NHS Risk Register

Catherine McKinnell Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

My inbox and postbag, like those of my colleagues, have been flooded with e-mails and letters calling for the publication of the risk register. Without it, MPs will be voting on changes to the NHS without knowing the full facts. I am overwhelmed, although not surprised, by the concerns of my constituents. I want to use today as an opportunity to express those concerns.

One key issue that I feel has not received enough attention to date is the level of risk posed to children by the proposed NHS reforms. Concerns about that have been expressed by more than 150 paediatricians, who have called on the Government to scrap the Health and Social Care Bill. First, they quite rightly question the Government’s assertion that this top-down reorganisation is even necessary. More importantly, however, they say:

“We believe that the bill will undermine choice, quality, safety, equity, and integration of care for children and their families.”

My colleagues have already described the shameful saga of the release of the risk register, so I will not go any further into that. However, we should be grateful for the interim insight given by NHS London’s assessment of the risks of reorganisation, which makes for grim reading. By virtue of the fact that the Government are refusing to publish the risk register, I can only be concerned about what the national picture must be. In addition to the risk of all patients receiving “sub-optimal care”, the London assessment refers to the risks to safeguarding children, the “dilution of expertise”, and

“weaknesses in information sharing systems and processes,”

and says:

“The consequences of this may be preventable harm to children”.

There is clearly a fundamental problem with the reforms when it comes to child protection. In order to safeguard children effectively from abuse and neglect, various agencies need to communicate and work together. However, the result of the NHS reforms will be to substitute co-operation for competition, to the detriment of good safeguarding and, ultimately, to the children whom it is supposed to protect. Each month we see a higher incidence of children being neglected by their parents and taken into care. In that context, and against the backdrop of significant cuts to children’s services, the Government should not be focusing their energies on unnecessary reorganisation that could increase risks to an already vulnerable group.

The Government’s policy is completely confused in this area. The Department for Education is aware of the need and expresses support for providing early help to vulnerable children and families. We should be focusing on training midwives to identify vulnerable families before a child is born, getting them the support they need if they are at risk. The NHS London risk report, however, has expressed grave concerns about the capacity of maternity services and the capability of the work force—as a direct result of the proposed reforms. Similarly, general practitioners—a first port of call for many families—have a key role to play in identifying and reporting risks of abuse. This is hampered where, as shown in the London risk report, the reforms will render their performance variable and, in some cases, poor.

In the words of the 154 paediatricians who wrote to The Lancet last week, the safeguarding of children

“will become even more difficult when services are put out to competitive tender and organisations compete instead of co-operate. Children who are vulnerable, neglected or abused will inevitably slip through the net…The bill will be detrimental to the goal of integrating care for the most vulnerable children across health, education, social care and the criminal justice systems in order to deliver good outcomes”.

It defies belief that the Government are insisting on pursuing reforms that have been assessed as potentially and needlessly resulting in harm to children. How, faced with that, can the Government continue with this folly?

Even in the face of the public’s reaction to the Bill, we have seen more than 150,000 signatures on the “Drop the Bill” petition, while hundreds of my own constituents have contacted me on this issue. My constituents and others up and down the country highlight the Government’s lack of transparency and accountability on this matter. The Information Commissioner has said that there is a strong public interest in disclosure of the information. An important point is being made about the risk register, which reveals that the Government have abandoned principles of proper governance on this matter.

Time and again we have heard the Government promising openness and transparency in government and in the NHS—the Prime Minister, the Deputy Prime Minister, the Health Secretary and others have extolled those virtues—but as the refusal to publish the register shows, those statements are nothing but platitudes. How can the Government claim transparency when they kept key critics of the Bill out of their meeting on Monday? It is a joke. The Government must publish the risk register, allowing proper and informed debate. We owe it to the people of this country who treasure our NHS—and we owe it especially to our vulnerable children.