Clause 9
Health Bill [Lords]
2:30 pm
Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)
I am concerned that the hon. Member for Eddisbury was worried about tired chief executives cutting and pasting things. Let me assure him that there will be no dodgy cut-and-paste dossiers from this Government—[Interruption.] I thought I would get that in before another Committee member did.
New clauses 2, 5 and 7 would oblige the Secretary of State to carry out an impact assessment of quality accounts and make a report to Parliament, covering the manner of publication, impact on services and demographic, social, economic and geographical factors. That is a worthy objective, but we do not need primary legislation to obtain it. It is worth emphasising that the quality of the care offered to patients is fundamental to the delivery of health care. High-quality care is better for patients and offers better value for money for the taxpayer. Despite that, historically the quality of health care has not been as high on the agenda as the discussion of the performance and operational efficiency of the NHS. That brings me back to the narrative that I gave of the development of the NHS, moving from dealing with underfunding, the need to get targets in, to the need to restructure it and now the need to move on to a new, higher agenda that is basically about bringing quality into the NHS as the focus of its activities.
Where elements of quality have received significant attention—for example, in respect of health care-acquired infections or reduced waiting times—we have seen significant improvements. Quality accounts enable quality improvement by promoting local accountability and transparency. They should enable clinical teams to open up dialogue with their community, which means that a large element of the quality accounts will be for local determination. That is why I am a little bit concerned about the requirement for overall reviews that would be brought in under the amendment.
The legislation as drafted provides a broad framework with broad principles, with the details to be determined later and set out in regulations and guidance. The current engagement in the testing processes is shaping these products. We will consult on our regulatory proposals later this year. It is clear at this point that the data required for a quality account are simply the existing service quality data that providers already report to Department of Health commissioners or the regulators. The legislation therefore sets out minimum requirements. There is no added burden on the NHS beyond the cost of preparing the document; all other work is or should be happening already.
The ambition is to make quality accounts a vehicle for quality improvement. That is why we are working closely with stakeholders in designing the format. More than 1,000 stakeholders have been consulted so far, including NHS managers, clinicians and patients. We will, of course, be implementing and developing ideas through secondary legislation. The process obliges us to present evidence of the real-world impacts resulting from our policies. So the sorts of data and information that the Opposition are currently seeking will need to be provided to Parliament, in any event, during the course of developing the detail of our policies on the quality accounts agenda.
The current testing process is the key to what we want to achieve. We have already started evaluating it. The first report will be available in the next eight weeks and will enable us to move to the detailed design phase. Thus, by autumn we will have firm proposals, strong evidence of their likely impact and an engaged and informed provider community waiting to implement them.
The consultation process—design, testing, implementation, evaluation and revision—will continue. One by-product of that process will be an annual impact assessment over the next three to five years, dealing with the impact of the policy against the wider criteria set out in the provisions tabled by the hon. Member for Eddisbury. That will become apparent when we publish our evaluation later this summer. However, I am happy to give a commitment now that I will ensure that we consider all the criteria in our impact assessments. He need not worry about that. We have taken on board some of the concerns that he has raised; indeed, they are concerns that we had before. Some of the information he requires will therefore come forward, and it is our intention to make an annual impact assessment over the next three to five years in any event. I hope that, on that basis, he feels able to withdraw his new clauses.