HC Deb 28 July 1998 vol 317 cc153-5
3. Mr. Dennis Turner (Wolverhampton, South-East)

What representations he has received on general practitioners' rights to information about the clinical performance of their local hospital. [50978]

14. Mr. Paddy Tipping (Sherwood)

What representations he has received on access by (a) general practitioners and (b) patients to information about the clinical performance of their local hospitals. [50989]

15. Mr. Peter L. Pike (Burnley)

What plans he has to publish average clinical performance of hospitals by procedure. [50990]

The Secretary of State for Health (Mr. Frank Dobson)

A wide range of people, including general practitioners and members of the public, have expressed strong support for our proposals to give patients and GPs a clear right to know about how their local NHS hospital is performing. As a first step, we shall publish hospital-based indicators in the autumn.

Mr. Turner

Does my right hon. Friend agree that it is essential in the modern, dependable national health service that we are seeking to build that patients and GPs should have access to information about the performance of their local hospitals? Should not the right to know be our clarion call?

Mr. Dobson

Yes indeed, I entirely agree with my hon. Friend. It is crucial that the information provided to GPs and local people is accurate, comparing like with like. Providing misleading information would be harmful not just to the hospital and the profession, but to the GPs and patients.

Mr. Tipping

Is it not the case that knowledge and information are power? Extending information to patients empowers them. That must be right, because they not only use the health service, but pay for it.

Mr. Dobson

It is certainly right in principle. People want, and are entitled, to know whether their hospital is performing up to national standards. People do not want to go shopping around and travel long distances for treatment, but they want to be assured that their local hospital is up to scratch. The information will help them.

Mr. Pike

Does my right hon. Friend agree that it is important that, when the information is published, on a hospital-by-hospital basis, improvements are made where there has been shown to be room for them? What role does he see for the Commission for Health Improvement in ensuring such improvements in the interests of patients and GPs?

Mr. Dobson

The crucial point is that local management and local doctors should know how their performance compares with national standards. If they are not up to the national standards, they should take steps to ensure that they get up to standard. The Commission for Health Improvement, while not quite a long stop, would not be the first organisation to be involved if the local management and local doctors were seen not to be responding to the information that had been made available. Until now, most of the information has not been available, even to the hospital trust boards.

Mrs. Virginia Bottomley (South-West Surrey)

I endorse a sensitive approach to providing information on clinical outcomes, especially considering the fact that some of the waiting list targets have been such a fiasco for the Government. What steps will the right hon. Gentleman take to reassure the research community, already affronted by the gratuitous cut in its budget, that a clumsy approach to naming and shaming, and hospital league tables, will not result in defensive medicine, a reluctance to take on difficult cases, and a stifling of innovation altogether?

Mr. Dobson

I shall ignore most of the right hon. Lady's preliminary remarks. On the sensible point that she made about trying to ensure that we do not stifle innovation, it is true that if someone tries a surgical procedure for the first time there will be no standard for it, and it will be a riskier form of treatment than procedures that have been frequently carried out.

I can safely say that at almost every meeting that I have had with doctors on that subject I have tried to emphasise that we do not want rules and standards to be laid down in such a way as to inhibit necessary developments. After all, not long ago the only place in Britain where one could have a hip joint replacement was where John Charnley worked, at the Wrightington hospital in Wigan—

Mr. Lindsay Hoyle (Chorley)

In Lancashire.

Mr. Dobson

Yes, in Lancashire; I apologise. 1 must admit that, as a Yorkshireman, I always did think that Wigan was in Lancashire; it always seemed to be there when it played against Yorkshire rugby league clubs.

Similarly, 20 years ago, Oldham—I know that technically, that is part of Greater Manchester, but at one time it, too, was in Lancashire—was the only place in the world where one could have a test tube baby. We must ensure that any new rules that we lay down do not inhibit wonderful developments such as those that took place at Wrightington and at Oldham general hospital.

Mr. Simon Hughes (Southwark, North and Bermondsey)

At the end of last week there were reports that the use of human albumin for transfusions may not be safe, and today there has been another report that the cervical cancer screening carried out by a London hospital has not been entirely safe. Given that last October Ministers said that we must have a national system of quality assurance for cancer screening, and that in December the Secretary of State announced the need for a Commission for Health Improvement to ensure that the whole country has the highest quality standards, can the Secretary of State today assure women in particular, but also all general practitioners and patients, that we will not have to wait any longer for a national system to ensure that transfusions, screening and all other services are of the highest clinical standard everywhere?

Mr. Dobson

As the hon. Gentleman knows, we are trying—carefully, so as to carry the professions with us, because if we do not, no new system will work—to put in place measures to ensure that standards are maintained. As for his reference to the use of albumin, I can only describe the article in The Observer as a grotesque travesty of the situation. The information was supplied to the Chief Medical Officer; the Chief Medical Officer asked the people who prepared it, after consultation within the Department, to send it to the Medicines Control Agency; the agency considered it; the Committee on Safety of Medicines was informed and also considered it. As long ago as 28 May, the committee concluded that it did not consider that withdrawal of human albumin products was warranted, and advised that an expert working group be set up. That group has met, and decided that withdrawal of human albumin products was not warranted. As Secretary of State for Health, I have to consider carefully the advice of those who have been put in a position to give me advice on such matters; I do not have to respond to hysterical articles by ill-informed journalists in badly edited Sunday newspapers.

Rev. Martin Smyth (Belfast, South)

The Secretary of State will be reassured by the fact that I support what he says at that level, not only about medical advice but about other advice. May I press him to tell us whether, when he deals with the procedures, information will be circulated to general practitioners about new procedures, so that they can guide their patients to places where those are being carried out? May I also express the hope that the statistics will major not on mortality figures, but on successful procedures—and not only clinical procedures, because many other procedures are vital for good health?

Mr. Dobson

I accept the hon. Gentleman's point. Mortality statistics are fairly straightforward, but statistics showing how well people do after an operation—if they have survived—are more difficult to calculate, evaluate and log in any system. We are going to enormous lengths to ensure that our proposals command the support of the profession; indeed, the first figures that we shall be publishing in the autumn command the support of those who are carrying out operations. If we could not carry them with us, the proposal would be absurd.

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