Leading article: A healthy increase in transparency

Saturday 28 November 2009 01:00 GMT
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This is proving to be an annus horribilis for the NHS. First Stafford, then Basildon, now Colchester – all elite foundation hospitals found to be failing and putting patients at risk, costing hundreds of lives. The negative headlines that had dramatically diminished during the golden years of Labour's NHS spending bonanza are back: "Failing hospital", "shocking death toll", "wards of shame".

Yet if one thing has changed in the past decade it is that the NHS now has a much tougher regulatory regime. How could care fail so disastrously when hospitals are subject today, as they were not in the past, to a battery of regular checks and inspections? The Tories and the Patients Association have chosen the easy target of the "tick box culture", and blamed regulators such as the Care Quality Commission and Monitor for providing a misleading picture of true performance.

There is, indeed, much wrong with the current performance measures, as the example of Basildon, rated "good" on its quality of care in October and slated for killing hundreds of patients in November, showed. They are too bureaucratic and not up to date. But that is a reason to refine them, not abandon them.

Some information is better than none. It is only because the regulators are out there, monitoring what is going on, that we have any idea what is happening in the NHS. In the case of the Stafford, Basildon and Colchester hospitals, it was the regulators who sounded the alarm and ordered remedial action – no one else. Without them, those trusts might have been allowed to stumble along for years, their appalling care and high death rates unremarked.

One of the greatest advances in the NHS over the past decade has been the increase in transparency. Doctors and hospitals used to bury their mistakes; now their mistakes are exposed for all to see. That is uncomfortable, and it means that the NHS may appear worse than it is because we are seeing its shortcomings for the first time.

The quickest way to improve the measures of performance is to expose them to public scrutiny and take the inevitable criticism on the chin. There should be only one way forward for the regulators: be damned – and continue to publish.

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