Health Bill [HL]

My Lords, Amendment 19, tabled by the noble Earl, Lord Howe, seeks to give the CQC a role in the data collection and analysis that go into preparing quality accounts. As I said in Grand Committee, I share the noble Earl’s view that data used in the preparation of quality accounts should be of the highest standards. The question is how to reach that stage of the highest quality of data. That is where we differ. I believe that the only way in which we will improve the quality of our data is to have clinicians taking ownership of the data that they provide and a clear framework of safety, effectiveness and patient experience. I assure noble Lords that one of the most gratifying things about High Quality Care for All is that it captures what drives clinicians. Quality is the organising principle of the NHS. We are introducing the process of clinicians taking ownership of the data and publicly reporting them following engagement with the clinical community across the country. The pride of any clinician is to publicly report the data on the care that they provide. I sympathise with the noble Baroness in relation to some of the challenges that measuring and collecting these data may bring. We are strongly encouraging the NHS to appoint further staff to help in the collection of these data and to improve the coding of many procedures and episodes of care that are provided through the NHS. I also believe that we need analytical power, epidemiological support and statistical competencies in the NHS. That is why we will be announcing the creation of 10 quality observatories in the 10 strategic health authorities. The function of these quality observatories will be to collect and analyse these data and, more importantly, to give them weighting against age, social deprivation and the disease entity. The data in themselves need to be refined and analysed before they become useful. The purpose of collecting these data is to empower clinicians to use the measures against the standards in constantly engaging in quality improvement. That is what drives clinicians; that is the movement that we are trying to create on the back of that. The noble Earl mentioned the north-west. He is right that the north-west has started a process of improving the quality of its data by working with external stakeholders. I believe that it has the best data collection system in the country. However, it did that by engaging its clinicians, who took ownership of the data. I suggest to the noble Earl that the NHS collects more data than any other healthcare system, but it does not have ownership of it. That is what will improve the quality. The regulator is not the person to do that, but the clinicians—those who are involved in care. That comes back to the second point raised by the noble Earl in his amendment, on the quality assurance of the data. As I have suggested previously, I strongly believe that commissioners, patient representatives and local communities could and should challenge organisations on the quality of data. The noble Earl also referred to the Audit Commission, which said that commissioners have a strong role in ensuring quality assurance. I will also support that way of ensuring that those who commission the services will, based on the information from the providers, constantly appraise and encourage them to seek that external validation; that is their job, rather than the job of the regulator in the form of the CQC. When the noble Baroness, Lady Young, was concerned about this in Grand Committee, I sympathised with her because the regulator, who is independent, is there to ensure that core standards of care are maintained rather than to assure the data quality. I believe that the commissioners should probably be playing a greater role in that. The noble Earl and I agree on the principles of improving data quality and I hope that I have reassured him that we have policies in which we can, at least, engage clinicians and provide them with the tools to make that happen. I hope that he will, therefore, be able to withdraw his amendment.