Public Health for the NHS

Media Release
For Immediate Use: Sunday 18th March 2012

Last Ditch Amendments Tabled to Health Bill How 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 “commercial confidentiality” from being used an excuse to hide crucial information about how public money is being spent in the NHS. Two amendments have been tabled for the House of Lords Third Reading debate on Monday 19th March by cross-bencher Baroness Finlay of Llandaff, a doctor and professor of palliative medicine. They amend Clauses 23 and 25 of the Bill and would require the NHS Commissioning Board and each Clinical Commissioning Group [CCGs] to establish and maintain public registers of commissioning contracts. This would mean that members of the public would not have to make requests for these contracts under the Freedom of Information Act 2000. No redactions from the contracts would be allowed. [1] In the new healthcare system established by the Bill, contracts between commissioners and healthcare providers, including private companies, will become the norm. Without the Finlay amendments, commercial confidentiality will be used routinely to refuse to release key information 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 Liberal Democrats at their 2011 Spring Conference and promised in the February 2012 letter about the 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 commissioners would ensure “transparency in the commissioning process”. However, he also wrote that these regulations would be based on the existing Principles and Rules for Co-operation and Competition in the NHS “which we will retain to ensure continuity”. These rules, and an exemption from the Freedom of Information Act (FoI) for commercially sensitive 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 Circle Healthcare under a ten year contract that began on 1st February 2012. [2] It is not possible for the public to make a fully informed judgement about the contract, because both the Treasury and Department of Health have refused to release key information, despite FoI 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 release a complete copy of the Full Business Case for the contract, or the financial models and methodlogy 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 the use of public funds. [3]

Commenting, Professor Allyson Pollock said: “Baroness Finlay is trying to close a huge loophole in the Bill. After hundreds of hours of debate in Parliament and thousands of amendments, this vital issue has still not been properly addressed. It is crucial to ensure proper financial accountability in the NHS, when in future care will be arranged through tens of thousands of commercial contracts. The Bill as it stands simply does not do this, despite promises by Mr Clegg, Baroness Williams and Earl Howe. If the Bill is not fixed, ministers, civil servants, healthcare businesses and managers will routinely claim exemption from Freedom of Information legislation on grounds of commercial confidentiality. And we will no longer be able to establish just what is being done with tens of billions of pounds of public money.”

ENDS
Contact: Professor Allyson Pollock Ian Willmore (media) Notes:
[1] The text of the two amendments is as follows: “Clause 23, page 26, after line 21 insert13Z3A Public register of commissioning contracts

07976 978304 allyson.pollock@gmail.com 07887 641344 willmorei@live.co.uk

(1) The Board shall establish and maintain a register of every commissioning contract entered into by it. (2) The register shall contain a copy of every such commissioning contract. (3) The register shall be available for inspection by the public at all reasonable hours and copies of each commissioning contract shall be provided on request at reasonable cost. (4) In this section, a “commissioning contract” means a contract entered into by the Board in the exercise of its functions in arranging for the provisions of services as part of the health service; and “contract” includes all documents constituting the contract, including variations and amendments, and already terminated contracts.” “Clause 25, page 51, after line 13 insert14Z23A Public register of commissioning contracts

(1) Each clinical commissioning group shall establish and maintain a register of every commissioning contract entered into by it. (2) The register shall contain a copy of every such commissioning contract. (3) The register shall be available for inspection by the public at all reasonable hours and copies of each commissioning contract shall be provided on request at reasonable cost. (4) In this section, a “commissioning contract” means a contract entered into by the clinical commissioning group in the exercise of its functions in arranging for the provisions of services as part of

the health service; and “contract” includes all documents constituting the contract, including variations and amendments, and already terminated contracts.” [2] http://www.circlepartnership.co.uk/about-circle/media/circle-and-hinchingbrooke-start-historic-partnershipfeb-12 Circle Healthcare is owned by companies and investment funds registered in the British Virgin Islands, Jersey and the Cayman Islands in an arrangement which allows investors to avoid tax on their shares. http://www.guardian.co.uk/politics/2012/mar/17/nhs-shakeup-health-firms-tax-havens Circle's Chief Executive is former Goldman Sachs executive Ali Parsa. Circle began its management of the hospital, which will last for ten years, on 1st February 2012. The Hinchingbrooke contract was signed after a thirteen month procurement managed by NHS Midlands and East, and a subsequent approval process from the Department of Health. [3] Copies of the Treasury letter available from Public Health for the NHS

The Public Health for the NHS network includes former Presidents of the Faculty of Public Health, more than fifty Directors of Public Health and the country’s leading experts in health policy and health systems analysis.