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Patient Safety Commissioner

Volume 816: debated on Thursday 2 December 2021


Asked by

To ask Her Majesty’s Government when the process to appoint the Patient Safety Commissioner will commence; and when they expect the Commissioner to be in post.

My Lords, we are making good progress towards appointing the first patient safety commissioner for England. We expect the appointment of the postholder by spring 2022. We have publicly consulted on the appointment and role of the patient safety commissioner and have agreement that the role will be regulated by the Commissioner for Public Appointments and subject to pre-appointment scrutiny.

My Lords, I thank my noble friend for that very interesting reply and I thank all those who have been involved in establishing the patient safety commissioner—the first in England and, I am told, the world. But my deep concern is that we are setting up the commissioner to fail, with a term of office too short to establish the role, set up a new organisation and get to grips with a very complex task. Three years is too short. Does my noble friend agree that five years would be preferable? Will she please work with colleagues to lengthen the term of office from three to five years, as is the case with the Children’s Commissioner?

I thank my noble friend for that Question. The postholder will be offered a three-year term of office and may be reappointed for a further three years, subject to ministerial agreement. This is in line with most other public appointments. We believe that three years, with a possible extension of a further three, subject to ministerial agreement, is the right approach. This means that, if reappointed, the postholder could serve up to six years, which is a good amount of time for the role to become well-established within the healthcare system.

My Lords, the independence of the patient safety commissioner is vital. Will that independence be built into the regulations to ensure that the patient community is confident that the commissioner has the authority to do the job and protect the patient?

Of course, that is vital. The commissioner must have the freedom to act independently if they are to be effective. We will work with the commissioner to agree how the commissioner’s independence will be safeguarded.

My Lords, one of the key tasks of the independent patient safety commissioner will be to make recommendations on patient safety issues as they relate to medicines and medical devices. The important question I would like to ask the Minister is: who will be responsible for implementing those recommendations and where will the accountability lie?

Accountability is obviously very important. We are making sure that the patient safety commissioner is complementary to the many bodies already operating in our health service and enhances their work. The commissioner will have the power to request and share information with relevant persons in the NHS or the independent sector in carrying out their core duties, which will facilitate joined-up working. Shared accountability to the Secretary of State for many of these public bodies and the commissioner will also help them to collaborate and co-operate across organisations, with a responsibility to improve patient safety.

My Lords, in view of the size of the liability for clinical negligence in the NHS, is it not urgent that the commissioner be appointed and be successful in introducing measures for increased safety?

Yes, we obviously want to get the patient safety commissioner in position as soon as possible. The consultation ran from 10 June to 5 August. We will shortly arrange for publication of the Government’s response to the consultation and publish the job advert and job description to kick off the appointment process. We will also bring forward the necessary draft regulations, which will be subject to debate in both Houses.

I thank the Minister for her reply to the question of the noble and learned Lord, Lord Mackay of Clashfern. However, the Government first said that the patient safety commissioner would be in post by the first quarter of 2022, and it is clear from the timetable that that will now not be achieved. So, can the Minister set out the current thinking on when the patient safety commissioner will actually be in post?

I fear that I cannot really add to what I said to my noble and learned friend. We are going to advertise the role shortly and we have finalised the relevant details. The patient safety commissioner will be a regulated public appointment, which means that the appointment process will follow the requirements of the Governance Code on Public Appointments. The process will be open and transparent, but all of this takes a bit of time. It may still be spring 2022.

My Lords, it is a shame that my noble friend cannot commit to a date. As others have said, this has dragged on. Given that she has given a commitment to do this by spring, can she say what the department is doing to come up with new ideas to ensure there is a genuinely broad and diverse field of candidates, so that patients’ voices really are heard?

I thank my noble friend for that question. As I said, the appointment process will follow the Governance Code on Public Appointments. The process will be open and transparent and the appointment will be made on merit. The process is regulated by the Commissioner for Public Appointments, who will approve a senior independent member of the assessment panel. The appointment will also be subject to pre-appointment scrutiny hearing with the Health and Social Care Select Committee.

My Lords, given all the pressures on the NHS at this difficult time, is it not more necessary than ever to have a patient safety commissioner who could hear and co-ordinate patients’ voices and act on their concerns? Are there some hopeful candidates waiting?

I am sure there are hopeful candidates waiting. I am afraid I have no idea who they are—obviously, that is not within my remit. I agree with the noble Baroness that we need to get on with this. I think the department realises that and is concentrating on moving this forward.

My Lords, I think it is worth reminding ourselves of the problem: we need a patient safety champion because many patients, particularly women, were disregarded and dismissed for many years by those across the whole of our NHS. This was graphically and effectively exposed by the report from the noble Baroness, Lady Cumberlege. Will the commissioner report to Parliament, and how will we ensure—I say “we” because I think we all have a responsibility in this regard—that their independence is safeguarded and their status protected?

Those are both very important questions. We place enormous emphasis on patient safety, which is central to effective functioning of the NHS. Appointing this commissioner will make sure that we are beginning to go ahead with that. As far as accountability is concerned—the consultation has not been announced yet, so I am probably going to be told that I am going beyond my brief—there is supposedly going to be an annual report. The commissioner will produce an annual report, to be laid in Parliament, setting out activities undertaken during the year. The commissioner may appoint an advisory board whose members will have a broad range of relevant interests, experience and knowledge of the health system.

My Lords, how will the Secretary of State inform the public about the commissioner and his or her role, and how should he or she be contacted?

I think that that will all become obvious when we have set out exactly how this is going to work. The fact that the commissioner has to report to Parliament annually is one way. How patients themselves will get in touch with the commissioner will be laid out in the regulations when that has all been sorted out.

My Lords, the important inquiry of the noble Baroness, Lady Cumberlege, shone a light on the consequences of the dangerous drug, Primodos. Is the Minister aware that within the last 18 months, 19 parents of children severely damaged by Primodos have died, while still worrying that their children would be left financially dependent on the state? They died in despair. What can the Minister do to ensure that others do not also die without hope, knowing that justice has not been served and that the request for redress, recommended in First Do No Harm, the report from the noble Baroness, Lady Cumberlege, has also been refused?

It is upsetting to hear of these deaths, and we offer our deepest sympathy, obviously, to the children and families. Our priority remains improving the future safety of all medicines and devices. This means we will continue to focus our work on direct support for future safety, and on improving how the system listens to patients and supports and monitors safety and clinical practice in respect of medicines and devices. This is very much what the patient safety commissioner will be concentrating on.