Two of Andrew Lansley’s big summer announcements have irked some in the NHS for a number of reasons, and they were both information publications of sorts.
Both releases justified themselves in part by transparency itself. Prime Minister David Cameron said soon after the election he wanted to “open up” data across government to fuel what he called a “post bureaucratic age”.
There was less elaboration of what would be released, how, why, and when.
1. In the first case, a Department of Health press release listed the number of breaches of single-sex accommodation rules reported by 74 hospital trusts, which were not named.
The statement itself said there were significant problems in the figures - it only covered half of England; was not being recorded consistently; was “collected through an informal, invalidated exercise”; and trust figures were not comparable.
This was presented as part of the justification for a diktat – of the sort Mr Lansley has previously attacked – for the introduction of mandated reporting and publication of breaches.
The release received the kind of press coverage – critical of the previous government’s record – that would have been expected by its authors.
There is strong support for publishing more information about the quality of services, which single-sex breaches potentially are. But most say, again as Mr Lansley has argued in the past, this will best achieved by professionals developing and agreeing indicators, then reporting against them. Processes are in place for this and they will hopefully be furthered by the government’s proposals, for example the forthcoming outcomes framework and information strategy.
2. The second publication came in a press release from Mr Lansley’s office which listed 2009-10 spending by each primary care trust and strategic health authority on management consultancy.
Again there was doubt over the data. Sums included areas other than management consultancy – for example architects – and the release said: “Further validation of the figures is currently being carried out by the Department of Health.”
In a minor statistical offence, the statement said the total spend (£314m) was “equivalent to almost 10,000 nurses”. The footnotes clarified this was actually 9,342 nurses, not nearly 10,000, and the calculation was based on nurses’ earnings – significantly less than the actual cost to the NHS of employing a nurse and therefore producing an overestimate.
The release had an unashamedly political purpose – attacking spending “in the last year of the Labour government” and what was described as NHS organisations’ “wasteful spending” and “unnecessary bureaucracy”.
The theme of public sector spending runs through several of the “post bureaucratic” publications. Mr Cameron’s initial three offerings included senior civil service salaries and the Treasury spending database. A bizarre Cabinet Office collection of employment and consultancy data in June resulted in an official ticking off from the UK Statistics Authority.
The government clearly has good reason to focus on public spending and waste. But comparative information on this would seem to be best provided through tested processes, like those of the Audit Commission, which is facing abolition, or established back-office benchmarks, rather than uncertain figures on one area of spend.
As the “opening up” continues information publication will remain tangled up with policy and politics, so it would be nice to try a transparent process for deciding what is released.