Clause 50 - National performance data

Health and Social Care (Community Health and Standards) Bill – in a Public Bill Committee at 9:30 am on 10 June 2003.

Alert me about debates like this

Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health) 9:30, 10 June 2003

I beg to move amendment No. 417, in

clause 50, page 17, line 36, leave out

'has the function of publishing'

and insert 'must publish'.

Photo of Peter Atkinson Peter Atkinson Conservative, Hexham

With this it will be convenient to discuss the following amendments: No. 418, in

clause 50, page 17, line 37, at end add—

'(2) For the purposes of this section data relating to the provision of health care shall include all data relating to performance by NHS bodies.

(3) The Secretary of State may by order exclude certain categories of data relating to the performance of English NHS bodies and crossborder SHAs from the responsibility of the CHAI under subsection (1) on the grounds that publication of such data would prejudice the efficiency of the NHS.

(4) Any power of the Secretary of State to make an order under subsection (3) shall be exercisable by statutory instrument.

(5) A statutory instrument containing an order under this section shall (unless a draft of the statutory instrument has been approved by a resolution of each House of Parliament) be subject to annulment in pursuance of a resolution of either House of Parliament.

(6) The National Assembly may by subordinate legislation, made by statutory instrument, exclude certain categories of data relating to the performance of Welsh NHS bodies from the responsibility of the CHAI under subsection (1) on the grounds that publication of such data would prejudice the efficiency of the NHS.'.

No. 479, in

clause 50, page 17, line 37, at end add—

'(2) For the purposes of this section data relating to the provision of health care shall include all data relating to performance by NHS bodies.

(3) If the Secretary of State or the Assembly wishes to exclude certain categories of data relating to the performance of NHS bodies from the responsibility of the CHAI on the grounds that publication of such data would prejudice the efficiency of the NHS, then it must lay regulations before Parliament setting out what data it proposes to exclude, and the specific reasons for doing so.'.

Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health)

These amendments deal with the issue of data and the way in which data are published and reported on by CHAI. The amendments are intended to seek further clarification from the Government on their thinking and on the purpose of the clause.

I hope that the Under-Secretary will be able to elaborate further about the way in which it is intended that CHAI will publish these reports. In the previous debate, the Under-Secretary said that CHAI would be empowered to make decisions about when it would publish material in an abbreviated or summarised form. Amendment No. 418 seeks to go further and clarify whether the Government intend that particular categories of data, relating to the performance of NHS bodies, especially cross-border SHAs, will be published, and I look forward to hearing what they intend to do in respect of amendment No. 418.

Photo of Chris Grayling Chris Grayling Shadow Minister (Education) 9:45, 10 June 2003

Amendment No. 418 in the name of the hon. Member for Oxford, West and Abingdon would permit the Secretary of State to exclude certain categories of data, relating to the performance of English NHS bodies and cross-border SHAs, from the responsibility of CHAI, under subsection (1), on the grounds that publication of such data would prejudice the efficiency of the NHS.

Clearly, these probing amendments have been tabled to extract from the Under-Secretary clear information about performance data. He said earlier that he did not believe that it was the responsibility of

CHAI to measure the quality of treatment, and I will return to that in the debate on the next two clauses.

Will the Under-Secretary clarify whether he expects national performance data from CHAI to reflect the quality and outcomes of health care, as well as the provision and nature of the processes that take place in the NHS? It is fundamentally important that in all the data and measurement of action that take place in the NHS trusts, there is a significant swing of the pendulum away from the process towards quality. We have already debated that, but I want clarification from the Under-Secretary on how far the Government will go in permitting CHAI to assess the quality and outcomes of health care and whether the NHS actually makes people better.

Photo of Andrew Murrison Andrew Murrison Conservative, Westbury

The Audit Commission recently published several authoritative reports about data collection in the NHS, and I would be interested to know to what extent the Minister, when drawing up this part of the Bill, has taken them into account. Does he agree that Government bodies need to be consistent on whether they publish data? The Audit Commission, which presumably will have an ongoing interest in what goes on in the NHS and could very well carry out investigations requiring data in the future, must operate to the same guidelines as CHAI. It would be unfortunate if CHAI were required to publish its data in one way and the Audit Commission in another way, especially as they might sometimes be assessing more or less the same thing. I hope that the Under-Secretary will attempt—so far as possible—to ensure that those two bodies behave in the same way.

Photo of David Lammy David Lammy Parliamentary Under-Secretary (Department of Health)

The amendments make a complicated provision that appears to require CHAI to publish all performance data available in the NHS, but allows the Secretary of State, or the National Assembly for Wales, to exclude certain data by statutory instrument if they think that collecting it would prejudice the efficiency of the NHS. Finally, they provide for either House to annul that instrument. In a sense, that broadly contradicts the arguments of the hon. Member for Sutton and Cheam and his hon. Friend the Member for Oxford, West and Abingdon about the independence of the new inspectorate. We provided for CHAI to publish the performance data but we have not attempted to restrict what that data should or should not cover. The Opposition amendment is thus contradictory in trying to tie CHAI's hands and to burden it with the requirement to publish all performance data. That, frankly, is cumbersome, overly bureaucratic and risks increasing the burden on the NHS.

Much performance data is collected at the moment and published locally by the NHS. To require CHAI to collect and publish that data again is a waste of resources, and the NHS can do without that. That relates to the point that was just raised. We want inspectorates to work together across the board to reduce the burdens on bureaucracy. That is why we included that requirement in the Bill. As the hon. Gentleman knows, that was also the aim of the Cabinet Office report, ''Making a Difference:

Reducing Burdens in Hospitals''. That work continues.

My hon. Friend the Member for Ealing North has sought to rectify some of the drafting defects of his own and other amendments, but the difficulty remains. If those amendments were carried, they would distract CHAI from its primary focus of assessing and reporting on the performance of the NHS.

To answer the point raised by the hon. Member for Epsom and Newell (Chris Grayling), CHAI has a function to publish data. It decides what to include and takes account of all the factors in clause 49(2). He knows that CHAI will publish further performance data later this year. Having looked at the range of indicators, the hon. Gentleman knows that there is, for example, data for acute and specialist trusts on a clinical focus relating to deaths within 30 days of heart bypass operations; emergency readmission to hospital following discharge; and thrombolysis treatment time. Those are clinical indicators against which acute and specialist trusts must, at present, indicate their performance. Alongside those are patient-focused indicators such as better hospital food, day case booking, cancelled operations and so forth.

The hon. Gentleman, therefore, knows that CHAI currently asks our acute and specialist trusts to collect data for a broad range of indicators, and that will undoubtedly continue. First and foremost, however, what to include must be up to CHAI, and I do not intend to prescribe that now. Furthermore, the Audit Commission may continue to publish data on financial management but it will not carry out comparative studies on the economy, efficiency and effectiveness of English bodies.

I hope that the hon. Member for Sutton and Cheam will withdraw those amendments.

Photo of Paul Burstow Paul Burstow Shadow Secretary of State for Health, Shadow Spokesperson (Health)

I have listened carefully to the Under-Secretary. The hon. Gentleman's point about independence was certainly well made, and I take it on board. In the context of earlier debates, it is an important issue. As the hon. Member for Epsom and Ewell said rightly, the amendments seek further clarification of the Government's intentions. Certainly, we are not in the business of asking CHAI to duplicate its activities or the activities of others.

Having listened to the Under-Secretary and to his reassurances, I beg to ask leave to withdraw the amendments.

Photo of Simon Burns Simon Burns Shadow Spokesperson (Health)

I am a little confused about this group of amendments. Is it right that the hon. Member for Sutton and Cheam seeks to withdraw amendments Nos. 417 and 418? I should have liked to hear an explanation of amendment No. 479, which is selected in that group.

There is no reference, explanation or discussion of how amendment No. 479 seeks to improve the Bill.

Photo of Peter Atkinson Peter Atkinson Conservative, Hexham

I am not sure whether the hon. Gentleman was making a speech, an intervention or a point of order.

Photo of Simon Burns Simon Burns Shadow Spokesperson (Health)

I think I was doing all three.

Photo of Peter Atkinson Peter Atkinson Conservative, Hexham

I allowed the hon. Gentleman to speak after the hon. Member for Sutton and Cheam had asked leave to withdraw the amendment. Technically, therefore, the amendment cannot be withdrawn and we must vote against it.

Amendment negatived.

Amendment made: No. 173, in

clause 50, page 17, line 37, leave out

'other than NHS foundation trusts'.—[Mr. Lammy.]

Clause 50, as amended, ordered to stand part of the Bill.