Public Health for the NHS
For Immediate Use: Sunday 18th March 2012
Last Ditch Amendments Tabled to Health BillHow Will We Know What They're Doing With Our Money?
A last ditch attempt is being made to amend the Health Bill, to prevent claims of “commercialconfidentiality” from being used an excuse to hide crucial information about how public money isbeing spent in the NHS.Two amendments have been tabled for the House of Lords Third Reading debate on Monday19th March by cross-bencher Baroness Finlay of Llandaff, a doctor and professor of palliativemedicine. They amend Clauses 23 and 25 of the Bill and would require the NHS CommissioningBoard and each Clinical Commissioning Group [CCGs] to establish and maintain publicregisters of commissioning contracts. This would mean that members of the public would nothave to make requests for these contracts under the Freedom of Information Act 2000. Noredactions from the contracts would be allowed.  In the new healthcare system established by the Bill, contracts between commissionersand healthcare providers, including private companies, will become the norm. Without theFinlay amendments, commercial confidentiality will be used routinely to refuse to release keyinformation about these contracts, and it will become impossible for the media, researchers or the general public to establish the facts about how NHS money is spent.Strong rules on financial accountability and transparency were demanded by LiberalDemocrats at their 2011 Spring Conference and promised in the February 2012 letter aboutthe Bill from Nick Clegg and Shirley Williams. In a letter to all peers dated 22nd December 2011, Health Minister Earl Howe promised regulations covering healthcare commissionerswould ensure “transparency in the commissioning process”. However, he also wrote thatthese regulations would be based on the existing Principles and Rules for Co-operation andCompetition in the NHS “which we will retain to ensure continuity”.These rules, and an exemption from the Freedom of Information Act (FoI) for commerciallysensitive information, are already being used to prevent public scrutiny of NHS contracts,as shown by the case of Hinchingbrooke hospital, which is now being managed by CircleHealthcare under a ten year contract that began on 1st February 2012. It is not possible for the public to make a fully informed judgement about the contract, becauseboth the Treasury and Department of Health have refused to release key information, despiteFoI requests from Professor Allyson Pollock and academic researchers at Queen Mary,University of London. The Government is claiming exemption under Section 43 of the Act,which deals with commercially sensitive information. The Treasury letter refusing to releasea complete copy of the Full Business Case for the contract, or the financial models andmethodlogy on which it is based says that: “the commercial interests of the NHS and/or Circle”are more important in this case than the public interest in transparency and accountability in theuse of public funds.