Legal Aid, Sentencing and Punishment of Offenders Bill

Guy Opperman Excerpts

Monday 31st October 2011 Commons Chamber

The group of people I am most concerned about are those whose injuries will last a lifetime. The right hon. Member for Dwyfor Meirionnydd mentioned birth injuries, and I am particularly concerned about parents who need to ensure that care is provided beyond their lifetimes to their children. Many of us have dealt with elderly parents who have had worries of this kind for children with brain injuries. Members of this House and those in the other place need to be assured that this combination of measures—the willingness of solicitors and counsel to undertake cases as an appreciation of their significance and the public good, the availability of the Government’s exceptional provisions for some types of serious case and what remains of the CFA system—will between them cater for some of these very serious cases. This House and the other place will need to be given some assurance; otherwise, I strongly suspect that when the Bill comes back to us it will have been significantly amended.

[Guy Opperman (Hexham) (Con)]

I think I am unique in this House in that I have had a great deal of experience in clinical negligence and have practised for the best part of 12 years almost exclusively on behalf of claimants. I have conducted well over 100 clinical negligence cases, against a multitude of general practitioners, hospital trusts and the like. They were primarily insurance-backed or conditional fee arrangement cases, although some of them were occasionally legal aid cases. I believe that, in the great tradition of the Government, I have still been unpaid for some of that work, notwithstanding the fact that I have not completed any work as a lawyer since I was elected in May 2010. So I should declare an interest in that I believe I have some legal aid fees outstanding, not that I am pressuring the Minister in any way to beat a path to my clerks and my chambers to pay the bill.

I should also declare an interest as a former lecturer and a member of Action against Medical Accidents—AvMA. I have written extensively on this area and am a member of the Association of Personal Injury Lawyers. I have given instructions to a multitude of different hospitals up and down the country, assisting them on how they can avoid clinical negligence claims. I was retained as counsel for several hospital and trust institutions, advising on how to avoid these claims and how to move forward. I should also declare an interest in that I am part of the team pushing for a culture of openness and have met the hon. Member who so very helpfully saved my life in May, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). So I have also conducted an in-depth study of the NHS over the past six months in a way that I did not expect when I was first elected.

My final declaration is that I have great respect for the right hon. Member for Dwyfor Meirionnydd (Mr Llwyd), who occupies part of a seat that I fought in 2005 of the Lleyn valley and peninsula in what was Caernarfon. I know that he is an outstanding MP and barrister and I have great respect for the points that he makes, as I do for the submissions and proposals of the right hon. Member for Carshalton and Wallington (Tom Brake) and the hon. Member for Kingston upon Hull East (Karl Turner).

Let me address the proposals of the right hon. Member for Dwyfor Meirionnydd regarding the duty to come clean. It must surely be the case that NHS authorities should come clean at an early stage and I endorse some of the comments that were made about this being something to be addressed not so much in the Bill as in the NHS’s culture and approach. I regret to say that I disagree with my hon. and learned Friend the Member for Sleaford and North Hykeham (Stephen Phillips) about this, and I have a copy of an article that I wrote for an Association of Personal Injury Lawyers publication on this exact point. In my experience there is ample evidence of isolated examples of an NHS trust deliberately defending a claim on an ongoing basis in the hope that the relevant individual goes away. That is a serious allegation to make, but it is not just me who says it—cases have been reported. I recommend very highly the amazingly well-written edition of APIL PI Focus, volume 20, issue 3, which I co-authored, which addresses that particular point.

[Stephen Phillips]

I make it clear for the fourth time that I have no experience in this area, and I have no doubt that such cases exist, but are they not exactly the sort of case that the civil procedure rules were introduced to deal with? Judges have powers to ensure equality of arms and if defendants behave badly they ought to be punished accordingly.

[Guy Opperman]

I totally endorse that point and such defendants are punished accordingly, particularly in the punitive elements of costs when they are assessed. There are punitive factors that my hon. and learned Friend as a judge would know one is able to impose in a civil court whereby—[Interruption.] I accept that he is not a civil judge—it shows. There is an ability to punish the offending NHS institution or doctor, but the fair point that has been raised and must be addressed is that the powers that would exist to a civil judge, were my hon. and learned Friend to be one, would arise quite far down the track in civil litigation and not at the outset. I come back to the legitimate and fair point that we should address this issue to NHS trusts and particularly to two types of individual, including, first, to chief executives. Regrettably, there are examples of a failure of leadership by chief executives because, clearly, they are mindful of their budgets and they do not like the idea of a culture of openness in which mistakes are admitted. In those circumstances, whether implicitly or directly, efforts are made to suppress litigation against NHS trusts.

The second group of individuals who should be involved is doctors and consultants. Because theirs is such a hierarchical profession, instead of having a culture of openness in which mistakes are readily admitted, there is, sadly, from time to time—I have professional experience of this—a failure to admit mistakes. As the hon. Member for Kingston upon Hull East will sadly and tragically have discovered—and I have been involved in several such meetings—there is a post-operative debrief within the health service.

[Neil Carmichael (Stroud) (Con)]

This is not really my field, but I know from my constituents that a large number of them who have experienced difficulties in the NHS are extraordinarily concerned about the lack of transparency and the weight of expertise against them, because they are not, of course, particularly skilled in that area. Does my hon. Friend agree that that is one of the big problems we need to address, as I hope we are doing in the Bill?

[Guy Opperman]

I am grateful to my hon. Friend for his intervention, but I will not deal with it in any great detail—I mean no disrespect to him—because I wish to go back to the point I was making. We must have a system within the medical profession that allows its members to start to accept that it is perfectly understandable that mistakes are made, because they are human beings, and that there is insurance to cover such matters when they take place. With the best will in the world, that should be accepted. That recognition, however, does not exist to the degree that it should.

[Richard Harrington (Watford) (Con)]

Does my hon. Friend think that that phenomenon is unique to the medical profession? Does it apply to many other professions, including his former profession, the legal profession, where mistakes are not openly broadcast and are dealt with internally, often unofficially, rather than publicly?

[Guy Opperman]

I did not expect to be attacked by my own side for my former profession. I agree that we all need to accept that when we make mistakes we should own up to them, and that goes for politicians, too.

In fairness, I should speak to the amendments. Surely the point is that there should be a statutory duty of candour in the health service, and that is what is missing. If it needs any encouragement, I know of three separate reports that deal with it: the Levinson and Gallagher report, “Disclosing Harmful Medical Errors to Patients”; the Robins report in the Law Society Gazette; and “Why do patients complain?”, from the Association of Personal Injury Lawyers. All three reports, and reports from across the world—there is good evidence in Australia and New Zealand—show that where there is openness and admission of blame, the amount of litigation subsequently goes down, rather than up. For nine out of every 10 clients I saw as a professional barrister practising on clinical negligence, the first two questions they asked were: “Why did they not apologise?”; and “What will be done to ensure that it does not happen to anyone else?” Nine out of 10 clients would fully understand that no doctor gets up in the morning and makes a mistake deliberately. They understand that it is because they are making clinical errors under intense pressure. In that respect, those are the things that need to be addressed by the Health Secretary, rather than in the Bill.

[Mrs Eleanor Laing (Epping Forest) (Con)]

Will my hon. Friend give way?

[Guy Opperman]

I will, but for the last time.

[Mrs Laing]

Does my hon. Friend agree that the difference between mistakes made by his profession, which is also my profession—I speak to him with sympathy—and those made by the medical profession is that in the case of the latter the consequences can be truly tragic and cannot be put right? Therefore, there must be some mechanism that is open, understandable and available to the public as a whole to try to help when something goes tragically wrong and affects a person’s life.

[Guy Opperman]

With respect, there are ways forward on those issues, not least the idea of a joint report to be completed by a defendant and the claimant together. It would be easy for the Health Secretary to address that by ordering individual chief executives, particularly in relation to cerebral palsy cases, to provide an independent expert’s report assessing the birth. If that happened, litigation would go down, as would the funding to the taxpayer, and we would have speedier and better resolution of these issues. I regret to say that those sorts of things have been said by a number of Members in both Houses in the past and no one has addressed it. However, I stress that that is a matter for the Health Secretary, rather than one that arises out of the Bill.

I am conscious of the time and want to address the other points that have been made; I apologise that I did not do this on Second Reading, but clearly I could not be present in the House at the time. I accept entirely the points made by the hon. Member for Kingston upon Hull East about the fear of the loss of legal aid, and I will address individual children’s cases, in particular, in a moment. The fear of the loss of legal aid is not something that is new to the legal profession, or in relation to negligence or the practice of personal injury law. Those same issues arose throughout the 1990s and 2000 in relation to the Woolf reforms, and many of us who were practising barristers at the time were concerned that individual litigants would be unable to go to the personal injury courts or elsewhere and bring litigation. With no disrespect to the submissions made, the matter has not been resolved, and on this particular issue conditional fee agreements have without question filled the gap. They have been extremely successful—some, including certain Ministers, would say almost too successful—at filling the gap where legal aid previously existed.

--- Later in debate ---

[Mr Speaker]

Order. I am not absolutely sure in my mind, so the hon. Gentleman might wish to indicate, whether he was intending to allow the hon. Member for South Swindon (Mr Buckland) to have a brief opportunity to speak. I do not know whether he was intending it, but if he is I am sure he will be approaching the conclusion of his remarks.

[Guy Opperman]

I am grateful for the advice and assistance, Mr Speaker, and I will conclude in approximately one and a half minutes—

[Stephen Pound (Ealing North) (Lab)]

Too long.

[Guy Opperman]

I am most grateful to the hon. Gentleman for that observation—from his usual sedentary position. If he had taken more exercise, he could have stood up to say it.

In broad terms, will complex cases concerning children be subject to exceptional funding? That is the first point that the Minister needs to address.

The second point that I ask the Minister to take away with him is whether, in a complex child case and, particularly, in cerebral palsy cases, a joint or an independent report could not be commissioned, so that there is an assessment at that stage of whether there is a case to answer. If there is a case to answer, the obtaining of legal aid would clearly follow thereafter; if there is not, the matter would not proceed.

On that quiet note, and with apologies to the sedentary hon. Member for Ealing North (Stephen Pound), I resume my seat.

--- Later in debate ---

[Mr Djanogly]

My hon. Friend’s point goes back to children and their eligibility on the basis of income. A certificate is issued in the name of the minor or the patient and it is their resources that are assessed in the normal way, not those of the litigation friend, children’s guardian or guardian ad litem who is bringing or defending the proceedings on their behalf.

However, in family cases where the applicant for funding is a child, the resources of a parent, guardian or any other person who is responsible for maintaining him or her, or who usually contributes substantially to his or her maintenance, are required to be treated as his or her resources unless, having regard to all the circumstances, including the age and resources of the child and any conflict of interest, it appears inequitable to do so. The applying solicitor should submit appropriate means forms for the child and parents or others responsible for or contributing to his or her maintenance or, more usually in the first instance, explain in the application itself why non-aggregation of means would be appropriate in the circumstances of the particular case, having regard to the position of each of the parents or others on the issues in the case and the party status of the child.

Where children have sufficient understanding to decide that they want to seek an order in family proceedings for themselves and actually start proceedings, there may be no conflict with one or both parents and it may be reasonable to take the means of the parents, or one of them, into account. However, where a child is joined as a party in ongoing proceedings by an order of the court, the assessing officer is likely to accept that the party status of the child justifies non-aggregation.

I hope that that answers my hon. Friend’s point.

[Guy Opperman]

On the tricky issue of cerebral palsy among children, would the Minister consider persuading NHS trusts in all such cases, of which there are not many, to commission an independent report as a first step, before any application for legal aid is made?

[Mr Djanogly]

My response to that applies more broadly than to just cerebral palsy. We believe that the NHS Litigation Authority should more frequently take the initiative in the preparation of reports. Where possible, there should be joint reports, not least to help cases along more swiftly.

Our approach means that public funding will not be available for each and every claim involving a public authority, but it will be available for the most serious cases and to address serious abuses. Most claims for damages will be removed from the scope of legal aid because we have sought to focus our limited resources on cases where the client’s life, liberty, physical safety or home is at risk. Therefore, we do not consider that most claims seeking financial compensation from public authorities merit public funding. However, the Bill ensures that legal aid is available for the most serious damages claims that concern an abuse of position or power, or a significant breach of human rights by a public authority.