I should have picked up on this sooner, but I’ve been rather distracted over the last week by the birth of my baby daughter.
Anyway, about three weeks ago I blogged on the potential threats to information access caused by the NHS reforms. The threats are three-fold:
1. The abolition of Primary Care Trusts – the bodies which decide how NHS money is spent locally – in favour of GP consortia. PCTs currently meet in public to take decisions, and there is no commitment that consortia will do the same. How, then, are those holding the purse strings to be held accountable?
2. The push for more Foundation Hospital Trusts: These are hospital trusts which have some freedoms from government rules and regulations. Sadly, one of those freedoms has, up until now, been the right to meet in private, rather than in public.
3. The closure of strategic health authorities: Not, in my opinion, necessarily a bad thing but it does remove one more way into NHS information as all PCTs and hospital trusts report to the SHA. In future, this sort of monitoring will be done by an organisation called Monitor. The level of monitoring, and how accountable it will be, remains unclear.
But Andrew Lansley, the health secretary, has delivered some good news on point 2, concerning founation hospital trusts. He is inserting a section into his Health and Social Care bill which will force Foundation Trusts to hold their board meetings in public.
This is really good news for journalists – and puts to bed the myth that having to hold the meetings in public is a distraction for a hospital trust, or that it adds extra red tape.
In my original post on this subject, I focused on Heartlands Hospitals Trust in Birmingham, a foundation trust with a huge budget which treats hundreds of thousands of people a year. It has been meeting in private for several years, and its publication of board agenda papers and minutes has become increasingly sparse.
Lord Hunt of Kings Heath, the new chairman of the Trust, responded to the blog [in the comments] saying he was committed to opening up the Trust, and he’s proved as good as his word – announcing board meetings will become public again with immediate effect. According to the Birmingham Post, the main Childrens Hospital in Birmingham is following suit.
All good news – but still not enough. What is happening here is a correction of an error made by Labour, returning a right to witness hospital decisions being made which should never have been taken away.
There is still a huge worry about the impact the creation of GP consortia will have on information freedoms. The real power in the local NHS will be with these consortia. They’ll decide many of the things PCTs decide at present, such as what treatment to approve, what projects to support and so on. There is still no indication as to how the public, and therefore the Press, will be able to monitor their decisions.
Clarity is also needed on how councils will deliver their newly-created public health role, which they will take on from primary care trusts. Decisions such as whether an area should support putting fluoride in water is currently taken by a PCT, but in future could be taken by a council. Will this be in a public manner, with discussion beforehand?
I wouldn’t dream of suggesting my post prompted a change in the government’s mind on Foundation hospitals, but hopefully it made some noise in pointing an inadvertent error in the system, so once again thanks to Roy Greenslade, Press Gazette, the Newspaper Society and Hold the Front Page for flagging it up to others. Hopefully, further accountability will follow soon.