Health and Social Care Bill

Baroness Masham of Ilton Excerpts

Monday 19th December 2011 Lords Chamber

[Baroness Jolly]

My Lords, I, too, support this amendment. I have some personal experience that I can bring to bear, and it was not until I was reading through the amendments a week or so in advance that I put these things together. Some years ago my mother became really ill with a very strange set of symptoms and no one could work out what the problem was. Eventually her GP came round. Like many people of that age, she takes several drugs. He sat down on her bed, took out her box of drugs from her bedside table drawer and went through them. There was one drug that she should not have been taking at all. It was completely wrong and should have been taken sparingly, not three times a day. My mother lives in a small town and the GP knows the pharmacist well, so he high-tailed down to him straightaway to find out what exactly the issue was. In this case, the dispensing pharmacist was unaware that there was a mistake.

It was really quite interesting to see how it had all happened. The medicines were all stored on a shelf in alphabetical order by drug name, not brand name. The drug in question was adjacent to my mother’s normal drug, and both were generics produced by the same pharmaceutical company. The narrow little rectangular boxes looked the same, so the pharmacist had picked the wrong one off the shelf, popped it into the bag with the rest and it had gone home. My mother, whose sight is not what it was, had taken them all out of their boxes and popped them all into her pill box. The deal was done, it was really very easy, and the whole thing was completely indistinguishable.

Fortunately my mother recovered once it was sorted out. It was a regular, well-known, high-street pharmacy, and it was absolutely excellent. It wrote a letter immediately saying that it was going to instigate a clinical governance review. It then wrote again to tell us exactly what it had done, including changing its methods of storage and ensuring that someone double-checked all drugs before they were bagged-up. This had been a mistake, but there is absolutely no doubt that it was completely negligent, and also avoidable. However, it was not criminal. There was no malicious intent. It could have been terrible, but mercifully it was not. The employer spoke to the pharmacist who admitted exactly what she had done once they had worked it all out. The pharmacy took proportionate discipline, and that is what we as a family wanted. We wanted something to happen, for it be arranged that the mistake could not happen to anyone again and for anything that happened to be professional and proportionate. That is what happened. As a result, I totally support the amendment that my noble friend has tabled with the support of the Royal Pharmaceutical Society.

[Baroness Masham of Ilton]

My Lords, I shall add a few words because a pharmacist contacted me. Pharmacists are being encouraged to take on more and more, and the drugs are extremely difficult. Some drugs are the same but have different names. It is extremely difficult for patients too, and as they often go to pharmacies for advice it is really very important there this is openness and honesty when a mistake is made. However, I would not like this amendment to open a door for more mistakes to be made.

[Baroness Thornton]

My Lords, I support the amendment. I would have put my name to it, had I had the opportunity. However, in Committee those on the Liberal Democrat Benches have tended to block up their own amendments and have not sought support from across the House, which is a great pity.

My experience in dealing with the many drugs that my mother takes is that in fact pharmacists are often those who spot the doctor’s mistake. Our local pharmacists do an excellent job. My wider interest in this Bill and in pharmacists is that they play the proper, important role they need to play at local level in the health and well-being boards and with the planning at a local level of both preventive medicine and their jobs at dispensing.

This is also about a level playing field in regulation, which is very important. This Bill offers probably the only opportunity that there will be in the next few years to put right this wrong. I hope, therefore, that the Minister will support this amendment—and if not this one, then one like it at a later stage in the Bill—and rectify this error.

--- Later in debate ---

I hope that I have set out the complexity of this situation, and I would ask the Minister to respond to the amendment, which the Royal College of Nursing vigorously supports, and to look at the regulation of healthcare support workers. I beg to move.

[Baroness Masham of Ilton]

My Lords, I have put my name to Amendment 338, as I strongly agree with the Royal College of Nursing that mandatory regulation for all healthcare support workers, in order to ensure standardised training and therefore a suitable skilled workforce, is the best way forward.

As currently proposed, the health Bill provides for a voluntary register, which the RCN believes to be insufficient. A voluntary register will not protect patients from inadequate healthcare workers, who will be impossible to regulate. I am concerned that nurses who have been struck off the register can then take jobs as unregistered healthcare assistants. One only has to look at the dangers patients have been put in when patients died of insulin poisoning at Stepping Hill Hospital near Manchester and nurses were found to be stealing drugs, at the terrible suffering of patients at the Mid Staffordshire foundation trust and at the appalling treatment of residents at the Winterbourne View care home near Bristol. The latest reports from the Audit Commission, the Patients Association and the CQC highlight further problems with care of the frail and elderly. Is there not enough evidence to make the Government realise that something positive has to be done to make matters safer and better for patients?

I agree with the Royal College of Nursing that it is vital to quality patient services that anyone who is responsible for delivering care should be regulated and accountable for their actions. I received a letter recently from someone living in Malta, who said that in the state hospitals they have colour-coded uniforms for all the staff. Care assistants are clearly distinguishable in maroon and white. We have to get our house in order for the sake of patients, who seem to be becoming more and more vulnerable, rather than safer.

House resumed.