David Oliver: We need statutory duty of candour and transparency for NHS executivesBMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5111 (Published 21 November 2017) Cite this as: BMJ 2017;359:j5111
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I fully agree with David Oliver that statutory professional registration for non-clinical senior NHS managers with the same legal obligations around candour and transparency as medical staff would be welcome.
Simon Stevens, head of NHS England, showed the way in his recent speech to NHS Providers (1) observing that: “in a democratically accountable NHS, the public have a right to know . . . Our duty of candour requires us now to explain the consequences of our decisions, to help inform the difficult choices that will be made for the year ahead.”
He also stated: “ . . . if you think modern Britain should look more like Germany or France or Sweden then we’re underfunding our health services by £20-30 billion a year . . . 2018 is poised to be the toughest financial year . . . the budget for the NHS next year is well short of what is currently needed to look after our patients and their families at their time of greatest need . . . After seven years of understandable but unprecedented constraint, on the current budget outlook the NHS can no longer do everything that is being asked of it. That judgement is confirmed today by the Kings Fund, the Nuffield Trust and the Health Foundation. They independently size next year’s funding gap at £4 billion. They show there’s nothing out of the ordinary about needing such a sum. In their words, it would just be a return to the average increases of the first 63 years of the NHS’ history, as against the exceptional choking back of funding growth of the past seven years . . . . in many parts of the country next year hospitals, community health services and GPs are more likely to be retrenching and retreating . . . . it is going to be increasingly hard to expand mental health services or improve cancer care. . . . the NHS waiting list will grow to 5 million people by 2021. That’s . . . . One in ten of us waiting for an operation”.
I hope those like Stevens who are already speaking out will encourage others to do likewise. As Oliver opined, it should be a key part of the role of senior NHS managers to describe problems that we all know are there but that aren’t being talked about. Commissioners should bear this duty of candour in mind when trying to sell Accountable Care Systems to their unsuspecting public.
Competing interests: No competing interests