Clause 51 - Annual reviews
Health and Social Care (Community Health and Standards) Bill
10:30 am
Mr Paul Burstow (Sutton and Cheam, Liberal Democrat)
I entirely agree. The difficulty for the new management team that came in after the Commission for Health Improvement's report in 2001 was to lift the morale of the staff off the floor. The morale was so low partly because of management failings, but also because the star rating system gave a black mark against that trust; an unfounded black mark, in some ways.
The more recent example concerns finance. There has been an ongoing dispute between the acute trust, Epsom and St Helier NHS Trust, and one of the commissioning primary care trusts, the East Elmbridge and Mid Surrey primary care trust, over a sum of £2.1 million that the acute trust argues that it is owed by the PCT. The matter was eventually referred to arbitration, the outcome being that the trust will get about one third of the amount back.
The acute trust already has a substantial deficit—this is the point about performance rating that is relevant to this amendment—that currently within the criteria for performance management would not cause it to lose a star. The problem now is that because it is no longer going to get all of the £2.1 million from the East Elmbridge and Mid Surrey primary care trust, it suddenly finds itself in a situation where, through no fault of its own, but because of an arbitration process, it will inherit from that PCT an increased deficit; a deficit that is sufficient to lose it one of its stars.
Through no fault of its own, and because of the way the criteria for performance rating work at the moment—they are set by the Department—my local acute trust could, later this year, find itself losing a star. That would send a signal to my constituents, to patients and to staff that would be bad for morale and bad for the reputation of that trust. However, it has nothing to do with the clinical efficacy of its work or of its performance in terms of the health care it provides.
That is why it is important to have a system of performance rating that is at the behest and design of the Commission. It is part of this process of independence, and it is an essential part of how the Commission should discharge its responsibilities in respect of measuring performance. It would give confidence to my constituents and to the public at large, as well as to staff working in the national health service. That confidence is sadly lacking because of the perceived political nature of the performance management system that operates, which is
increasingly being documented in evidence by bodies such as the Audit Commission. I look forward to the Under-Secretary's response to those concerns.