A level playing field is the holy grail of trust managers who see themselves as competing with the private sector for clinical work. Key to that is confidence that patients and their GPs will be able to make informed choices about where they should go for treatment.

A level playing field is the holy grail of trust managers who see themselves as competing with the private sector for clinical work. Key to that is confidence that patients and their GPs will be able to make informed choices about where they should go for treatment.

But according to advance details of a Healthcare Commission report, seen by HSJ, the quality of data on clinical quality from independent sector treatment centres is so inconsistent that meaningful comparisons are impossible. Not only that but the report, commissioned by chief medical officer Professor Sir Liam Donaldson, says that baseline data is so poor that it seems unlikely the problem can be solved in the short term.

Now that we know this, the question is what can be done. An NHS built on the ability of patients to switch suppliers as a way to improve performance will falter if those choices are not meaningful. NHS managers will not be content for ISTCs to continue underperforming in this way while they see their own activity and costs under pressure. Meanwhile those private providers with a good story to tell on data will be frustrated that its application will be limited by the failure of others.

And there is the hugely pressing problem, highlighted by the report, that a lack of high-quality data is putting good governance at risk. That means all concerned will want not just the implementation of the report's recommendations but a clear idea of when that will happen and how their success will be monitored. Slow but steady progress on improving data quality will not be sufficient.