DH chief defends early implementation of NHS reforms
The Department of Health’s most senior civil servant has defended work to implement the government’s NHS reforms before its Health Bill has been passed, in evidence to a tribunal.
DH permanent secretary Una O’Brien, giving evidence at the Information Rights Tribunal, also said she felt “very deeply” that risk registers about the reforms should not be made public.
The tribunal is hearing the DH’s appeal against the Information Commissioner’s decision in November that the department’s “transition risk register” and “strategic risk register” should be published. Former shadow health secretary John Healey, who had requested the information, was a party to the case.
Ms O’Brien said on Monday she believed strongly that if the information was published it would mean civil servants not declaring risks fully in future, for fear of their work being published and “embarassing ministers”.
She said that would “undermine the management of risk” in departments therefore disclosure was not in the public interest.
She said: “My concern and that of other permanent secretary colleagues is [that if the registers were published] the articulation of risk would be insidiously pulled back from, step by step, in all other types of decisions.”
Ms O’Brien said: “Because the public is interested in a subject it does not translate into the public interest in [information being published]. It is actually in the public interest to have ongoing free and frank discussions between ministers and officials.”
She was also pressed at the hearing on the timing of the development and implementation of the reforms. In particular, Ms O’Brien was asked about the controversial issue of implementation before the bill has been passed. The bill is still going through its final stages in Parliament.
Counsel for Mr Healey and the commissioner raised issues including the clustering of PCTs, creation of “pathfinder GP consortia” and instructions from NHS chief executive Sir David Nicholson about implementing the reforms in 2010.
However Ms O’Brien said: “Every step that was being taken and is being taken has to be taken within the current legislative framework.
“All the existing arrangements and accountability which were in place in 2010 are in place now. PCTs are clustered but the formal accountability remains as it is until they are actually abolished.”
Of pathfinder GP consortia - many of which are now established as sub-committees of PCTs - Ms O’Brien said: “They do not have budgets, [and] they are not bodies corporate. Therefore they are not allowed to do commissioning and they will not be until legislation is passed. They are groups of GPs who have come together to work with [primary care trusts].”
Mr Healey is expected to argue that risk is an important part of the debate on the reforms, and that risk registers a tool for implementing rather than making policy, therefore their publication would not inhibit policymaking.
The appeal tribunal was due to continue on Tuesday and is expected to announce a decision between Tuesday and early next week.