NHS Risk Register

Clive Efford Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Mr Lansley]

It is because we are clear that the reason he said that was that there was no mechanism available to Monitor in legislation for the maintenance of services and interventions. The Bill will mean that there is.

I sometimes think that the shadow Secretary of State has not actually read the Health and Social Care Bill. He keeps saying that this or that is in it, or that it does or does not do this or that, but for the first time since 2003, when his predecessor’s legislation stated that there should be a mechanism for dealing with hospitals that are failing, we are setting out a proper structure for the continuity of services. He says that it is just about de-authorisation, but it is not.

[Clive Efford (Eltham) (Lab)]

rose—

[Grahame M. Morris (Easington) (Lab)]

rose—

--- Later in debate ---

[Mike Freer]

I will tell the hon. Gentleman what I did say. When I met GPs, I said that I would support putting patients first. Moreover, reform of the NHS was clearly specified in the Conservative manifesto on which I stood.

The previous Government sought to involve the private sector. Where was the risk register then? Was it published when the private sector was involved in the NHS? No, it was not. Will we get to see that risk register now? I doubt it.

Risk registers are, by definition, meant to explore everything that could possibly go wrong. They never make happy reading. The Secretary of State has already published more information than has ever been published before. He has already published relevant risks connected with the Health and Social Care Bill in the combined impact assessments, which consist of 400 pages of detailed analysis. The Opposition see the release of the risk register as simply an opportunity to cherry-pick the doomsday scenarios that it may contain. It is no more than a charter for shroud-waving. Every risk register contains such scenarios, and opponents would present them as fact.

I oppose the publication of risk registers because it would be impossible to pick and choose which were to be published and which were not. Once the Pandora’s box has been opened, it is open. The Opposition may argue that the publication of this risk register is in the public or the national interest. No doubt Department of Health risk registers examine what could go wrong, as in the case of other threats. What about threats relating to terrorism or outbreaks of infectious diseases?

[Clive Efford]

Will the hon. Gentleman give way?

[Mike Freer]

I have already given way twice.

There are clearly good reasons why the details of such threats should not be open to public scrutiny. Some might argue that their publication too is in the public or national interest, but we are not hearing that argument today; we are hearing only about this register, and not about the others. The Opposition’s stance is strong on opportunism and weak on intellectual coherence.

Let us look at their record in government. In 2009, when the shadow Health Secretary was Health Secretary, he refused a freedom of information request for publication of the Department’s strategic risk register. According to the Department,

“'a public authority is exempt from releasing information, which is or would be likely to inhibit the free and frank provision of advice or the free and frank exchanges of views for the purpose of deliberation'”.

There was also reference to the neutering of the free exchange of opinions between Ministers and advisers. That held then, and it holds now.

There is another issue, which was touched on by my right hon. Friend the Secretary of State. If the Department of Health is forced to issue all risk registers, what about other Departments? Will the Treasury have to release all risk registers involving the economy? Would that not cause financial havoc in the international markets? That explains why past Administrations have also refused to publish such documents. From a governance perspective, the Government’s stance is entirely right.

One of the problems of risk registers is that they are meant to be frank about what could go wrong. Any Member who has served on a project board will know how valuable such registers can be and how invaluable completely blank ones can be, and will also know that if the authors of risk registers are afraid to be open because of what might be misinterpreted, routine publication will cause them to become bland and anodyne and will render them useless.

The motion is simply posturing at its worst, and I will be voting “No” this evening.

--- Later in debate ---

[Andrew George]

I am grateful for that intervention, because it plays into my next point, which is on my general concern about the nature of Opposition day debates. It is not that I think that Opposition parties should not have the opportunity to debate issues, but such debates tend to over-dramatise the political tribalism of this House. It is in the nature of government that when in government people tend to have to face up to and take unpopular decisions, whereas in opposition they tend to avoid them. Equally, on this issue, those in opposition tend to say that they would be more open, because they look at the matter from a different perspective and take the view that they would have more open government. When people come into government, they tend to err on the side of seeing good technical reasons for why they cannot engage in the process of open government.

[Clive Efford]

rose—

[Andrew George]

I will give way, although I am going to lose time.

[Clive Efford]

I shall be brief. This transition risk register refers specifically to the Bill, about which there is widespread concern. The register is unprecedented in that regard so, with due respect to the hon. Gentleman, his argument really does not hold.

[Andrew George]

I am cantering around the issues. I have signed the early-day motion, so I judge that disclosure is better than non-disclosure. However, I wish to make a further point about the kid psychology of this whole thing. We all tend to want what we cannot have and if we obsess about this issue, we might take our eyes off the ball of what the debate ought to be about. That brings us back to the point made by the former Secretary of State.

I ask the Minister who is winding up: when has the disclosure of such documents actually harmed Government public services? If we were given examples of where disclosure of information has actually harmed the delivery of effective government, we could begin to mount a case for trying to define the lines of where and when such documents should be published. On the basis of the debate so far, I am not sure that we have demonstrated that if we were given the new toy in this political playground—the publication of the risk register—it would necessarily improve the quality of the debate.

Of course, the main show, rather than the sideshow, is the Bill itself. I am concerned that if the risk register were to be published soon, and we were to have information that would perhaps help to change people’s minds and enable a more informed debate, it would not be possible to come to a considered conclusion that it would be best to withdraw the Bill because of the nature of the prism of the Westminster village. Given the virility contest in which such decisions are taken, the climbdown needed for a Secretary of State to withdraw a Bill such as this would be catastrophic both for himself and for the Government. So we end up continuing on with something that I believe could be catastrophic for the NHS—I have put my views in the public domain on many occasions on this issue.

The right hon. Member for Leigh (Andy Burnham) may want to win over Liberal Democrats, but describing us as “spineless” will not necessarily get many of us into the Lobby with him. If he does not want to contaminate his party with people he believes are so infected with such a disabling condition, I am not sure that it will help.