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MPs criticise distortion of priorities at key health care regulator

Following its annual review of the work of the Care Quality Commission (CQC), the Commons Health Committee yesterday reported that the bias of the work in the CQC away from its core function of inspection and towards the essentially administrative task of registration, represents a significant distortion of priorities  

Launching the report Rt Hon Stephen Dorrell MP, Chair of the committee said:

"The committee has decided to undertake an annual review of each  major health regulator.

In its review of the CQC, the committee concluded that the organisation's priorities became distorted by a statutory deadline for the registration of dentists and that this distortion led directly to a drop of 70% in inspection activity during the second half of 2010-11 compared with the same period in the previous year.

The primary causes of this distortion, which resulted in increased risk to patients, were the unrealistic statutory obligations imposed on the CQC."

Findings

The committee reports that:

• The CQC was established without sufficiently clear and realistic definition of its priorities and objectives
• The timescales and resource implications of the functions of the CQC were not properly analysed
• The registration process itself was not properly tested and proven before it was rolled out
• The CQC failed to draw the implications of these failures adequately to the attention of ministers, Parliament and the public.

In the light of these findings, the committee welcomes the government's decision to postpone registration of GP practices, and recommends that proper planning, including piloting of the model for registration, should be undertaken before the revised date of April 2013 is confirmed.

Inspection activity

The committee also reviews the inspection activity of the Care Quality Commission. It welcomes recent announcements that the CQC intends to undertake annual visits of all NHS and social care providers.

It goes on to stress the importance of the role of inspectors in assessing the culture in care providers:

• In its recent reports on the work of the GMC and the NMC the committee emphasised the importance it attaches to the obligation which rests on all healthcare professionals to raise concerns if they recognize, or ought to have recognized, evidence of failure of professional standards. The committee believes it should be a key objective of CQC inspections to ensure that each provider organization recognizes and respect this professional obligation and provides proper security to those professional staff who discharge it effectively.

Commenting on this recommendation, Mr Dorrell said:

"This is an absolutely key finding. CQC inspectors cannot hope to uncover every failure of care; they can and should, however, focus on the culture of the organization to ensure that professionalism is respected and that the proper systems of reporting and accountability operate effectively.

We are often asked what assurance can be given to whistleblowers. The best answer is to secure an open culture in which the professional obligation to raise concerns is embedded and respected.

That is what CQC inspectors should be looking for – and why their inspection activity is so important to patients".

Further Information 

• About Parliament: Select Committees