Health Bill [HL]

That may have been Aneurin Bevan’s vision when he said that the echo of a bedpan falling in Wales would be heard in Whitehall. I see the NHS having that accountability at a local level in years to come. I sympathise with what has been said. I can even go further and say what is happening, certainly with some of the suggestions from another regulator, Monitor, about developing the service line reporting to get that information-based service. The noble Lord could get that information on orthopaedics and figure out where the orthopaedic wards are rather than basing it on wards. We want to measure services. The experience, effectiveness and safety should be around either a disease entity or a speciality interest. That has been successful in certain lines; for example, in cardiovascular mortality rates with the transparency of reporting of mortality following coronary artery bypass graft. We have seen that before. Amendments 33 and 36, tabled by the noble Earl, Lord Howe, and the noble Baroness, Lady Cumberlege, appear to open up the scope of quality accounts to include any information that can be published. I appreciate that the noble Earl wishes to see NHS healthcare providers given as wide a latitude as possible in drawing up the accounts—I share that aim—but my slight concern as we try to focus on quality is, for example, that we do not want financial accounts to be part of quality accounts. I would like to keep them within the framework of safety, effectiveness and patient experience.