comment: Healthcare Commission must act to shore up the system's credibility

Published: 22/07/2004, Volume II4, No. 5915 Page 17

As HSJ went to press, the messages contained in this year's star-ratings were still being picked apart. Overall it looks as if the ratings indicate a year of steady improvement for the NHS - and in that much they appear to be a fair reflection of reality.

The ratings also reveal some dramatic turn-arounds in performance. None more so than in Thames Valley, where the improvement is astonishing. Managers and their colleagues deserve congratulations, as do all those who played a part in driving up standards across the NHS. But the ratings also throw the spotlight on areas of concern, particularly primary care in London and mental health. Again, here the stars confirm what many in the NHS already know.

Within minutes of the ratings being announced, the usual arguments about the fairness of the methodology were beginning to filter into the HSJ office from those on the service's front line. This uncomfortable and unsatisfactory position will continue until 2006, when the Healthcare Commission implements its new approach to performance measurement.

Such arguments undermine the credibility of NHS reform. The commission must not assume it can wait two years to resolve disagreements - it must review what is does in time for next year's star-ratings swansong. l