NHS watchdog more reliable, says minister

The Government defended the NHS regulator today after a report found a raft of underperforming hospitals and consistently high death rates.

Health Minister Mike O'Brien said work by the Care Quality Commission (CQC) was more reliable and broader in scope than a league table compiled by Dr Foster Intelligence into hospitals' performance.

He insisted in an interview with GMTV that, although there was "still a lot of work" to be done, the NHS was a "lot better than it has ever been".

"What the Care Quality Commission does is that it actually goes in and it inspects any hospitals it has concerns about, so if there is a statistical issue which they are concerned about they can go in and inspect it," he said.

"They have done that with a number of hospitals; they have identified Basildon for example, which is where help has had to go in to look after the management of that hospital and improve it, because they have inspected it.

"Dr Foster just looks at the statistics and it derives conclusions from the statistics. If you are looking at who do you rely on, it is the Care Quality Commission."

Mr O'Brien was speaking as the CQC was accused of being "toothless" after the report by Dr Foster Intelligence rated a dozen hospitals as "significantly underperforming", despite nine of them being rated good or excellent by official regulator the CQC.

Seven hospitals were also found to have considerably higher mortality rates for the past five years.

Bottom of Dr Fosters' league table was Basildon and Thurrock University Hospitals NHS Foundation Trust, which last week had an emergency task force ordered in to improve standards.

The CQC insisted there was no need for similar interventions elsewhere and branded some of the Dr Foster data "flaky".

But Katherine Murphy, director of the Patients Association, said: "It's clear that we are dealing with a toothless regulator.

"What confidence can we have in a system that claims hospitals are excellent or good when in fact they are consistently underperforming?

"The public will be so confused because there is so much conflicting information."

The CQC said comparison of the Dr Foster figures and its own assessments were "spurious" as they measured different things and employed different methodology.

It said its annual check was "the most comprehensive assessment of the NHS ever undertaken", involving a declaration by each trust as to whether they were meeting 44 standards.

Dr Foster's latest Hospital Guide identified 27 trusts with unusually high mortality rates - totalling 5,000 more deaths than expected last year.

Seven showed the trend over the past five years - with the Basildon and Thurrock Trust currently ranked worst with a death rate 31 per cent higher over the past year than the national average.

The other six hospitals with consistently high death rates identified in the report were Royal Bolton Hospital NHS Foundation Trust (22 per cent higher than average); Tameside Hospital NHS Foundation Trust (19 per cent); Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust (15 per cent); Kettering General Hospital NHS Foundation Trust (12 per cent); University Hospitals Coventry and Warwickshire NHS Trust (12 per cent); and Pennine Acute Hospitals NHS Trust (10 per cent).

Dr Foster's research also uncovered widespread safety issues, including 39 per cent of trusts "failing to investigate unexpected deaths or cases of serious harm on their wards".

Items such as swabs and drill bits were left inside patients after surgery in at least 209 cases and surgeons operated on the wrong part of a body at least 82 times.

A total of 478 operations were also cancelled in 2008/09 because patient notes were missing.

And 848 of 5,024 people who died after being admitted for "low-risk" conditions were under 65.

The other trusts whose overall performance was ranked lowest by Dr Foster were University Hospitals Coventry and Warwickshire; Weston Area Health Trust; South London Healthcare Trust; Tameside Hospital Foundation Trust; University Hospital of South Manchester; St Helens and Knowsley Hospitals Trust; Mid Yorkshire Hospitals Trust; Blackpool, Fylde and Wyre Hospitals Foundation Trust; and Hereford Hospitals Trust. The 12 are completed by Basildon and Thurrock; Lewisham; and Scarborough and North East Yorkshire.

Of these, St Helens and Knowsley was rated excellent by the CQC and three others - Mid Yorkshire, Weston, and Scarborough and North East Yorkshire - were rated fair.

Chief executive Cynthia Bower said: "Both Dr Foster's and our assessment show the NHS is improving. But there are clearly areas in which the NHS needs to take action.

"The 12 trusts identified by Dr Foster as 'underperforming' must look very closely at this information. We will be checking to ensure they address safety issues.

"We are continuously monitoring all trusts and regularly demand action on aspects of care.

"But I want to be clear that we are not currently seeing the wider systemic failings of the kind we found at Basildon in any other trust.

"People should be clear that things can change and we may have to take action in future. We won't hesitate to do this, just as we didn't hesitate in the case of Basildon."

Shadow health secretary Andrew Lansley said: "Gordon Brown promised that he would have a 'deep clean' and that all NHS hospitals would be clean and safe. He has failed.

"Labour said that their new inspection regime would keep NHS patients safe. It is now clear that regime is fatally flawed."

Several trusts among the named and shamed have accused Dr Foster of using incomplete figures which failed to show the true picture.

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