§ 1. Dr. Brian Iddon (Bolton, South-East)If he will make a statement about the hospital star ratings. [19655]
§ The Secretary of State for Health (Mr. Alan Milburn)Performance ratings for acute hospital national health service trusts were published on 25 September. This is the first time that hospital trusts have been publicly classified according to their performance, with more freedom and rewards for the best performers and more help for the poorest.
§ Dr. IddonI thank my right hon. Friend for that answer, but will the same performance rating criteria, especially the nine key criteria, be used to assess hospitals in the current year as were used in the first exercise? Will they be modified in view of the lessons that we have learned from it?
§ Mr. MilburnI expect some modification in the criteria. As my hon. Friend knows, it is the first year that they were used and that each hospital's performance was assessed. As we have said, the criteria and the star ratings are far from perfect. However, it is important for patients to know how well their hospitals are performing. After all, they belong to the patients and no one else.
As my hon. Friend knows, the House is considering a measure that proposes that the Commission for Health Improvement rather than the Department should publish the star ratings and, I hope, provide proper, objective and independent assessments of performance in all parts of the NHS.
§ Mr. David Amess (Southend, West)How can the Secretary of State justify a crackpot scheme under which one hospital received a zero rating but came top in clinical services? Will he explain to my constituents how giving Southend hospital a one-star rating helps the recruitment and retention crisis? This rotten Government are to blame for the state of the health service.
§ Mr. MilburnSometimes I wish that the hon. Gentleman was more straightforward in expressing his views.
696 The sense that no one in authority—in government or elsewhere—cared about hospitals that received a lower star rating or was prepared to do anything about it would be the most demoralising thing for staff at Southend hospital or any other hospital that got such a rating. The point of assessing performance and taking action on it is to try to get incentives right so that the good performers have more freedom and the poor performers receive help, support and, when necessary, intervention to enable them to improve.
§ Hugh Bayley (City of York)Does my right hon. Friend agree that if we want to improve clinical practice, it is as important to have information on the clinical outcomes of individual doctors as on individual hospitals? Will he consider the feasibility of publishing information so that the public know which doctors achieve the best outcomes?
§ Mr. MilburnIt is important for the public to have as much information as possible about the performance of organisations and clinical teams in the NHS. As my hon. Friend knows, the medical profession has moved a great deal on that in recent years. For example, I met the Society of Cardiothoracic Surgeons of Great Britain and Ireland before the Bristol statement. It has done impeccable work in considering the performance of individual clinical teams. I hope that, in time, and provided that it has clinical credibility, we can publish more and more information about not only organisational performance but clinical outcomes. In the end, we must all answer a simple question: does the patient have a right to know how well the clinical team, doctor and hospital are performing? The answer must be yes.
§ Dr. Richard Taylor (Wyre Forest)Does the Secretary of State agree with one of the conclusions of the Whipps Cross inquiry report, that, to comply with hospital ratings,
The imperative to avoid a 12-hour wait for a bed is an over-riding driver behind bed management to the detriment of good clinical care"?
§ Mr. MilburnNo, I do not agree. The hon. Gentleman knows from his constituency experience that one of the greatest anxieties about the NHS is not so much the quality of treatment when patients get to hospital, or even to the general practitioner's surgery, but the wait to get there. Waiting is detrimental to patient and public confidence. It is right to continue to decrease waiting times as we improve quality. If the hon. Gentleman considers the star ratings, he will find a variety of measures that consider matters from the patient's perspective and assess the standards of care. It is important that we always get the balance right.
§ Tim Loughton (East Worthing and Shoreham)Is the Secretary of State happy with a ratings system under which one hospital bumped up its star rating for waiting times by keeping patients waiting in ambulances outside rather than on trolleys inside, and another earned zero stars but received a glowing report from the Commission for Health Improvement? Is this not merely another gimmick to allow the Secretary of State to shift the finger of blame away from the Department? In any case, what real choice does the scheme create for patients whose 697 local hospitals have received zero stars? What does it give them besides the knowledge that they are now officially forced to attend a failing hospital?
§ Mr. MilburnIf I may say so, the Opposition always urge on us greater devolution to front-line services. That is where the responsibility should lie. Quite rightly, it should be for local managers, doctors and nurses to make the decisions. For the first time, the star ratings show that the national health service is a less monolithic organisation than it used to be. As every patient and member of staff knows, the NHS—an enormous and complex organisation—is characterised by some outstandingly good performance and, sadly, by some rather poorer performance. It is about time that we came clean to patients about where the performance is good, poor or indifferent. I should have thought that the hon. Gentleman would be persuaded of the case for more openness and devolution.