While the extent to which national clinical databases publicly disclose comparisons of the quality of providers' care is indeed an important question to address, this article does not acknowledge that most of the leading databases already undertake this. These include, though are not restricted to, adult critical care (ICNARC CMPD), severe trauma care (TARN), lung cancer (National Lung Cancer Audit),neonatal intensive care (NNAP), hip fracture (NHFD), coronary angioplasty, hip and knee replacement (National PROMs Programme), acute stroke care (SINAP) and paediatric intensive care (PICANet).

Competing interests: I chair the DH National Advisory Group for Clinical Audit & Enquiries and am a trustee of the Intensive Care National Audit & Research Centre