Clause 51 - Annual reviews
Health and Social Care (Community Health and Standards) Bill
11:00 am
Mr Roger Casale (Wimbledon, Labour)
The hon. Gentleman told the Committee that he had a commitment to raising standards in the national health service. My hon. Friend the Under-Secretary and other members of the Committee have questioned that commitment. But taking that commitment, and that of his colleagues, as one will, we have seen that he has a distorted view of how improvement is brought about and how changes in the national health service are made.
When the Conservatives were in office, they did not think that it was necessary to have any national standards to bring about improvements to the health service. We have heard in previous debates on previous amendments that they do not want a star rating system to impose standards. Now we hear that the criteria by which we are to regulate improving standards in the health service should be outwith the powers of the Secretary of State.
The hon. Member for Epsom and Ewell has demonstrated that he fails to understand that when it comes to improving the standard of care in the health service, the process of change does not start at the centre. It is not the result of the stretching out of the long arm of the Secretary of State. It is a bottom-up process that starts in organisations with a commitment to change and improvement on the part of clinicians and everyone else who works there.
The Secretary of State's role is to set the conditions by which such change can take place and be sustained; to set out the general direction of travel; to identify best practice according to set criteria; and to spread that best practice around the health service. That is why it is important that we reject the amendment and leave the setting of criteria to the Secretary of State.
We want to see improvements and an increase in quality. However, I do not want to see improvements in one hospital only; I want to see more equality in the health service and in standards of care throughout the country. We must not leave it to chance and the occasional inspection—as the hon. Gentleman for Epsom and Ewell seems to suggest—to raise the standard of care in one particular hospital. We must have clear criteria, standards and mechanisms by which we get not only improvements, but a higher level of equality throughout the country.
The Epsom and St Helier NHS Trust has been mentioned in the debate on this amendment and on previous occasions in this Committee, and it illustrates the point that I am making, which is that the hon. Gentleman for Epsom and Ewell understands very little about how the process of change comes about. It is a bottom-up process; one that, in this case, started with consultation and engagement with everybody working in St Helier hospital. If the hon. Gentleman knew that, he would understand why it is important to have clear criteria, a clear direction of travel, clear
benchmarking along the way and clear rewards to show that the process of change is happening.