Select Committee attacks lack of consultation on internal Government policy-making
Stinging criticism from MPs on the threat to patient confidentiality
The myriad arms of Government are constantly urged to work together and to avoid the ‘silo mentality’. So, when two bodies agree on a controversial policy, how much consultation should there be?
Last week saw the Chair of the Health Select Committee call for the immediate withdrawal of a memorandum of Understanding between NHS Digital and the Home Office, whereby data can be shared for the purposes of tracing potential immigration offenders. In a straightforward clash between two conflicting policies – the confidentiality of patient records and the enforcement of immigration laws, the Committee regards the public interest as having been inadequately considered through a proper consultation.
In its hearing on 16th January, NHS Digital had clearly defended itself, but MPs are in little doubt that dialogue was inadequate. Note the words in the letter sent by Dr Sarah Wollaston on behalf of her colleagues this week:
It is unfortunate that …. Both NHS Digital and the Department of Health have continued to maintain that consultation on the memorandum of understanding was unnecessary, or would have been inappropriate, because it was merely an “internal governance assurance document” which “represents the operationalising of existing functions”. That is wholly to miss the point. It is not the MoU itself on which full consultation should have taken place, but on the practice of data-sharing for immigration enforcement which it enshrined. That full consultation clearly has not taken place.
Quite apart from the substantive argument – which will clearly pitch the values and principles of the medical profession (as well as data privacy advocates) against more zealous immigration rule enforcers, the Institute sees in this several issues of major importance for politicians and policy-makers.
- Inter-departmental discussions take place all the time, but maybe we need better guidance as to when these need to be formalised into proper internal, stakeholder consultations. On occasions, there will be a case for a public consultation, but it is clearly unsatisfactory for any public agency (and there are about 1,000 of them) to be in a position where it cannot explain contentious actions without evidence of a structured dialogue.
- It is high time that Parliamentary Select Committees took a more robust approach to consultation – or the lack of it. A short foray into the celebrated book ‘The Blunders of our Governments’ confirms how many political and administrative screw-ups arise when civil servants or politicians race headlong towards decisions without adequate consultation.
- The Health Select Committee under Dr Wollaston has also recently persuaded the Department of Health that its plans for Accountable Care organisations should be subject to consultation – and demonstrates how influential Parliament can be when backbench Members of Parliament take the initiative.
This all reinforces the case for an All-Party Parliamentary Pubic Consultation Group, which the Institute is still seeking to establish.
In the meantime, it will be interesting to see if traditionalists in the civil service will seek to oppose the Select Committee’s approach, or whether a genuine attempt will be made to re-open this contention policy.