HC Deb 30 June 1998 vol 315 cc133-4
3. Dr. Desmond Turner (Brighton, Kemptown)

What action he is taking to improve patients' access to information about local hospitals' clinical performance. [46603]

15. Fiona Mactaggart (Slough)

What action he is taking to improve patients' access to information about local hospitals' clinical performance. [46615]

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

We want to develop a system that will provide general practitioners and their patients with access to fair and accurate indications of clinical performance in their local hospitals. As a first step, we shall publish later this year a number of hospital-based clinical indicators on deaths and complications covering a range of operations.

Dr. Turner

Is not the public availability of meaningful information on clinical outcomes an absolute prerequisite for achieving the universally high standards of clinical performance that the Government want? Moreover, had we had such data in the public purview before now, we might have detected sooner such unfortunate occurrences as the poor surgical performance on babies in Bristol or the appalling record of hip replacements. Does my right hon. Friend agree that the data can be of vital help in transforming the health service?

Mr. Dobson

It is certainly our wish that the various arrangements that we are making to set quality standards and make sure that they are met will avoid awful occurrences such as the deaths of babies who had heart operations in Bristol, the cervical cancer screening failures in Kent and Canterbury and the breast cancer screening failures in Devon and Exeter. To do that, it will be necessary for the people who are conducting the operations and the hospital management to have data available to them, and we believe that it should be made available also to local general practitioners and patients.

Fiona Mactaggart

I congratulate my right hon. Friend on using the opportunity of the 50th anniversary of the NHS to end the cloak of professional secrecy that has kept patients in the dark about the results of treatments. However, I urge him to think carefully about how he presents the information. There are areas of clinical practice where information is publicly available—for example, for in vitro fertilisation and other fertility treatments. Those tables can be misleading because clinics that use the most adventurous treatments or treat older women seem to have less successful results than those that use basic treatments, treat conservatively or treat young women. I urge my right hon. Friend, in publishing this information—which I welcome enormously—to think about the quality of information to patients, so that they can understand it as well as possible.

Mr. Dobson

It is certainly the case that we are trying to make sure that any information that is published commands the support of the professionals involved. As I said in my first answer, that means making sure that the information is both fair and accurate.

I have said in the House before, and I will say again, that Great Ormond Street hospital for sick children is in my constituency. The surgeons there frequently perform extremely difficult and complex operations on children who have already undergone operations in other hospitals. Sadly, the children often die, despite the efforts of the doctors, nurses and other staff at Great Ormond Street.

We certainly need to have in place a system that reflects the complexity of operations and the state of health of the patients. I am determined to have statistics that properly reflect all the circumstances; without them, no one, least of all the patients who would otherwise be misled, will benefit.

Mrs. Jacqui Lait (Beckenham)

Is not one of the most useful techniques to determine clinical excellence Health Services Accreditation? Can the Secretary of State assure me that its disposal will be carried out to the highest possible standards, that no undue influence will be exerted on such disposals, and that those involved in the process who may have a conflict of interest will be invited to withdraw and fall silent?

Mr. Dobson

The process of accreditation of a group of doctors or an institution necessarily involves judgments by other doctors. There is no way people without the necessary professional expertise can judge other people's professional expertise. From time to time, there may appear to be conflicts of interest because of connections within the medical and other professions. We shall try to avoid that—but we cannot get away from the fact that the only people capable of judging professional competence are other members of the same profession. We do need outside influence, but in the end there is no point in getting someone who is not a liver transplant expert to judge the skill of another liver transplant expert.

Dr. Evan Harris (Oxford, West and Abingdon)

Does the Secretary of State accept that the inquiry into the Bristol scandal may find that the problem was not to do with the publication of data but rather to do with the failure to act on data known to the professionals? Given the way that the media may report such data, is there not a danger of repeating the second-generation pill scare? Information wrongly portrayed in that case led to greater inefficiency, poorer health, and a greater number of unwanted pregnancies and abortions.

Finally, does the right hon. Gentleman agree that there may be an increased use of palliation instead of operations; and that clinical judgments may be distorted in an attempt by surgeons to avoid appearing low down league tables when dealing with difficult, possibly terminal cases?

Mr. Dobson

I am not quite sure from that whether the Liberal party is for or against the publication of this information. I thought that I had made it clear that we want the statistics published to show the nature and complexity of the operations and the general state of health of the patients. As far as I know, that commands the support of the representatives of the medical, nursing and midwifery professions; providing that we act in this way, none of the problems to which the hon. Gentleman refers should arise. Meanwhile, someone in the Liberal party needs to make it clear whether it believes in keeping the information secret or making it public.