Examination of Witnesses (Questions 280
- 284)
THURSDAY 16 MARCH 2006
MS ANNA
WALKER, PROFESSOR
SIR GRAEME
CATTO AND
PROFESSOR PETER
RUBIN
Q280 Dr Stoate: I do not want to
stop you, but I am still not satisfied. The fact is that you are
doing something about it, you have got some of the information,
you are making some progress. It is so fundamental, I cannot believe
we are having this conversation. You should have access to all
the information, all of which should be available to those who
need it. As a GP, I have to decide which units patients should
be referred to and I have no information to go on. The fact that
you are working on it does not cut it.
Ms Walker: A message to us which
says: "This needs to be done and to be done as quickly as
it possibly can" I entirely understand. There are two issues
that make this more complex. This is not an excuse; it is an explanation.
One is this question of the publication of this information in
a genuinely understandable way and which takes account of differences
that you may have in case mix. That is actually really important
from the patient's point of view, because you do not want to frighten
a patient who does not need to be frightened, so you do have to
look at whether this information is properly adjusted.
Q281 Dr Stoate: That is fair enough.
I accept that.
Ms Walker: So these things do
take a bit of time. We have that. We have those discussions underway.
We have a programme planned for it. A message from you as a committee
which says: "This is important. Get on with it," we
would understand.
Q282 Dr Stoate: Do you ask for clinical
outcome data before you inspect NHS providers?
Ms Walker: No. We have a lot of
information available on the NHS. It does not tend always to be
systematic but, because there is a lot of information, we can
put in place and have in place systematic processes for looking
at it. That is different from whether it is publicly available.
So we are making a lot of use of information in the NHS and we
are moving to publishing more of that. One of the big questions
I know we are going to face about the publication of information
in the independent sector and ISTCs is: Is it systematically available
in the same way as the NHS?—and that is something else we
need to move forward.
Q283 Dr Taylor: When you inspect
an ISTC you obviously get a lot of data. We have been given this
morning, by the partnership health group which is Care UK, an
exemplary list of their readmission rates, their complications.
The only thing that is missing from that, when they do a comparison
with Nottingham City Hospital, is a statement of the different
difficulties of the operations, because independent sector treatment
centres only take the two lowest risks, I think. If you do these
inspections, do you automatically have that sort of list available?—which
seems to me everything you need to know about what is going on.
Ms Walker: I do not know whether
those who have gone into these particular ISTCs have had this
list or not, but they do have information available on which they
then carry out the check in relation to the standards and the
regulations. And, of course, we also have that information, which
is not systematically published, for the reasons I was explaining
earlier, about encouraging patient safety on serious untoward
incidents. So there is outcome information which is used for the
purposes of inspection.
Q284 Dr Taylor: And you have mentioned
the information gap to the public and obviously the time that
it takes to get the news out to the public that a particular place
perhaps is not as safe as others. What can you do to minimise
that?
Ms Walker: I think there are two
sorts of unsafe, if I may put it like that. I think where we need
to be is: a regular flow of public information, so that that is
always available to those who are taking a choice. Every so often,
you will have a more significant and serious problem. If it is
serious enough, then that information has to go into the public
domain as an emergency. On the whole, we do not get those, but
there is always the possibility that we will.
Chairman: Could I thank you all very
much indeed for this morning's, now this afternoon's, session.
I am sorry we have overrun by a few minutes. I think that is the
order of the day. We will have the report to you at some stage
in the future with the recommendations. Thank you.
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