By Vivienne Russell | 30 March 2011
The Care Quality Commission is ‘struggling’, not up to the challenges it has been set and has lost the confidence of the public, MPs have warned.
In a strongly worded and wide-ranging critique, the Public Accounts Committee today said it had ‘serious concerns’ about the governance, leadership and culture at the watchdog. Despite having less money and more responsibilities than its predecessor bodies, it had failed to spend its budget because of delays in filling staff vacancies.
The PAC’s report cast doubts on whether the CQC would be able to achieve one of its main tasks for next year: the registration and assessment of 10,000 GP practices. The regulator risked becoming little more than a ‘post box’, the MPs say, because registration would be decided on the basis of information and assurances given by GPs rather than on a robust independent assessment of the standard of care they provide.
The CQC is also failing in its role of information provider to the public about residential care homes, the PAC found. It had not set out a clear picture of homes in each area or provided meaningful comparisons between providers. It urged the watchdog to develop something to replace the star ratings for homes that were scrapped in June 2010.
PAC chair Margaret Hodge said: ‘The CQC plays an absolutely vital role in protecting people from poor quality or unsafe care, but it has failed to perform that role effectively.
‘It has clearly been struggling for some time and the Department of Health, which is ultimately responsible, has not had a grip on what the commission has been doing.’
There was also criticism of the CQC’s decision to close its whistle-blowers’ hotline. Hodge said the commission ‘needs to do more to do more to strengthen its whistle-blowing arrangements’ and called for the hotline to be reinstated.
NHS leaders said the PAC’s conclusions reflected many of their own concerns. David Stout, deputy chief executive of the NHS Confederation, said: ‘An effective regulator needs a clear role if it is to earn the confidence of the organisations it regulates.’
He added that the CQC needed adequate and specialist resources to make judgements about the full spectrum of health services.
‘There is a world of difference between assessing the quality of care in a GP surgery, a district nursing service, an ambulance service and an acute NHS hospital.’
A CQC spokesman said the commission was ‘disappointed’ that the PAC had not recognised some significant recent improvements.
‘These improvements were noted in the Performance and Capability Review published by the Department of Health in February, which referred to CQC’s “considerable” achievements in “setting the essential platform from which tougher regulatory action can be taken when needed”,’ he said.
On whistle-blowing, the spokesman said it was ‘inaccurate’ to say the hotline had been closed. Instead, the watchdog had put in place a team of specially trained call handlers to deal with whistle-blowers.
He added that GP registration was on track to be completed successfully by April 2013, while a ‘clear system of ticks and crosses’ on the CQC website allowed people to make choices about their care or raise concerns.
CQC chief executive Cynthia Bower announced in February that she was stepping down after four years in the post. Her resignation coincided with publication of the DoH’s capability review.
