Petition against health bill might trigger debate

BMJ 2012; 344 doi: (Published 17 February 2012) Cite this as: BMJ 2012;344:e1201
  1. Matthew Limb
  1. 1London

A new Commons debate could be triggered on the controversial Health and Social Care Bill after more than 100 000 people signed an e-petition demanding the bill’s withdrawal.

Critics have also stepped up pressure on ministers to disclose the full scale of internal warnings from NHS officials about the continuing risks associated with implementing the health proposals.

Shadow health secretary Andy Burnham said support for the Drop the Health Bill e-petition, submitted by GP Kailash Chand, sent a clear message to the prime minister about people’s feelings.

In addition, Mr Burnham said “devastating” revelations in risk assessment papers drawn up by NHS regions supported the case for abandoning the bill.

E-petition campaigners needed at least 100 000 people to sign up so that their case can be considered eligible for a new Commons debate by parliamentary business managers.

Mr Burnham said, “Even though the petition has passed the 100 000 mark, I urge people to keep on signing. The greater the number of people who add their names, the more strength they will give us to speak out against it in the final parliamentary battle.”

The threshold was reached as details emerged (Guardian, 14 February, p1) of new quarterly risk analyses of the challenges facing the four English NHS regions—London, the south, midlands and east, and the north.

Some risks, including those related to the quality of patient care, costs, and staffing, are graded “significant” or “high” despite action having been taken to mitigate them, according to the Guardian.

The latest risk assessment report for NHS London was submitted to the region’s board on 25 January.

It highlights risks that a lack of clarity surrounding transition to a new system could mean NHS London failing to manage organisational change effectively, reduce management costs, and prevent talented staff from leaving.

With regard to safeguarding children in London, the report says there remain “significant” risks that children could suffer “preventable harm” that could damage public confidence in the NHS.

The NHS London register also refers to risks of failures or deteriorations in the financial positions of one or more NHS organisations with the resulting loss of operating credibility.

Mr Burnham, commenting on the reports, said, “You know something is seriously amiss when NHS London has identified a risk of ‘preventable harm to children’ but has been unable to reduce it.”

A spokesman for NHS London told the BMJ the report contained risks that were only “potential” and that its purpose was to identify possible issues and to take action to prevent them from becoming “real.”

He said, “The risks highlighted are of how we manage the process—not of the NHS reforms themselves.

“The more we plan for and pre-empt possible issues, the less of a risk they become.”

While regional risk reports are available to the public, the government has so far refused to publish the national risk register, which is a separate document drawn up by civil servants.

Ministers say this is standard practice and is designed to protect the quality of advice given to government while enabling risks to be properly managed and mitigated.

The Department of Health has appealed against a ruling by the Information Commissioner that the transitional and strategic risk registers should be published, prompting a tribunal hearing to be scheduled to take place next month.

A Department of Health spokesman said, “Their purpose is to record likely and unlikely risks often in worst case terms, and it has implications for all other government departments, which would seriously undermine future decision-making for fear hypothetical discussions might be released before being fully developed into policy.”

Numerous risks pertaining to the bill were already contained in impact assessments and other published documents, the spokesman said.

Labour has called for a debate on the issue to be held in parliament next week.


Cite this as: BMJ 2012;344:e1201

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