§ 8. Bob Russell (Colchester) (LD)
How many acute hospital trusts have three stars; and how many trusts have lost this status since it was introduced. 
§ The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman)
In 2003mdash;04, 74 acute NHS trusts received three stars, compared with 35 in 2000–01. That demonstrates that overall trust performance has improved. Twenty trusts lost their three-star status in the most recent year's figures.
§ Bob Russell
Does the Minister agree that the star system is misleading the public and is grossly insulting to medical and support staff in those trusts that have gone from three stars to two stars and then to one star, given that their work rate has not diminished? The staff are working their socks off, but for other reasons such as the way in which the accounts are done or the privatised cleaning services, the star rating has been dragged down. On the clinical focus measure, one-star Colchester comes ahead of two-star Ipswich, two-star Chelmsford and three-star Southend. Given the choice, where would the Minister prefer to go and which of those hospitals provides the best clinical focus for patients?
§ Dr. Ladyman
The hon. Gentleman completely misunderstands the purpose of the star-rating system. It is, first and foremost, a tool to help management improve the overall standard of the hospital. Secondly, it is a tool to ensure that local people understand in a simple way what is happening in their local trust. He says that financial management and accounting are unimportant. Does not he realise that every £1 wasted means less treatment for his constituents? Every £100 or £1,000 that is not spent properly means delays to someone's operation. That is why financial stringency is important in the ratings system.
§ Mr. Kevin Barron (Rother Valley) (Lab)
Does my hon. Friend agree that both attaining and retaining three-star status is a challenge for everybody working in the national health service? Will he congratulate both my local hospital, Rotherham general hospital, which for the third year running has retained three-star status, and the primary care trust, which has attained it for the first time? Does he agree that hard work locally and increased funding nationally is improving health care and the health of the people of Rotherham and the surrounding area?
§ Dr. Ladyman
I entirely agree with my right hon. Friend. As he says, attaining and keeping three-star status is difficult, and it is doubly difficult because, of course, we make the standards higher every year. The fact that the hospital had three stars last year and this year means that it is continuing to improve and my right hon. Friend should be proud of, and congratulate, all the people in the NHS who have contributed to that, as well as the Government for the funding that made it possible.
§ Mrs. Patsy Calton (Cheadle) (LD)
What warning did the Department of Health give hospitals seeking foundation trust status that they would not receive the 1118 £1 million achievement award under the capital bonus scheme for maintaining three-star status if they were successful in achieving foundation status? I hope that, as a reasonable Minister, he will reconsider that decision, given that it is causing particular problems for hospitals that had expected to receive that £1 million bonus.
§ Dr. Ladyman
The Minister of State, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), who deals with those matters, takes a sympathetic attitude and he assures me that such hospitals are receiving the £1 million.
§ Mr. Bob Blizzard (Waveney) (Lab)
Will my hon. Friend look closely at the fine detail of the process for assessing performance for star status? My local hospital, the James Paget Healthcare NHS Trust, was a three-star hospital and worked out that this year, if in a particular month it had carried out fewer operations, it would have retained its three-star status. Does he agree that we should not have a system in which through some bizarre quirk a hospital can lose a star because it did more work?
§ Dr. Ladyman
I can give my hon. Friend the assurance that he seeks. The Commission for Healthcare Audit and Inspection—a body completely independent of Government—is responsible for both devising the mechanism for inspection in the star-rating system and carrying it out. The commission is reviewing the inspection process to ensure that some of the anomalies are removed and that there is richer and broader representation of issues about which the public have every right to know—a right that the Conservatives would take away from them.
§ Mr. John Baron (Billericay) (Con)
With regard to the Minister's answer to a previous question, he should at least accept that public confidence in the star-rating system is very low, with recent research by the Consumers Association showing that 50 per cent. of patients would not use star ratings to help them choose a hospital. Is that any wonder when star ratings tell a person whether their local hospital has long waiting lists but not about the waiting list for their particular condition and when star ratings unfairly tar all departments, whether good or bad, with the same brush? Will he recognise that stars may be a good way of measuring hotels but not complex organisations such as hospitals and will he stop fiddling with the system? Will he scrap it and replace it with clinical standards and better information, which would be far more useful to the patients?
§ Dr. Ladyman
I wonder how members of the public would know anything about their local hospital if we implemented a policy that took that information away from them. Of course, the Consumers Association found that a significant proportion of people would not rely only on the star-rating system to judge their local hospital; I would not either and nor would my hon. Friends. We all make judgments based on a mix of information, including local experience, family referrals, the views of local staff and the star-rating 1119 system, but at least the star-rating system gives a basis for people to make sensible decisions and obtain objective information.
§ Mr. Harry Barnes (North-East Derbyshire) (Lab)
In determining star status, how much weight is given to whether a dedicated stroke unit has been established in a trust? Unfortunately, the Chesterfield and North Derbyshire Royal Hospital NHS Trust has not yet established such a unit, so what action is being taken to assist, encourage and press trusts to set up such essential units?
§ Dr. Ladyman
First, I can tell my hon. Friend that an indicator on stroke care is part of the clinical focus score card used in assessing star ratings. Every acute trust ought to have a dedicated stroke unit. That is one of the priorities that we set under the national service framework for older people. I am sorry to hear that his local trust has not yet achieved that, but I assure him that it should be working to achieve it as soon as possible and I will certainly do everything that I can to encourage it to fulfil that objective.