Open Public Services White Paper

Lord Patel Excerpts

Monday 11th July 2011 Lords Chamber

[Baroness Verma]

The noble Lord raises a number of interesting points. I did say that we are building on what the previous Government were doing. We are trying to make it a build-on that will be a bit more directed and focused on what the outcomes are going to be. I think that we are still in that mode of debating. It is important that we debate and discuss the best possible ways of delivering. These conversations do not stop just because a paper is produced. Consultation is an ongoing process, but it is also very important that we do not become so blinkered that we decide that the White Paper is not going to deliver anything. The White Paper is already able to deliver a lot, because we are building on what was already in place.

The structures will, of course, have areas that we will need to fine-tune and to look at how things can be made much tighter, but the Government are making sure that we have continuity plans and safety nets in place so that we can ensure that, when people make those choices, they are not left without support mechanisms. That is why we want to encourage champions to come forward through organisations such as Which? or HealthWatch and also make sure that there are ombudsmen for each sector, so that everyone knows that there is a line of recourse if they face difficulties.

[Lord Patel]

My Lords, on the face of it, allowing patients a choice as to where they wish their care to be delivered seems a good idea, except that there are several problems. One is the quality of information we have: if that choice is to be based on outcomes, it is pretty poor.

The second is that the outcome is not based on one treatment: it is the quality of the journey of care of a patient that delivers the best outcome. For instance, poor outcomes in cancer may well be, and are, related to late referrals of cancer patients. How does a patient know what quality of information they will be given that will allow them to make a choice as to how they wish their care to be provided, based on these outcomes?

Another issue is that the best quality might be far away from where the patient can go or have access to. So how would they make that choice? Most importantly, if we are going to do this—and the idea seems good—it should be based on what we have learned from pilots. Have there been any pilots done that will tell us how this will work?