Oral Answers to Questions

Debate between Tom Brake and James Gray

Thursday 13th September 2012 Commons Chamber

[Tom Brake]

I thank the right hon. Gentleman for that. He is an experienced and respected parliamentarian, and he will be aware of the range of measures available to put a Minister on the spot over any alleged failure to make the most important policy announcements to this House: urgent questions, Select Committee investigations, Prime Minister’s questions, points of order and raising matters in the Backbench Business Committee. I hope he agrees that that is an impressive list of effective sanctions against errant Ministers.

[Mr James Gray (North Wiltshire) (Con)]

The Government have increased the number of ministerial statements made to this House, and you, Mr Speaker, have increased the use of urgent questions to hold the Government to account, which is also welcome. However, it sometimes feels as if there is not much point in attending events such as the Budget debate or the Queen’s Speech debate, as one has read all about them in the previous Sunday’s newspapers, which shows that not enough is yet being done. Will the Government consider making use of Westminster Hall, or elsewhere, in order to have far more ministerial statements and, crucially, far more opportunities for Back Benchers to scrutinise what Ministers are up to?

[Tom Brake]

It is worth pointing out that over the recent period there have been 32 statements by the Prime Minister. We are making more statements per day than under the previous Government. I agree, however, that it would be a good idea to allow Westminster Hall to be used for oral statements, and the Leader of the House has expressed support for that.

Prisoners (Voting Rights)

Debate between Tom Brake and James Gray

Tuesday 11th January 2011 Westminster Hall

[Tom Brake]

The fact is that we abide by the rules of the European Court of Human Rights, and it has ruled that the Government should take action. I believe, as does the hon. Member for Stretford and Urmston, that it is appropriate for the Government to do so. The hon. Gentleman may disagree, as may others, but they take the debate slightly away from the right of prisoners to vote to the subject of the European Union, on which there will be a longer debate—[Interruption.] I mean aspects of the European Court and human rights that will be the subject of another debate in the main Chamber.

It is right that the Minister should clarify why four years was chosen. In the briefings that I have seen, the justification is that four years is the cut-off point between a short-term prison sentence and a long-term one. I have seen no other argument for why that threshold should have been chosen. The Minister should respond to that point.

The Minister should also respond to the hon. Member for Kettering and others, who said that concern had been expressed that compensation might have to be paid. If a total of 85,000 prisoners claimed £750 compensation, it could amount to tens of millions of pounds. The Minister will have heard that some accuse the Government of making up the figures. I hope that he will tell us where the information about these potential compensation claims came from and say whether he stands by the contention that the Government might be liable for a large number of claims if no action is taken.

I hope that the Minister will also explain why the voting rights that he proposes are to apply to Westminster and European elections only, and not to other polls. If the Government were to allow prisoners to vote in local elections exclusively, it could be argued that prisoners would be less able to influence the Government’s prison agenda if they could vote only in local council elections. I would be interested to hear why those two elections were chosen.

[Mr James Gray (North Wiltshire) (Con)]

Will the hon. Gentleman give way?

[Tom Brake]

In a moment. The Minister has rightly made it clear that if the proposals go through, prisoners will be allowed to vote only in the constituencies that they came from or with which they have a connection and not in the constituency in which the prison is placed. The risk of large numbers of prisoners swinging an election result will therefore be greatly reduced.

[Mr Gray]

The hon. Gentleman has partly answered my question. Does he accept that if prisoners are allowed to vote in local elections in places such as Wandsworth or Wormwood Scrubs, they would have a decisive number of votes in tight elections?

Candour in Health Care

Debate between Tom Brake and James Gray

Wednesday 1st December 2010 Westminster Hall

[Tom Brake (Carshalton and Wallington) (LD)]

It is a pleasure to serve under your chairmanship this morning, Mr Gray. I congratulate my hon. Friend the Member for Poole (Mr Syms) on securing the debate and on lucidly and concisely setting out precisely why the Government should look carefully at a statutory duty of candour. I have not heard any effective arguments against it, but I will come on to some arguments from opponents. My hon. Friend set out why the duty would boost public confidence and he rightly pointed out that an apology—as we have probably all experienced—often, first, helps to secure closure for a family if a loved one has been involved in a tragic accident, and, secondly, can defuse a difficult situation that could end up in the courts for years afterwards. He has rightly set out the reasons why a duty of candour is a necessity.

My hon. Friend started by quoting from the Liberal Democrat manifesto, and I would expect nothing less in the coalition, so there is no need for me, as a Liberal Democrat, to do so. He also mentioned that the proposal has been carried through to the coalition agreement and, subsequently, into the NHS White Paper, which—although it perhaps does not contain a proposal as specific as a duty of candour—certainly makes it clear that hospitals need to be open about mistakes and always tell patients if something has gone wrong. One development to which he did not refer was the fact that legal aid will no longer be available in cases of clinical negligence, which I hope the Minister will pick up on in her response. I wonder whether that will have an impact and whether that strengthens the case for a duty of candour.

As I said in my opening remarks, there are opponents of a duty of candour. A briefing has been sent to Members by the Medical Protection Society, which is a

“leading provider of comprehensive professional indemnity and expert advice to…health professionals around the world.”

The briefing states that the society is committed to promoting openness in health care and supports the principle in the NHS White Paper that hospitals should be open about mistakes and always tell patients if something has gone wrong. However, it goes on to say that the MPS strongly believes that a change in culture would be more effective than a statutory duty. However, I agree with Action against Medical Accidents, which also briefed me for the debate. It said that perhaps the MPS is missing the point: it is not a question of a duty of candour or a change in culture, as it is perfectly possible to have both. Indeed, the duty of candour is one way of supporting and underpinning a change of culture, so that health care organisations are always open and honest with patients when things go wrong. The MPS says that it has been advocating that change in culture, and it is true that a number of organisations have been advocating it for the past 50 years or so, but the desired change has not happened. I am not sure how much longer one can wait for it.

There is an issue about guidance and about how seriously organisations take guidance when they are statutorily required to do other things. There is always a risk that guidance gets left aside while organisations focus on statutory duties. As the MPS said, it is correct that there is a professional duty for doctors and nurses to be open with patients in the event of a mistake, but there is a wider issue about there being no statutory duty on all health care organisations to promote and support that practice in their organisations. As my hon. Friend the Member for Poole said, the medical professionals may want to be open but, unfortunately, they are being advised by managers, who are not subject to the same professional codes and perhaps believe that less openness is the best course of action. My hon. Friend referred to the Stafford case, and, as I understand it, it was a legal officer who sought to suppress the doctor’s report in that case. When the General Medical Council was asked to confirm how many cases it had brought against a doctor specifically for a breach of this part of its code, it confirmed that it has not brought a case against a single one.

My hon. Friend also referred to the very sad case of Robbie Powell and the sterling efforts that the family have made. I am pleased to see that Mr Powell has joined us here today.

[Mr James Gray (in the Chair)]

Order.

[Tom Brake]

I am sure that Mr Powell will be listening carefully to what is said and reading the remarks in Hansard later. That family have played a major role in bringing this issue to our attention and are working with AvMA to promote what they hope will become Robbie’s law.

The MPS has provided information that I think works against its case. Its research shows that, at the moment, a third of doctors are not prepared to be open and honest when an accident occurs. If so many doctors feel constrained from or concerned about being open when an accident has occurred, it supports the case for a culture of candour. The MPS also refers to states in the United States where there is a duty of candour and where it perceives that there may be a difficulty in enforcing the duty. In his remarks, my hon. Friend the Member for Poole made it clear that the Care Quality Commission has confirmed that it could and would enforce a statutory duty, and would be in a position to do so, if that were part of its regulations.

Another issue that the MPS raised, which we need to respond to, is that the proposed duty would not include near misses. It is arguing against the duty of candour, but at the same time saying that it would be a problem if near misses were not included. I understand that there is a general agreement that, although it might the norm for near misses to be reported to the patient, there would be discretion in cases in which reporting a near miss might cause unnecessary harm. There is recognition that the near miss issue needs to be addressed carefully.

One important fact is that, whether it is a duty or a requirement, it must apply to all health care organisations. If there was one thing in the coalition agreement that was slightly remiss, it was the fact that it referred only to hospitals, but there is a wider health body that we need to include. I am sure that the Minister will clarify in her response that the duty of candour, or the requirement, would need to apply not only to the patient but, sadly, if the patient has died as a result of the accident, more widely to include family members. It should not be strictly restricted to the person who had the misfortune of suffering the accident.