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Mr. Miller: It is important that the Minister should cover the issue of no-fault compensation; I raised it with him in a meeting last year. The issue is surely that the hospital trust and the Department have acknowledged that, as a result of these clinical trials, some women suffered damage. The degree to which that happened in each individual case is quite varied. Some of the cases are extremely serious, as I and my hon. Friend the Member for Rossendale and Darwen have described.
If we simply leave it to the legal system to deal with the matter, it will be dealt with on a case-by-case basis-- because, as the Minister pointed out, the cancers involved are very varied--and we shall not be able to deal with the overall problem. Would it not be more sensible for the Department to instruct the trusts to release all the information, not just for the legal process but--more important--in the interests of research, to prevent this from happening again?
Mr. Sackville:
I shall come to the hon. Gentleman's last point later. As for the release of information, he must bear in mind the fact that legal action is pending, and the trust has a right to coduct the case as it sees fit.
I have spoken at some length about the reasons why we believe that no-fault compensation is inappropriate. The Government have concluded that where--sadly--clinical accidents have occurred, our most appropriate action is to seek to improve claims management practice within the current system, defending claims that should be defended but not causing expensive delays when claims should be settled.
In his response to the National Health Service (Compensation) Bill, the then Secretary of State for Health undertook to consider arbitration as a possible alternative to the courts for the resolution of clinical negligence claims; the Department of Health subsequently consulted widely on a possible arbitration scheme for the NHS, but the outcome was inconclusive.
Rather than dismiss the idea out of hand, however, it was decided to put it to the newly formed clinical negligence working group. That joint departmental and
NHS group was set up to consider how best to help NHS trusts to manage their exposure to clinical negligence claims, which are the main cause of litigation. The group considered the proposals put to it very carefully, but its firm advice was that arbitration did not represent a significant improvement on litigation, and should not be pursued.
The group reached that conclusion for a number of reasons. It was convinced that arbitration would not appeal to plaintiffs; in particular, they were thought unlikely to commit themselves in advance to be bound by the outcome, which is a requirement of arbitration. In complex cases--and clinical negligence cases often are complex--arbitration would not necessarily be cheaper than the courts. A paper-based arbitration system, such as that put before the group, would require a better quality of written information than is often available.
The group did feel, however, that mediation offered constructive possibilities for the resolution of clinical-negligence claims, which should be explored further. That advice was put to my ministerial colleagues in the Department, and was accepted. Since then, work has focused on mediation, and I am pleased to say that a good deal of progress has been made. Pilot schemes using mediation for that purpose have been set up in two English regions--Northern and Yorkshire and Anglia and Oxford.
We believe that mediation offers a genuine alternative way of settling claims, in which the parties to the dispute come together to agree a solution. It is non-binding, but in suitable cases it is thought likely to be a humane and cost-effective way of enabling all aspects of a case to be resolved to everyone's satisfaction. Savings may be hoped for in legal costs.
Where agreement is reached, compensation will be arranged in the same way as in any other out-of-court settlement. If, in some cases, full agreement cannot be reached, mediation offers a possibility of narrowing the issues for subsequent consideration. Of course, we do not expect mediation to be a panacea, but we hope that it may prove helpful in suitable cases.
The pilot mediation schemes began operating in April, and the first mediation, which took place in September, was considered very successful by all the parties concerned. However, it will be some time before we are able to draw any firm conclusions from the schemes. When the outcome has been properly evaluated, we will decide whether mediation should be extended to the NHS as a whole.
I make it clear that we see it as a priority to minimise the risk of any adverse effects from radiotherapy, although it is recognised that most treatments have some element of inherent risk. That is why we have issued guidance to health authorities on quality assurance in radiotherapy. We want to ensure that all radiotherapy units have in place the necessary systems to ensure a quality service.
Last year, I launched a new document called "Quality Assurance in Radiotherapy" which has been disseminated throughout the national health service. In offering deepest sympathy to those who have suffered any accident as a result of this or any other cause in the course of medical treatment, it is appropriate to give a firm commitment on behalf of the NHS.
Ms Janet Anderson:
I look forward to hearing that commitment. I think the Minister said that mediation is to
Mr. Sackville:
I said that two trials are in progress, and that we are committed to two schemes in two regions. I also said that not all accidents will be amenable to mediation. It is a question of the parties concerned finding that that is a suitable way forward which may bring a solution. Obviously, good will is needed on both sides. Although it is non-binding, it is a way to find a solution. I have said that we do not intend that trusts or any other
Before the hon. Member for Rossendale and Darwen intervened, I said that, in any discussion of a case of this sort, it is right to give a commitment on behalf of the NHS. It is that we shall constantly seek to raise the standards of quality and safety of all treatment on offer. We shall do everything in our power to ensure that events such as the tragic events that have been described never happen again.
Question put and agreed to.
Adjourned accordingly at thirteen minutes to Eleven o'clock.
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