Search tips
Search criteria 


Logo of bmjThis ArticleThe BMJ
BMJ. 2007 July 28; 335(7612): 173.
PMCID: PMC1934438

Failure to monitor independent centres prevents comparison, says watchdog

A “cock-up” by the UK government has impeded the ability of the Healthcare Commission to assess independent sector treatment centres (ISTCs), says the watchdog's chief executive, Anna Walker.

She says that a government oversight has impeded the commission's ability to assess the safety and quality of the centres.

The commission declared this week that the Department of Health had failed to ensure that the data collected on the controversial clinics were compatible with the data used to monitor the rest of the NHS.

The commission had aimed to review the first 23 centres, which were set up to carry out high volumes of straightforward elective surgery to cut NHS waiting lists. The commission interviewed 2000 patients, made inspections, and checked health records.

Ms Walker said that there were gaps, however, because “comparative data has not been systematically collected.

“Where independent providers serve NHS patients we must ensure we have the proper systems to provide reassurance about what is being provided,” she said.

“That is why we are calling for one system that allows comparable information to be published on all major healthcare providers, whether public or private, whether they are treating NHS patients or otherwise.”

Beginning in October, the Royal College of Surgeons will carry out its own study, funded by the Department of Health, to assess the success of operations carried out in the centres.

Bernard Ribeiro, president of the Royal College of Surgeons, said, “It is imperative that patients receive a sustained, safe, and [high] quality service, which is consistent across surgical providers. Data on the occurrence of complications and readmission still need to be confirmed, and this initiative will do that.”

None the less the government was criticised for failing to ensure that the Healthcare Commission was able to complete its review properly.

The BMA consultants committee said that it was “dismayed” to hear of the latest problems with collection of data.

Norman Lamb, Liberal Democrat spokesman on health, said, “This long delayed report begs more questions than it answers about standards in the centres.

“The NHS must be able to operate on a level playing field with these centres, but the government has no real idea of how they are performing.” And he added, “In some areas independent sector treatment centres have been foisted upon communities where they are not needed.”

The results of the Healthcare Commission's survey showed that patients were generally more positive about the treatment received in independent sector treatment centres than care provided by NHS hospitals. Ninety six per cent of such patients who were surveyed rated their overall care as “excellent” or “very good.”

Peter Walsh, chief executive of the campaigning group Action Against Medical Accidents, said that the Healthcare Commission had “skimmed over” areas of serious concern, particularly patient safety and the systems in place for tackling claims of malpractice.

He said, “The report seeks to reassure, but admits it does not have sufficient information about ISTCs. It is not clear whether clinical negligence claims data were even looked at. We find it surprising that the report skims over the . . . problems of flying in teams of doctors from overseas who do not necessarily meet the standards required of those trained in the UK [United Kingdom].”

Ben Bradshaw, health minister, said the report showed that the centres were “performing well in a number of areas,” and he said that the government would strive to ensure that data were standardised in the future.

Articles from The BMJ are provided here courtesy of BMJ Publishing Group