NHS secrecy update: Some good news, but still a long way to go

I was quite surprised by the response to my post last week about the perils of the new NHS legislation for journalists. It seems to have caught the eye all over the place, so particular thanks to Roy Greenslade, Press Gazette and the Editor’s Weblog for linking to it and commenting on it.

I raised two main concerns: Firstly that the NHS reforms put an emphasis on creating more hospital foundation trusts. Currently, hospital trusts given foundation status are given the right to hold board meetings in private.

My second concern was the accountability of the GP consortia which will replaced primary care trusts in commissioning services. Currently, PCTs meet in public – there is no such provision for consortia to do the same at the moment.

Simply relying on the goodwill of health bosses to meet in public ‘because it’s a good thing to do’ isn’t enough – two thirds of existing foundation trusts meet in private – real evidence of the need to do enshrine the right of the press and public to attend board meetings in public.

Since last week, things have move on a bit, with revised NHS legislation due to be proposed today. Of interest to journalists will be the power of health and well-being boards, which are being set up by councils, being beefed up and patients given a greater role on them.

Exactly what these powers will be remains to be seen but it still won’t be good enough – the people taking the decisions, the consortia and the hospitals, simply have to meet in public.

Another key change will be the expansion of the GP constoria to include other health professionals, such as doctors and nurses. Very wise, but still, as far as we can tell, a closed shop when it comes to making decisions.

David Cameron keeps talking about accountability in the NHS, but unless the press and public have access to meetings to scrutinise decisions as they are being made, the public will essentially be stuck with a past-tense overview and scrutiny role.

As we know from local government, anyone who tells you that overview and scrutiny committees are effective ways of holding cabinet-style councils to account is either deluded or a member of the cabinet which knows the scrutiny they come under is toothless.

So, what are the chances that someone will listen if we make a noise about it? Well, I’m hopeful. In my last post on this issue, I focused on Heartlands Hospitals, a Foundation NHS Trust which serves much of Birmingham and the wider Midlands. Its board meets in private but they have a panel of governors who meet several times a year to represent some 100,000 ‘members’ of the hospital.

It’s past-tense scrutiny, in my opinion. Anyway, I chose Heartlands because they seemed to illustrate the problems we face quite well. Their chairman, Lord Hunt, has responded via the blog:

As a large employer and a significant deliverer of healthcare across the region we are very keen to be both open and transparent. We have recently been reviewing the opportunity to return to having public board meetings and this is something we are considering along with additional Governors meetings all of which are already open to the public. We hold member seminars on a monthly basis to which anyone can attend and we are working with the Governors who are publicly elected to improve the information flow and understanding not just within our Governing Body but also with our 100,000 members and the public.

We are very keen to make available as much information about the organisation as possible and have recently started to publish all of the freedom of information requests we receive. We will also from next month be publishing ward by ward patient experience date which looks at what our patients are saying about the care they receive in hospital. This is already displayed on each ward for the public and patients to see. The next information which will be published is our nursing matrix data which shows ward by ward the standards of care set against important issues like pressure sores and falls. As the new Chairman of the Trust and supported by our new chief executive I appreciate we have a long way to go, but we are more than willing to share information.

We have a long track record of working with the media and are keen to invite them in to ask questions and see for themselves the work we are doing. This includes a project which we hope will be taken-up by the BBC looking at care of the frail elderly in hospital. I, along with the Board, am committed to patient safety and quality and fully appreciated the need to share information to show how we are tackling some of the most challenging changes to the NHS whilst continuing to drive up standards for our patients.

Thank you for raising this issue – I will be sharing this with the Board.

There are many positives there – and it’s good to see someone arriving in post talking about making the board meetings public again. But it shouldn’t rely on a new chairman having to challenge privacy – open meetings has to be the norm.


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