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02 August 2018

NMA Warns Secrecy Proposals Will Damage Public Confidence In Healthcare System

The News Media Association has warned that a blanket ban on disclosure of information will damage public confidence in the healthcare system after a Committee recommended that evidence in investigations into tragic scandals such as Morecambe Bay and Mid Staffs should be private.

The Joint Committee on the Draft Health Service Safety Investigations Bill has published a report today advocating that a new investigatory body will carry out investigations into serious patient incidents that “will operate in the ‘safe space’ which will reduce the fear of talking openly”.  The Committee dismissed concerns that it was reducing transparency when it should be increasing it, without further justification. 

Instead, it recommended that such “safe space” should apply to all providers of healthcare, not just the NHS, all evidence gathered, not just witness statements, and regardless of whether it is part of an investigation. 

The NMA said: “The blanket ban on the release of information provided to the HSSIB will undermine public confidence and patient safety, not improve it.  The public and other stakeholders will not be able to assess the rigor of the investigation, the propriety of the recommendations, or whether improvements are being made if they do not have access to the information on which the recommendations are based.”

The Campaign for Freedom of Information also condemned the recommendations, saying: "The new body will operate on the bizarre assumption that patient safety is best secured by secrecy. Only its published report will be available, everything else will be protected from disclosure under FOI including hospital procedures, statistics, details of staffing problems or anonymised reports of incidents in other countries.

“Investigators would not even be allowed to put one person’s account of an accident to another witness anonymously to ask if they agree. The select committee now proposes making all background safety information supplied to the new body secret too. If the safety body gets something wrong, it will be protected from scrutiny by this disproportionate indiscriminate restriction.”

In representations on the proposals, the General Optical Council has said of safe spaces that “it would have a negative effect on fitness to practice investigations and ultimately on patient safety. It will permit the creation of a “strong wall” prohibiting regulators from accessing information which could be used to hold an individual to account. It will also limit the ability of patients and the public to understand the reasons why things went wrong, and in certain circumstances why their family members were harmed.”

The NMA said the Committee has no basis to believe that this prevention of disclosure will lead to better regulatory outcomes and makes these recommendations contrary to the advice of many from within the medical field.

The importance of transparency in helping to secure justice for patients could not be clearer. In investigating the Morecambe Bay midwifery scandal, the Professional Standards Authority specifically referenced the long fight of journalists in uncovering information kept secret by the Nursing and Midwifery Council.  This emphasises the importance of transparency and access to information for the sake of patient safety and public confidence.  Openness, not safe spaces, are needed, the NMA said.

In making these recommendations, the Committee has missed the fundamental point that in improving patient safety and trust, there needs to be a level of transparency that the public can rely on. Putting the evidence that recommendations are based upon beyond the reach of even the patients that the evidence concerns means that, yet again, the public is being asked to put blind faith in a system that it has been given little reason to trust, the NMA said.