Health Transition Risk Register

Lord Hunt of Kings Heath Excerpts

Thursday 10th May 2012 Lords Chamber

[Lord Hunt of Kings Heath]

My Lords, I am most grateful to the noble Earl, Lord Howe, for repeating the Statement on the health transition risk register. I should start by declaring an interest as chair of the Heart of England NHS Foundation Trust and as a consultant trainer with Cumberlege Connections.

As we have heard, the First-tier Tribunal, on appeal from the Government, found against them and ordered the disclosure of the register. The Government have decided not to appeal to the Upper Tribunal but, instead, a ministerial veto has been exercised since, as we have been told, Ministers regard this as a matter of principle, not law. I must say to noble Lords that I very much regret that decision.

The noble Earl, in repeating the Statement, made reference to what was intended when the legislation was brought in, but I have to say that we regard this as a major change of policy from the precedent set by the previous Government. Use of the ministerial veto in the past has been reserved only for issues of national security and Cabinet discussions. Applying the veto to what are essentially day-to-day matters of domestic policy is a step back towards secrecy and closed government. It is also a major change of policy in relation to publication of risk registers. The previous Government, under similar circumstances, released the risk register on the third Heathrow runway after an order from the Information Commissioner. This veto is very much a matter of regret, and I should like to ask the noble Earl a number of questions.

Can he explain to the House how the use of the veto in this circumstance meets the exceptional criteria that government rules require? Can he say whether it is now government policy never to publish risk registers, even if ordered to do so by the courts? In repeating the Statement, the noble Earl claimed that civil servants should be allowed to have frank and free conversations. However, this matter was considered in detail by the tribunal. Does he not think that the tribunal has therefore come to an entirely reasonable conclusion on that matter? Does he accept that the recording, reporting and treatment of risk are not optional activities but core responsibilities for any government department?

I should also be grateful if the noble Earl could clear up a number of confusions over statements made in the past 24 hours. In the blog post for Liberal Democrat Voice yesterday, the Deputy Leader of the other place wrote that it would also be right to publish much of what is contained in the risk register as soon as possible. Can the noble Earl explain exactly what that means? The noble Earl himself was interviewed on yesterday’s Radio 4 “Today” programme and it seems that he was really implying that the case for vetoing the release of the NHS transition risk register was a general and not an exceptional one. He said in the interview:

“It is about allowing civil servants to have frank and free conversations, uninhibited by the thought that those conversations are going to be made public”.

When it was put to him:

“You could apply that to any single freedom of information request of government discussions”,

the noble Earl confirmed:

“The effect of the judgment, if we had not vetoed, would be that Governments and civil servants shouldn’t be allowed to talk about key aspects of policy formulation, including the risks”.

I do not see how that could be said to come within “exceptional” criteria, and I should be grateful if the Minister could clarify the matter for the House.

The noble Earl also said at the end of the interview:

“We have every intention of publishing the risk register in due course, when we think the time is right”.

It is 22 months since the Government’s reform policies were published in the White Paper, 19 months since my right honourable friend Mr John Healey, to whom I pay great tribute for his persistence in this matter, put in his FoI request, and a month since the Health and Social Care Act received Royal Assent, so I ask the noble Earl when the time will be right for the risk register to be published. Although this is a matter of principle and therefore Ministers are not going to appeal again, apparently the veto is of only a temporary nature, and therefore it would be good if the noble Earl could explain to us exactly what was meant by his final comment.

Will the Minister come clean on the real reason the Government will not produce the risk register? The fact is that they had a huge amount of warning from people in the NHS, echoed by officials in private, about the impact of their very misguided changes to the NHS, and the reason for the register not being published is very simple: it is political embarrassment. Will the noble Earl also acknowledge that the Government have put the health service through an extraordinary amount of turmoil? Thousands of people have lost their jobs and fundamental change is taking place at a time when the real issues for the health service are meeting the Nicholson challenge of efficiencies, major reconfiguration and improving the quality of primary care. That latter point has been neglected in our debates and I think that it goes to the heart of many of the problems in the health service.

When the Government inherited the NHS, it was in a very good condition. Waiting lists had been cut dramatically and there had been huge investment in the infrastructure. The Government could have chosen to build on that; instead, they adopted fundamental change, pulling the NHS up by its roots and causing major confusion. It is a change that enjoys very little support within the health service.

Perhaps I may now take the noble Earl to the judgment itself, which I think goes to the core of this argument. It says:

“From the evidence it is clear that the NHS reforms were introduced in an exceptional way. There was no indication prior to the White Paper that such wide-ranging reforms were being considered. The White Paper was published without prior consultation. It was published within a very short period after the Coalition Government came into power. It was unexpected. Consultation took place afterwards over what appears to us a very short period considering the extent of the proposed reforms. The consultation hardly changed policy but dealt largely with implementation. Even more significantly the Government decided to press ahead with some of the policies even before laying a Bill before Parliament”—

I repeat: even before laying a Bill before Parliament. It continues:

“The whole process had to be paused because of the general alarm at what was happening. The public interest in understanding the risks involved in such wide-ranging reforms of the NHS in the circumstances just described would have been high, if not exceptional in this case. Risk registers would have provided the public with a far better understanding of the risks to a national institution which millions depended on”.

Yes, indeed. The argument for publication of the risk register when this House and the other place were considering this legislation is overwhelming, and I think that the use of the veto in this case is shameful.