NICE conference focus

Published: 12/12/2001, Volume II2, No. 5835 Page 10 11

In his first public appearance since his appointment, Professor Sir Ian Kennedy, shadow chair of the Commission for Healthcare Audit and Inspection, signalled that his approach would continue the Commission for Health Improvement's supportive and developmental ethos

In his first public appearance since his appointment, Sir Ian responded to questions about the government's healthcare inspection regime after a presentation on his Bristol Royal Infirmary inquiry report.

He told delegates: 'There is some political interest in the term 'inspection', ' but added: 'Even if one is committed by others to the word inspection, I do not think one needs to adopt a limited definition of it. As I understand the remit of CHAI, it includes improvement, inter alia.

'A simple 'visitation' without something more is not going to do that... We have to ensure it includes some element of improvement.'

He acknowledged that 'a very great deal of taxpayers' money is being invested' in the NHS and people were entitled to find out how it was being used, but he emphasised: 'Merely to inspect and say, 'That is not very good and you must improve', without seeking to facilitate or advise or help that improvement, is missing a trick.

'I begin with the simple premise that one is there for the public and the patients. Merely saying pull your socks up... doesn't help patients [or] help the public.'

Sir Ian said the government had taken up most of his report's 198 recommendations, but it was 'unfortunate' that the National Institute for Clinical Excellence was not outside the NHS.

'NICE, we recommended, should be arm's length because There is a tension always in government - the government can set standards but they may not survive bad political weather.

'But I can see and detect a journey by NICE... towards what we can call independence.' This was based on gaining the trust of the Department of Health, he said.

Sir Ian warned there was still 'tension' with the DoH about the national service frameworks and 'the standards that emanate' from them.

'If a framework becomes too detailed and sets standards, you get what Bristol was about - two or three bodies setting standards.'

At Bristol, this had resulted in 'things falling through the cracks'.

He also warned that NICE could be seen as a rationer or a spokesperson for 'big pharma', and suggested that to offset this, the agency could offer the government different options for the uptake of new treatments, making the cost implications clear.

In a passionate response to a paediatrics professional, Sir Ian also blasted the lack of progress on improving the 'Cinderella service' provided for children.

'The progress We have made regarding children has been slow - depressingly slow, ' he said.

A national director of children's services had been appointed but the children's framework has yet to appear.

'The chapter [of the Bristol report] on children was written in anger. . . this particular Cinderella had never been to the ball and that remains the case.'