Health and Social Care Bill
Derek Twigg (Shadow Minister (Health); Halton, Labour)
This clause is important. The explanatory notes state that the organisation mentioned in the clause title supports the NHS in analysing its current practices against best practice and implementing changes to achieve better results. What we have been talking about in terms of improving quality is paramount to improving patient safety, about which we have had a long discussion. Obviously, a body that plays an important role in analysing current NHS practices against best practice and bringing about changes to achieve better results is very important. It will be interesting to hear what the Minister has to say about the rationale for the measure.
I refer again to the gold mine of information that is the impact assessment. It states:
“An alternative possibility is that the functions remain provided by, and staff employed by, the social enterprise under a contract to provide the leadership for commissioning improvement services directly to the Commissioning Board. It is possible there might be indirect costs from staff due to underperformance from changes. However, it is believed the changes will be small and negligible in cost terms.”
It would be useful to know the Government’s position, because I cannot underestimate the concern of the Opposition about the impact of the changes in the Bill—obviously on patient safety, but also on quality improvements and commissioning. Those are essential elements throughout the health services in terms of clinical care and patient pathways.
We have some concerns about the provision. We have raised concerns about patient safety under the previous clause, so I will not try your patience, Mr Hancock, by going through all that again. It would be useful, however, to hear from the Minister about the rationale and to have my questions answered.
Paul Burstow (The Minister of State, Department of Health; Sutton and Cheam, Liberal Democrat)
I agree with the hon. Gentleman that the impact assessment is a gold mine of information, and I urge anyone who is closely following our proceedings to ensure that they do not rely solely on the extracts. When it comes to it, they should source everything directly from the document. If they do, they will sometimes get a fuller picture.
As the Committee has already seen, the Bill provides for the NHS commissioning board to have the functions of the NHS Institute for Innovation and Improvement that will support the board in promoting innovation and leading quality improvement. Clause 19 places a duty on the NHS commissioning board to promote innovation when exercising its functions. We also had a recent debate on the role of NICE in promoting innovation. Innovation could be achieved, for example, through the NHS commissioning board’s developing guidance for commissioning consortia, hosting some clinical commissioning networks, where appropriate, and working to encourage a culture of innovation within commissioning organisations.
Clause 19 also provides for the NHS commissioning board to make payments as prizes in order to promote innovation in the provision of health services. Promoting innovation in this way will support the delivery of quality and productivity improvements across the NHS to help transform health care for patients and the public. With the board’s responsibilities around innovation, the arm’s-length body is no longer necessary and that is why clause 262 provides for its abolition. The issue is about ensuring that patient safety and innovation are not subcontracted or at arm’s length, but rather that they are at the heart of what the NHS is about.