John Healey: Hidden risks that lie at the heart of huge NHS reforms

It was back in 2010 as Labour’s shadow health secretary that I first asked the Department of Health to release this information, the “transition risk register” relating to the controversial Health and Social Care Bill.

A risk register contains an objective list of the risks associated with the implementation of a programme or policy, confirming and giving reassurance that the Department has considered fully what might go wrong and taken steps to ensure the risks are minimised or managed.

Risk has been at the heart of concern about the NHS reforms from the outset. Lack of evidence and confidence about how well the Government was prepared to deal with the risks was a major cause of growing professional, public and Parliamentary alarm at the plans throughout last year.

When the Government refused my FoI request, I referred it to the Information Commissioner. A year later, the Information Commissioner came to the legal judgment that the risk register – which he has had the benefit of seeing – must be released.

He said there was “very strong public interest in disclosure of the information, given the significant change to the structure of the health service the government’s policies on the modernisation will bring”. And he said it would “aid public understanding and debate”.

But the Health Secretary still refuses. It begs the question, just what is Andrew Lansley trying to hide?

David Cameron promised “no top-down reorganisation of the NHS” before the election; now he is forcing through the biggest reorganisation in NHS history – at the same time the health service is facing the biggest financial squeeze since the 1950s.

But this isn’t a matter of whether you are for or against the reforms.

It’s about people’s right to know the Government’s own assessment of the nature and scale of the risks they are running with the quality, safety and efficiency of our NHS. They want to know the Government are doing everything they can to reduce risks to patients and services.

But the Government haven’t reassured us of that yet – that’s one of the reasons why concern and criticism is still growing from the public, patients, health professionals and Parliament.

Ministers are dismissive. They’re out of touch. They simply can’t see what the NHS means to people, how much it matters.

We all need the NHS. We trust it when we are most fearful. We utterly depend on it when we are most vulnerable.

The NHS in England treats three million patients every week. It employs more than 1.4 million staff. It provides some of the best health care in the world free at the point of need to each and every one of us in Britain, throughout our life.

That’s why our NHS matters so much and means so much to everyone in the country. That’s why there has been such a swell of concern about the reorganisation and such a swell of support for the Government to be open about the risks. And that’s why the Information Commissioner has judged the balance of public interest is in disclosing not withholding the risk register for the NHS reorganisation.

Meanwhile, Parliament is being asked to pass legislation for this NHS reorganisation. It is crucial that MPs and the public have all the information available before a final decision is made on this controversial bill.

Staff and patients are really worried about the costs, uncertainties and risks such a huge upheaval will bring. Everyone I speak to – whether in hospitals, GP surgeries or charities – says they are confused about what the changes will mean and worried about whether standards will slip.

In Rotherham alone, £18m that was promised for patient care is being held back this year and next to cover the costs and risks of the root-and-branch reorganisation. Across Yorkshire, more than £300m is being held back.

The chorus of criticism and coalition of calls for the bill to be dropped or significantly amended further is greater now than at the start of the bill’s Parliamentary passage and when I made my disclosure request.

The Government must respect the legal ruling of the Information Commissioner. And I trust the Tribunal will reject their appeal today. They must release this risk register to allow for fuller scrutiny of their plans by the public and by Parliament, and to reassure us all that the big risks in their far-reaching NHS reorganisation are being properly handled.