There is a memorable scene in ‘Doctor in the House’ in which the surgeon, Mr Lancelott-Spratt tells a patient who is wondering what’s wrong with him, “Don’t worry my good man, you won’t understand our medical talk”
It’s rather like the government’s attitude to the risk register …
Dear Mr Donovan,
Thank you for your correspondence of 21 and 22 November about the Information Commissioner’s recent judgment that the Department should publish its transition risk register. I have been asked to reply.
The Department’s view is that the ruling of the Information Commissioner carries with it very significant implications, not only for the Department of Health, but also for other departments across Government.
The Department has been open about the outcomes that our modernisation proposals will deliver throughout the reform process, for example through the Impact Assessments that were originally published alongside the Health and Social Care Bill in January. The Impact Assessments have been updated during the Bill’s passage through Parliament, most recently in September, and are available on the Department of Health’s website at www.dh.gov.uk by typing the reference number ‘16620’ into the search bar.
You may be aware that risk registers are a basic tool for the management of policy implementation. They are working documents that inform advice relating to the entire range of areas for which Government departments are responsible, including financial risks, policy risks and sensitive commercial and contractual risks. To enable robust risk management, the Department believes that officials must be free to record all potential risks and their mitigating actions together with an estimation of their likelihood and impact, fully, frankly and with absolute candour, in confidence that this information will not be disclosed. The Department believes that the way in which these risks are expressed in worst-case terms would present a misleading picture and be open to misinterpretation if placed in the public domain.
The Department therefore considers that making this information publicly available at the time the requests were made would have compromised both the register’s quality and value as a basis for advice to ministers and decision making. The Information Commissioner’s decision has caused concern in other Government departments in terms of the effects of publication on risk management in general, and the construction of risk registers in particular.
In light of this, the Department of Health has decided to appeal against the Information Commissioner’s decision in both cases. Earl Howe made a statement to the House of Lords on 28 November that outlined the Department’s position and set out the reasons for our decision. Earl Howe also went as far as he could in offering up the categories of risk contained in the transition risk register. These include:
- how best to manage the Parliamentary passage of the Bill and the potential impact of Royal Assent being delayed on the transition in the NHS;
- how to manage planning so that changes happen in a co-ordinated way while maintaining financial control;
- how to ensure that the NHS takes appropriate steps during organisational change to maintain and improve quality;
- how to ensure that lines of accountability are clear in the new system and that different bodies work together effectively, including the risk of replicating what we already have;
- how to minimise disruption for staff and maintain morale during the transition;
- how best to ensure financial control during the transition, to minimise the costs of moving to a new system and to ensure that the new system delivers future efficiencies;
- how to ensure that future commissioning plans are robust and how to maximise the capability of the future NHS Commissioning Board;
- how stakeholders should be engaged in developing and implementing the reforms; and
- how to properly resource the teams responsible for implementing the changes.
It is expected that the Appeals Tribunal will consider this case in the new year. The Bill is currently before the House of Lords to continue its Parliamentary scrutiny.
More information on the Bill can be found on the Department’s website at www.dh.gov.uk/healthandsocialcarebill.
I hope this reply is helpful.
Customer Service Centre
Department of Health
23.02.2012 NHS Risk regiseter and FOI ”…the Information Tribunal will be focussing on that public interest issue around Section 35: Is the public interest best served in maintaining the convention of confidentiality around advice to ministers, or is it, in this case best served by going against this convention given the scale of the reforms, that the register should be released?”
15.12.2011 See this FOI request from Lord Owen about a major study on competition commissioned by Labour in 2006, on NHS Vault