§ 2.36 p.m.
§ LORD VIVIANMy Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
§ [The Question was as follows:
§ To ask Her Majesty's Government what safeguards at present exist within the National Health Service against mistakes in the conduct of surgical operations and whether they propose to introduce any more stringent safeguards; and whether they can give any estimate of the percentage of serious mistakes made on the operating table.]
§ THE PARLIAMENTARY UNDERSECRETARY OF STATE FOR COMMONWEALTH AFFAIRS (LORD BESWICK)My Lords, all hospitals have procedures directed to the prevention of mistakes occurring in surgical operations. In recent years the Medical Defence Union and the Royal College of Nursing have produced joint memoranda on this matter. The Health Departments had previously requested hospital authorities to review their procedures and are to consider whether further additional advice or guidance is called for.
In 1965, hospital boards throughout England, Wales and Scotland reported eight claims arising from wrong operations and 29 claims in respect of other surgical mistakes. This is a minute proportion of the number of surgical operations undertaken, which in the same year was over 2 million. Nevertheless, I deeply regret the occurrence of any such accidents.
§ LORD VIVIANMy Lords, while thanking the Minister for his full, lucid and encouraging reply, may I say that, in common with many noble Lords and 396 Ladies in your Lordship'. House, I feel that Her Majesty's Government—
§ LORD SHEPHERDMy Lords, perhaps the noble Lord will allow me to interrupt him to say that he must ask a question; he should not make a statement. Perhaps he would kindly put his remarks in the form of a question.
§ LORD VIVIANMy Lords, is the Minister aware that, in common with many noble Lords and Ladies in your Lordships' House, I feel that Her Majesty's Government have a very good record in the field of National Health surgery? Despite that, perhaps the Minister, the noble Lord, Lord Beswick, will allow me to ask three supplementary questions. First, would the noble Lord agree that it could be helpful in avoiding, or considerably minimising, the risk of isolated—I repeat, isolated—serious errors in surgery being executed on the operating table if the closest liaison is developed between ward sisters and the sisters in charge of operating theatres when handing patients over to the surgeon and the anæthetist? Secondly, would Her Majesty's Government agree, or would the Minister agree, that extra special care is called for when two patients with the same surname are to undergo a surgical operation from the same ward on the same day? As an example—
§ LORD VIVIANThirdly, would the noble Lord, Lord Beswick, agree that it does not help our National Health surgery service when, owing to a serious but isolated error, a brilliant surgeon and raconteur comes forward and grants an interview to the B.B.C. in which he recounts many instances of enucleation or removal of the eye—that is, the wrong eye—et cetera? The public, I feel—
§ LORD SHEPHERDMy Lords, I think the noble Lord, Lord Vivian, will agree that the object of Question Time is to elicit information, and the noble Lord is going a little further than that. I think the noble Lord has now put his question and I hope he will be content if my noble friend seeks to reply to him.
§ LORD VIVIANMy Lords, I apologise to the Leader of the Opposition and I will leave it at that.
§ LORD BESWICKMy Lords, may I thank the noble Lord, Lord Vivian, for emphasising the fact that although there may be a headline case, it is usually an isolated one; and that the overwhelming majority of operations in this country are carried out perfectly safely. So far as his three detailed questions are concerned, I fully agree with what he said in the first two; I am not aware of the details of the third. May I just add a word in connection with procedures—and I would emphasise this point. As he would probably agree, the conduct of surgical operations is essentially a professional matter and one for the doctors and the nurses. The fact that the two organisations to which I have referred have gone to the trouble of drawing up detailed memoranda shows that they are vitally concerned with this matter.
§ LORD PEDDIEMy Lords, may I ask my noble friend, briefly, what is the prospect of introducing standard procedures in all hospitals for the treatment of patients in preparation for an operation?
§ LORD BESWICKMy Lords, I compliment my noble friend on his brevity. May I say that his supplementary question covers a very wide field, and I should have thought that there were certain aspects here where standardisation would not be desirable. These are matters which were better left to individual surgeons.
§ LORD SEGALMy Lords, is my noble friend able to confirm that the majority of these mistakes have been made by junior hospital surgeons, and could steps be taken to insist that every operation list should be scruitinised beforehand by a senior hospital surgeon, even if he cannot attend the operation himself, before a junior surgeon is allowed to proceed with any hospital operation?
§ LORD BESWICKMy Lords, I should not like to generalise on that point. I think it would not be desirable to comment on that, or indicate that the danger is as suggested by my noble friend. May I add, in connection with the two recent accidents which probably prompted the noble Lord's Question, that an independent inquiry has been set up by the Bir- 398 mingham Hospital Board in order to establish the facts there, and I think it would be improper of me to start speculating as to what their findings may be.
LORD HAWKEMy Lords, may I ask what arrangements are made to compensate the victims of these mistakes? What does one get if one has the wrong leg cut off, for instance?
§ LORD BESWICKMy Lords, the noble Lord may have heard me use the word "claim" in my reply. Claims are made, they are considered, and where appropriate compensation is paid.
§ LORD BLYTONMy Lords, is my noble friend aware that recently a hospital surgeon took off the wrong leg from a woman and had to take the other one off? There may be a low percentage of cases among the number of operations, but it was a high percentage of that woman's legs. Can we not seek stringency in that respect?
§ LORD BESWICKMy Lords, I think that my noble friend is referring to the case in Birmingham to which I have already referred. As I have said, there is to be an independent inquiry, with a lawyer as chairman. I think the matter should be left to the inquiry.
§ LORD LEATHERLANDMy Lords, if we have now come to the end of this surgical aspect of this matter, I wonder whether a little technical detail could he corrected? The noble Lord, Lord Vivian, referred to my noble friend on the Front Bench as the "Leader of the Opposition". If that went uncorrected, the populace outside might feel that some grave calamity had overtaken us.
LORD HAWKEMy Lords, as mentioned from the other side of the House, this lady has had to lose two legs. What compensation has she received for that?
§ LORD BESWICKMy Lords, I should have thought that the noble Lord would have heard what I said—namely, that an inquiry was being held into this case and it would be quite wrong for me to speculate either as to who was to blame or as to what compensation might follow.
LORD HAWKEMy Lords, surely the inquiry is to apportion the blame, not to decide how much compensation she has to get. She has lost her two legs.
§ VISCOUNT DILHORNEMy Lords, will she not have a claim of negligence if anyone is found at fault, and then will it not be a matter for the court to assess compensation, in default of agreement?
§ LORD BESWICKMy Lords, I am extremely grateful to the noble and learned Viscount for telling his noble friend, more clearly than I could, where common sense lies in this matter.