Clause 8
Health Bill [Lords]
1:45 pm
Sandra Gidley (Romsey, Liberal Democrat)
I shall make a few general comments and I apologise if some of them were covered this morning, when I had to be elsewhere. I hope to use the opportunity, first, to get an assurance from the Minister that the quality accounts will not be used in any league table format. I do not think that that would be helpful in the greater picture, because trusts and hospitals tend to take their eye off the ball and concentrate on what they are being compared with.
Secondly, a slightly wider question is: why are we starting with family care trusts, NHS service trusts, special health authorities and NHS foundation trusts? I understand that it is completely right to wait a while to see how the quality accounts process beds down before incorporating the smaller bodies, but who will performance manage that? Who will ensure that quality accounts are useful? Where do strategic health authorities fit into the picture? Whenever I have written to the Department of Health about a problem with my local PCT, the Department has said, “It is nothing to do with us. You’ve got to go to your SHA, because they are responsible for performance managing.” To be blunt, the quality of performance management by the strategic health authorities has been very variable in the past, although that has improved, thanks to the reorganisation and the fact that there are fewer strategic health authorities.
Then we have the question of the Department itself. The impact assessment says:
“Part of the Quality Account will be specified by the Department of Health and the content will be set out in regulations.”
That is fine. Then it says:
“This part will focus on key Departmental priorities.”
I am not quite clear how we are monitoring the quality of the Department of Health. The assessment continues:
“The purpose of the DH-specified part of the Account is to ensure that patients, the public managers and clinicians have easy access to information on a provider’s performance against key Departmental priorities in a way which allows Account users to compare a provider’s year on year performance and to compare the performance of similar types of provider.”
We are getting into league-table territory there. What I want to home in on is
“easy access to information on a provider’s performance against key Departmental priorities.”
The other day, I was talking to a gentleman who voiced concern about the Department of Health managing the NHS Plus contract. I do not want to go into great detail, but there are quality aspects to the account of which the Department has failed to take note, and a note I have says that there have been no management quality issues on this contract managed by the Department of Health contract management board.
There seems to be no accountability of the Department. For example, the guidelines said that patient groups, with their specific knowledge, should have been involved, but they have not. The contract for the occupational health clinical effectiveness unit—I will follow this up with the Minister later—was placed with the Royal College of Physicians, but two specific quality requirements have not been enforced by the Department,
It seems a little rich for the Department to making trusts jump through hoops of producing quality accounts—although they are a good thing—when the Department itself is not being open and honest about how it is managing quality. Moreover, strategic health authorities, which might have a useful role to play, are being ignored.