NHS Risk Register

Jim Shannon Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

As a Northern Ireland MP, I will give a Northern Irish perspective. The need for the publication of the risk register is clear in my mind and in the minds of my constituents. My constituents tell me that they have concerns over the reform of the NHS and how it will affect them. It is therefore important for the risk register to be made public.

When one inquires into what a risk register entails, one is pointed to the guidance in the NHS paper, “Making it Happen: A Guide for Risk Managers on How to Populate a Risk Register”. A telling paragraph states:

“Managing risk effectively and embedding internal control into the processes by which objectives are pursued is extremely important for the NHS. The external driver in the form of a Statement on Internal Control, places a public disclosure obligation on individual boards of directors. That responsibility includes ensuring that the system of internal control is effective in managing risks. The production of a ‘live’ Risk Register is considered to be an integral element of good risk management practice by the Controls Assurance Team and NHS Litigation Authority and is a key feature of the Australian/New Zealand Risk Management Standard. It is hoped that this document will help NHS organisations progress this agenda.”

What has changed in that need to ensure that good risk management practice is carried out by the NHS for the benefit of the organisation? Why is this risk register not being published so that front-line NHS workers can understand the risks and give their input?

I want to give an ordinary perspective on this matter. One of the major hospitals in Northern Ireland, the Ulster hospital, is on the border of my constituency. Its catchment area includes some 200,000 potential patients. It is a fantastic hospital with friendly and helpful staff, from the porters up to the consultants. I have been in contact with a large number of its staff who have concerns over this matter. They are clamouring for openness and transparency. People from my constituency work in that hospital every day in their various roles. They want to ensure that they are part of any decision-making process, because they know that their experience and expertise should be considered in any debate. They are not being given such an opportunity at this time.

I and many Members on the Opposition Benches—and, I suspect, some Government Members—believe that there must be transparency so that people know whether the savings are worth the risk. Our health service is a priority. For many people it literally means the difference between life and death. It is essential that those on the front-line of the service are aware in advance of what the changes could bring so that they can prepare for them.

I have been contacted by the British Medical Association and many other bodies that have asked me to speak on their behalf and on the behalf of doctors, midwives and staff in the NHS. The letter from the BMA, which I am sure all Members have received, bears repeating:

“Health professionals are already seeing fairly chaotic and complex implementation of the reforms ‘on the ground’ which has already begun within the NHS. The challenges and potential risks identified with this process should be contained within the register. Furthermore, the staff currently trying to balance the implementation of the reforms with the drive to find £20 billion of efficiency would benefit greatly from the Government’s view of the risks associated with this difficult twin challenge.”

That must be put on the record in this House, as it has been by many Members today, to bring clarity on this matter. The opinions of those who are working on the ground must at least be considered, but they cannot give a full opinion without possessing the full facts.

I am not someone who believes that every aspect of public service should be disclosed. Defence matters clearly should not be disclosed, because it would put the lives of soldiers at risk. As a Northern Ireland MP, I know that from the time of the troubles up to the present day, there have been security matters that cannot be disclosed and that should be kept secret. However, it is my opinion that the reverse could happen if we do not release the risk register. I believe that not releasing it could cause danger and harm. I therefore support the disclosure of the risk register.

The NHS, although far from perfect, is something that we can have pride in because of the dedication of those who work in our hospitals: the doctors who take on extra shifts to ensure that every patient has access to care, the nurses who stay for an extra 10 minutes or more to finish changing people’s dressings, the auxiliary workers who ensure that the elderly patients eat all of their dinner, the porters who transport patients slowly enough so that they are not hurt, and the cleaning staff who work later than necessary to ensure that the wards are clean. Those people are part of the NHS, have knowledge of the NHS and have an interest in the NHS. My constituents tell me that they want the publication of the NHS risk register. I urge Members to consider that very carefully. The publication of the risk register is a single issue. I ask Members to support it tonight.