Contribution
My Lords, I have Amendments 13 and 63 in this group. I have also signed Amendment 68 in the name of my noble friend Lord Marks, who cannot be in his place today.
Amendment 13 seeks a statutory duty of candour and assistance that extends automatically to independent panels and reviews established by Ministers of the Crown and local authorities. The thinking behind this is that the borderline between some of these inquiries and bigger judge-led inquiries can be quite difficult to ascertain. Some have started at a lower level without a judge—I must be careful with my words; I do not mean “lower” in terms of competence but at a local level—but have led to an unsatisfactory result and ended up as a formal, judge-led inquiry decades later, having cost millions to the country and, more importantly, left the victims feeling that they have not been listened to and unable to access compensation. It is important that broadly the same rules for a duty of candour and assistance are included for those inquiries as well.
My Amendment 63 would introduce a duty for NHS trusts and foundation trusts in England to adopt codes of conduct for mandatory reporting of concerns in relation to systemic medical malpractice or serious wrongdoings in relation to patient safety in a trust. I spoke earlier about some of the problems that the NHS has faced since it introduced a duty of candour in clinical environments in 2016. The CQC is very clear that most of the trusts where there are major failings, including tragedies that have led to inquiries, have been those where there is a poor culture. The CQC can give many examples of high-performing trusts elsewhere where there is substantial trust in what is going on. This means that there is a favourable environment for whistleblowers and for reporting, even if it is not mandatory.
What has shocked the nation over recent years is the number of NHS scandals that keep emerging, which points to something very serious going on. I have already spoken about infected blood. That started in the 1970s and it still has not concluded. There are some women who still do not know whether their blood was infected because of a transfusion in the 1980s or 1990s, as GPs have only just been asked to check medical records to see whether they have female patients who may have had a transfusion. Unfortunately, I know from my own experience that my delightful hospital has destroyed all pre-2012 records. If that is the case, GPs will not be able to find much of that information out. This is not good practice.
However, the real scandal for all of us has been the maternity hospital reports. The Government now say that 14 trusts are being investigated by the inquiry led by the noble Baroness, Lady Amos. They include Shrewsbury, Leeds, Sussex, Somerset, Bradford and East Kent; I could go on. There is not a common theme to any one of these trusts, so something systemic is going wrong in our maternity system. I am very grateful to those people who have carried out investigations and exposed this, but all the points that we raised earlier about whistleblowing are true in maternity as well.
Then there is the sodium valproate scandal, which is still waiting for its first investigation. Women with epilepsy were prescribed a drug in pregnancy, even though the medical profession knew that it risked damaging the fetus. As a result, 20,000 children have either developmental or physical disabilities. There has been no investigation into the pharma companies or the doctors. The vaginal mesh scandal, where the wrong sort of mesh was used on women and has left them crippled for years, is the same. The women victims of that inside the NHS are distraught. I have already spoken about the nuclear test veterans who had a lot of their cases held up, partly through the MoD but also partly through poor record-keeping in the NHS. That is why my amendment seeks mandatory reporting of these issues. Otherwise, we will not catch these cases and there will be more scandals. That should not be so.
Finally, Amendment 68, tabled by my noble friend Lord Marks, probes the definition of a public authority for Chapters 1 and 3 of Part 2, and Chapter 2 of Part 2. As my noble friend is not here today, perhaps the Minister could write to let him know whether his concerns about things not being clear enough are justified.