Health Bill [HL]

The noble Baroness, Lady Barker, has made a very sensible proposition, that the introduction of the quality accounts be reviewed to assess its impact on various sectors of society, including some geographical issues. We thought very hard about the issue of publishing to Parliament. It is not in the Bill, but we have made a commitment that the National Quality Board will publish what we call a set of indicators at a national level—these are not the quality accounts but they will be built through the quality accounts—that will look at the progress of the NHS on a year-by-year basis. It is an opportunity that we have missed in the health service over the past decade in the investment that has been made. We may know, for example, that we are meeting certain targets, such as the four-hour wait or 18 weeks, but do not forget that that has had tremendous outcome improvements. The example that I gave earlier of a 48 per cent reduction in mortality rates following cardiovascular disease is something that the NHS should be proud of. Parliament should be reassured that £100 billion of taxpayers’ money is invested in a service that is constantly improving. It is our intention to publish a report annually to Parliament, and it is also our intention to identify a set of indicators that compare us with some neighbouring European countries. It is important that we measure like for like, because they have different funding systems and other things. I hope that I have reassured the noble Baroness that we will be doing that. I agree that we need to risk-stratify this information and data, because the health of the population will have an impact on the outcomes of their healthcare systems. That is one of the functionalities of the quality observatories. As for the wider assessment of this policy, the impact assessment exercise that was published alongside the Bill states that there will be a formal academic evaluation of the policy after it has been running for three years. It will assess the full effects of the policy, including the impacts on each of the six equality groups enabling any negative or unintended consequences to be addressed in the future. If a negative impact becomes apparent ahead of the evaluation, the department will take action to address that point. I am grateful to the noble Baroness for reinforcing this point and probing me to clarify the different reports and where we intend this information to lead us. I hope she will be able to withdraw the amendment.