Speeches by McKinnell.

“Do you collect data on how quickly complaints are responded to? As I think you have identified, Helen, there is an important correlation between responsiveness to complaints and the complainant not needing to then convert into litigation. Do you actually collect that data from all trusts?”

“That would be helpful.”

“Do you collect data on never events? To what extent do they become clinical negligence cases?”

“That is one of the things that is very hard when you hear some of the really tragic cases that happen, particularly in maternity services, where they often reach public attention, and you hear it happening in one trust, then another. The lessons may be learned within that trust but not necessarily effectively rolled ou…”

“In terms of the initial response contributing to reducing future harms, one of the complaints that has been made is that the NHS is drowning in patient safety recommendations. Every time there is a complaint, incident or never event, recommendations come out of it, but they do not necessarily seem to be streamlined, co…”

“Yes.”

“Do you think we allocate enough resource to deal with this in the NHS?”

“Presumably that will be looked at as part of the ongoing report into this issue by David Lock.”

“That is really helpful. We have talked a lot about the money and the costs, but, on the flipside, I think there are equal concerns about the impact on patient outcomes. You could argue that the current system is counterproductive to improving patient care in some cases, because it creates a lack of openness, transparen…”

“Do you have a sense of the extent to which that phenomenon contributes to England being such an outlier in the costs of clinical negligence? I refer to figure 15 in the NAO Report, which I am sure you have seen. The extent to which the costs per capita for England are so much larger than other jurisdictions, other than…”

“Neil highlighted the issue of the potential double payment by the Government, in effect: paying once for compensation and again for ongoing healthcare and care services through public services. I appreciate that that is the way that the legal system and civil procedure are set up, but I am less clear on why we do not h…”

“Going back to the issues that the Chair raised around the financing of this, if you cannot get to 100% voluntary redundancies, how are you going to factor in the additional cost and time that are going to be involved in moving to a compulsory route, if it is needed?”

“Have you given thought to where the geography might be more challenging? I am from the north-east; our ICB covers quite a vast expanse. It may not be so easy if you have a glut of voluntary redundancy applications from some ICB areas and not from others. What are you doing to make sure that it is a coherent process?”

“That is what you are working towards—great.”

“That begs the question: why wasn't a fraud risk assessment carried out to identify that?”

“Is it deemed to be at an acceptable level?”

“The scheme was established in an arm’s length way. It was established as being what we now see as—it has been accepted as—too layered and too fragmented, too opaque a system. It is all well and good to learn lessons now—Anna set out very clearly the impact on households—but it would be helpful to understand why it was …”

“It is a question for the Department. Why was the scheme set up in such a way that there was so little oversight and that we have now ended up in this position?”

“This we know, because it is set out in the Report. The fundamental question is, why that was not done before?”

“There seems to be a general pattern of a lack of foresight. Obviously, with hindsight that is always easy to say, but I think some really obvious issues have arisen here—the acknowledgement that this was a much bigger, broader and more complex scheme than anything that had been undertaken previously. I want to ask agai…”