises have equivalence of care when it comes to safeguarding inquiries by local authorities. Noble Lords may remember that I raised this issue in Committee but I was a little concerned by the response I received from the Minister on that occasion. I am grateful to Jenny Talbot and her team at the Prison Reform Trust for all the support and guidance they have provided throughout.
I welcome the Government’s commitment in this Bill to place responsibility for the social care of adult prisoners with the local authority in whose area the prison is located. The Bill outlines the responsibilities of local authorities towards people in prison who have care and support needs and would ensure that people in prisons are able to access care and support on a similar basis to those in the community. However, having made such a significant and welcome commitment to the social care of prisoners, there is an anomaly in the Bill, which states that people in prison and people residing in approved premises are not to receive equivalence of care when it comes to safeguarding inquiries by local authorities. Surely denying people in prison and people residing in approved premises the benefit of an inquiry by the local authority when safeguarding concerns are raised places an already vulnerable group of individuals at even greater risk.
Of course, I understand that prisons have a whole range of safeguarding measures in place. However, when there is a real problem that a prison has not resolved, why can a local authority not have an inquiry for a person who is vulnerable and at risk? Moreover, I cannot understand why people in approved premises—in other words, people who have been released from prison and are living in the community; for example, in a probation hostel—should be excluded from local authority safeguarding inquiries. If the local authority is not responsible for safeguarding vulnerable adults in approved premises in the community, who is?
When I raised this issue in Committee, the noble Baroness, Lady Northover, stated,
“if local authorities must also conduct inquiries in prisons and approved premises, we run the risk of duplicating inquiries. Prison governors and directors have the primary responsibility for preventing abuse or neglect of prisoners with care and support needs. Prison governors already have a duty to care for and safeguard prisoners. If we duplicate this responsibility, we run the risk that the lack of clarity will mean that safeguarding concerns fall between agencies”.—[Official Report, 29/7/13; col. 1585.]
I have a number of concerns about this response, two in particular. First, with regard to people in prison, the noble Baroness talked about the duplication of effort and lack of clarity. I suggest that this is simply not the case. My amendment would not limit the responsibility that prisons already have. On the contrary, their involvement on safeguarding adults boards would help to ensure shared learning and expertise, including, where necessary, the option for a safeguarding inquiry should safeguarding concerns not be resolved by the individual prison.
In fact, inquiries by local authorities should be viewed as another tool to help ensure our prisons are safe for both vulnerable prisoners and the staff who work with them. I am not suggesting that local authorities need to be directly involved in all interventions in prisons or that local safeguarding teams would need to be called upon to intervene in every safeguarding concern raised. However, directors of adult services need to be confident that their standards are consistent with those set out in the report No Secrets and any exceptions are explicit and jointly agreed. Therefore, I believe that an inquiry by a local authority will not duplicate the excellent work undertaken by Her Majesty’s Inspectorate of Prisons, or by the prison itself. It will complement and enhance it, and could potentially help save lives.
Secondly, the noble Baroness did not provide an answer as to who would be responsible for the safeguarding of people in approved premises, if it is not the local authority. For the sake of clarity, I will ask the question again. As I understand it, approved premises are the responsibility of the probation service and not of the prison service. Any responsibilities that prison governors have for safeguarding adult offenders end once that person is released and physically leaves the premises. As the Bill currently stands, people living in approved premises will not be the responsibility of local authorities as is everybody else who lives in the community. So if someone is living in approved premises, such as a probation hostel, and is part of the community, as is anybody else, and that person has been abused or neglected or is at serious risk, who will have the obligation to carry out a safeguarding inquiry?
In terms of safeguarding inquiries by the local authority, not providing people in prison or who reside in approved premises with the same equivalence of care as for other people in the community makes little sense. The Bill establishes that equivalence of care applies to prisoners, and this should extend to safeguarding and to how safeguarding concerns are dealt with. Local authority adult safeguarding procedures are well established within local communities and the safeguarding of people in prisons and of those residing in approved premises should not be excluded from this body of expertise.
Of course, prisons and approved premises, such as hospitals and care homes, should have their own internal safeguarding arrangements and responses to safeguarding concerns. However, by excluding prisons and approved premises from safeguarding inquiries by the local authority, prisoners and people residing in approved premises will be denied the equivalent protections afforded to other vulnerable adults. Further, the opportunity for constructive dialogue and shared learning, which some prisons and local authorities currently enjoy, may also be lost. As the Bill stands, this is a serious gap which places a very vulnerable group at risk. Therefore, I hope the Minister can provide some clarification, reassurance or, better still, accept my amendments. I beg to move.
Baroness Masham of Ilton (CB)
My Lords, I hope that the Minister will take note of the very serious points which the noble Lord, Lord Patel of Bradford, has made to your Lordships tonight.
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)
My Lords, these two amendments deal with changes to Clause 72 to impose a duty on local authorities to make safeguarding inquiries in prisons and approved premises. I thank the noble Lord, Lord Patel, for tabling these amendments. We strongly agree that a person with care and support needs should be protected against abuse or neglect wherever they live.
Prison governors and directors, and the probation trust in the case of approved premises, are responsible for safeguarding prisoners and for protecting them from abuse and neglect. They have in place procedures to follow in response to allegations of abuse or neglect, and they must provide assurance on this to the National Offender Management Service. The UK operates a comprehensive level of monitoring and scrutiny within prisons to ensure that prisoners are kept safe and secure and that governors and directors are accountable for taking steps to improve matters if necessary.
We have in place a fully independent prison inspectorate that carries out a rigorous programme of scrutiny; more than 1,700 volunteers on prison independent monitoring boards who monitor the treatment of adult prisoners; and a Prisons and Probation Ombudsman who investigates both the complaints of those in prison and all deaths that occur among prisoners. Her Majesty’s Chief Inspector of Prisons and the Prison and Probation Ombudsman require assurance that safeguarding procedures are in place and their implementation provides equivalent protection to that available in the community. Investigations by the Ombudsman will provide learning to improve effectiveness. The important thing is not to impose a duty on another body to conduct inquiries in prisons and approved premises, but to ensure that the procedures within the prisons and approved premises are informed by best practice and local expertise.
The Ministry of Justice and the National Offender Management Service have acknowledged that there is a need for improved directions on safeguarding to the Prison Service and probation trusts. They will be working with officials from my department and stakeholders to develop instructions and guidance that will give improved clarity about the roles and responsibilities of the Prison Service and probation trusts in safeguarding adults in their care. The Ministry of Justice encourages prison staff to be involved with local safeguarding adults boards, but the nature of that involvement is best determined at local level.
The Ministry of Justice and the National Offender Management Service will be producing guidance for prison staff on safeguarding in conjunction with their partners. This will be consistent with the broader advice and guidance on safeguarding adults in the community and will ensure that the importance of active engagements with SABs is routinely reiterated to prison staff. Any particular safeguarding considerations for older prisoners and those with dementia will be part of this operational policy. The guidance will set out clear instructions on the need for structured relationships with local safeguarding boards; for example, the model being employed by Surrey, where a memorandum of understanding sets out how prison staff will benefit from the expertise of social services and local authority safeguarding teams. It will also set out how and in what instances referrals to SABs will be made.
I hope that I have reassured the noble Lord, Lord Patel of Bradford, that the existing position makes clear the responsibility and accountability for the safeguarding and protection of prisoners, and that further guidance to prisons and approved premises will bring about the improvement and joint working that we all want to see. The proposed amendments to Clause 72 are therefore not necessary and I would respectfully ask him to withdraw this amendment.
Earl Howe
My Lords, this amendment concerns the new statutory duty of candour. This will place a requirement on registered providers of health and adult social care to be open with patients and service users about failings in care. The Francis report made a clear recommendation that there should be a statutory obligation to observe a duty of candour on providers of healthcare who believe that treatment or care provided by them to a patient has caused death or serious injury. This would require the provider to inform the patient of that fact. This amendment is a major step towards implementing that key recommendation of the Francis report.
The Government’s approach is to introduce this duty as a requirement for registration with the CQC. In Committee, noble Lords tabled amendments that sought to place the duty of candour in the Bill. The amendment that I am presenting today seeks to strike a balance; I make no apology for that, since it allows us to have the best of both worlds. The amendment tabled in my name makes it clear that the Government must introduce such a regulation. It does not present the Government with a choice; rather, it imposes a crystal clear obligation on the Government to put such a regulation in place. I hope that it will be welcome to noble Lords for those reasons. I beg to move.
Baroness Masham of Ilton (CB)
My Lords, the duty of candour means honesty and straightforwardness. We desperately need an open, honest, transparent and compassionate health service, and I hope that Amendments 140 and 152 will help to achieve that.
Something has gone desperately wrong with the care in some hospitals and care homes. We now live in a litigious society, and I feel that that has been increased by cover-ups when something has gone wrong and gagging people who try to speak out. People will go to any lengths to find out what happened to their loved ones if they are not told and given an apology. Good medical personnel will explain and apologise if something adverse happens. So often, that is all that is needed.
Patients know that there are risks, if they are explained when they sign a consent form. When they go wrong, lessons should be learnt so that they do not happen again. That is one of the reasons why openness is so important. Have lessons been learnt after the horrific situation of the Mid Staffordshire hospital? Recently I heard of a former police superintendent who had had a brain injury due to an accident, and was a patient in a well known central London hospital. When his wife and young son went to visit him, they smelt him before they saw him. They found him facing the wall in bed, unable to move and lying in soiled sheets and wearing a filthy gown. His wife was so upset that she told a nurse, who just said that they were overworked. The next time the wife visited she found him sitting alone, facing a curtain, looking miserable and wearing a pad that had not been changed. She said to her children, “We are taking Daddy home”, and smuggled him out of the hospital.