Performance of Private Hospitals (Hansard, 8 May 2002)

§ Mr. George Osborne (Tatton)

I beg to move, That leave be given to bring in a Bill to require private hospitals to publish independently audited information on clinical performance and on complaints from patients on the same basis as that required of NHS hospitals. A couple of weeks ago, I was at a children's tea party with my son when I started talking to Peter Touche, who was there with his twin sons, Charles and Alexander. The Bill is inspired by the tragic case of their mother, Laura Touche, who died three years ago of a brain haemorrhage after giving birth to the twins at the private Portland hospital in London.

In January this year, a jury inquest found that Laura had died of natural causes contributed to by neglect". The natural causes included high blood pressure, which led to the brain haemorrhage; the neglect referred to the fact that no basic medical checks were carried out by staff at the Portland hospital for two and a half hours after her caesarean operation. It was only when Laura herself alerted medical staff to the fact that she was feeling very unwell that anyone realised that something was wrong. She was rushed to a specialist NHS neurology hospital, but never recovered.

I know from my own son's recent birth at St. Mary's, Paddington, after caesarean section, that in the NHS a mother's blood pressure is checked regularly. It is checked every 15 minutes for the first hour after birth, every 30 minutes for the second hour, then hourly for the next three hours. In the country's leading private hospital, Laura's blood pressure was not checked at all. If that most basic of medical procedures had taken place, she may well have been alive today, and her children, Charles and Alexander, would have their mother.

But for the courage and determination of Laura's husband, Peter, the truth would never have been known. It has taken a three—year legal battle in the High Court and the Court of Appeal for the full story of Laura's neglect at the Portland hospital to emerge. It is sometimes said that individual cases make bad law, but Laura's death and her husband's struggle to uncover the truth reveal a more endemic culture of secrecy in many private hospitals, and it is that culture which my Bill seeks to attack.

Of course, cases of medical accidents and neglect sadly happen in all kinds of hospitals—NHS and private. One has only to look at the NHS's annual litigation bill to know that. It is often difficult for patients and their relations to get to the truth, regardless of where they are treated. A constituent of mine is still trying to find out what happened to the retained organs of her son, who died 30 years ago in an NHS hospital.

I hope that in the NHS at least, public scrutiny is at last prising open the closed, clam—like world of the medical profession, where few admit to a mistake and no one rats on a colleague. The inquiries at the Bristol royal infirmary in Alder Hey have certainly helped; so too has the requirement for NHS trusts to publish data on how they perform in relation to, for instance, waiting times, trolley waits, cancelled operations, hospital cleanliness, postoperative deaths and emergency readmissions.

156 As a member of the Public Accounts Committee, I have seen how the performance data—especially on such things as waiting lists—can be distorted and fiddled, often under intense political pressure. I hope that the new Commission for Healthcare Audit and Inspection will be sufficiently robust and independent to ensure that that no longer happens. Nevertheless, I am happy to commend the Government on the pressure that they have put on NHS trusts to be open about their performance. It must be good for patients and for taxpayers that NHS trusts find it more and more difficult to sweep their problems under the carpet.

With the Bill I want to extend that pressure to the private medical sector, where there are not the same incentives to be open and transparent. The website of the pressure group Action for the Proper Regulation of Private Hospitals, to whose work I pay tribute, is full of examples. The problem is more general, however. In evidence to the Select Committee on Health three years ago, the Independent Healthcare Association said: there is frequently an undue emphasis on hotel standards such as decor and not sufficient emphasis or expertise into inspecting standards of treatment and care". The Minister might say, if there were an opportunity to respond today, that a much stricter regulatory regime for private medical care has been introduced in the last month. That is undoubtedly true, and welcome. As of the beginning of April, all private hospitals are subject to new standards and to inspection by the National Care Standards Commission. They are now required, for example, to ensure that the risks of proposed treatment are fully explained to patients. They also have to have a proper complaints procedure, which would have helped in the Touche case.

However, there is still no requirement in the regulations for any private hospital to publish any data on its clinical performance. Unless the hospital volunteers the information, it is impossible to know how many deaths occur within 30 days of surgery or how many emergency readmissions take place, yet information of that kind is now freely available in the NHS. Although private hospitals now need to have a proper complaints procedure, there seems to be no requirement for them to publish complaints in the same detail. Other prospective patients therefore cannot judge the hospital's record for themselves.

My Bill deals with all those deficiencies in a straightforward way. It simply requires private hospitals to publish the same independently audited data on clinical performance that NHS hospitals now have to publish. It also requires private hospitals to publish, in the same detail, complaints from patients. I note in passing what officials have probably already told the Minister—that these requirements could be achieved through regulation under existing legislation—but sadly the option of a ten—minute rule regulation is not available to Back Benchers, so I am forced to propose primary legislation.

Most private hospitals have nothing to fear from being open and transparent. The staff who work in them do a great job, and many would actually welcome public recognition of the high standards of care that they offer. The Bill will, however, make life much more difficult for private hospitals with something to hide.

Some may ask why this is any business of Government. Does not private medicine mean exactly that—a private matter in which the state should not become involved? 157 But the state is already involved. More and more people are being forced to turn to private hospitals for their treatment. Last year, more than 1 million patients had surgery in the United Kingdom's 230 private acute hospitals, and the number continues to rise.

The state will become even more involved in the private medical sector, if the Secretary of State for Health is to be believed. Last week he announced that he was giving primary care trusts "full discretion" to commission care from

wherever it is best provided… from the public, private or voluntary sectors". He said: the provider of care is less important than the quality of care provided". I agree, but how can a primary care trust assess the best quality of care available, regardless of provider, if not all providers publish the same performance data?

If the Health Secretary means what he says about commissioning care from where it is best provided—I hope he does—that must also mean NHS patients routinely receiving treatment in private hospitals. Surely those patients have a right to know how those hospitals perform, just as they now know how NHS hospitals perform. Surely patients and primary care trusts have a right to be able to compare for themselves on the same terms the quality of care that is provided in two different hospitals. Surely the taxpayers have a right to see that their money is properly spent.

My Bill gives patients and taxpayers those rights and I commend it to the House.