Clause 12 - Further functions of the Commission for Health Improvement
NHS Reform & Health Care Professions
4:30 pm
Mr Oliver Heald (North East Hertfordshire, Conservative)
I welcome you to the Chair, Miss. Widdecombe.
I asked the Minister two further questions about the clause. The first question related to the vexed issue of the effect of clause 12(5) on the role of the Audit Commission. Under section 21 of the Health Act 1999, the Commission for Health Improvement can undertake Audit Commission work or work jointly with the Audit Commission. Subsection (5) requires the Audit Commission to consult the commission about its value-for-money studies. The notes refer to that as ''better co-ordination''. Will the Audit Commission continue in practice to undertake its value-for-money studies when the CHI is, or could be, competent under section 21 of the 1999 Act? If the Minister is prepared to give a clear statement on that, we will be happy; or relatively so.
Secondly, clause 12(2)(c) adds a provision for the CHI to report on
''the quality of data obtained by others relating to the management, provision or quality of, or access to or availability of, health care for which NHS bodies or service providers have responsibility''.
Does that provide a route by which the problems encountered by bodies such as the national confidential enquiry into perioperative deaths might have their concerns addressed, or is it simply designed to discover why the information that the Health Department receives is less accurate than it might be?
I will give a taste of the problems that the cancer study revealed. The NCEPOD study referred to the problem of data and explained that it found
''poor hospital information systems. Medical records and their content are one of the building blocks of our medical system and problems with the organisation and content of medical records have a considerable impact on clinical care and education. The report contains evidence that medical record keeping is falling below acceptable standards. Unfortunately, poor record keeping will inevitably lead to poor completion of NCEPOD questionnaires, which might call into question the validity of some of the data in the Enquiry.''
The report has become a huge media story, and it is obviously not helpful to the Government to be told that cancer is dealt with in such an appalling way in this country. If a problem exists with the methodology,
data and medical records, it would be good to sort it out so that we know where we are. The study draws conclusions such as:
''Most patients with cancer who die within 30 days of an operation are admitted as an emergency or urgently and many are not referred either to a surgeon with a subspecialised oncology interest, a multidisciplinary team, medical oncologist or specialist cancer nurse when it is indicated. Clinical networks and local guidelines should be constructed in order to ensure that all patients with cancer receive and early and appropriate referral to specialists.''
There is obviously a serious concern about the treatment of cancer.
Will the provision in subsection (2)(c) help reports such as the NCEPOD one, or is it designed for internal Department of Health purposes?