“’More transparency is needed about big decisions affecting our NHS’ “

“Eddie Duller OBE, a director at Healthwatch Oxfordshire, the county’s watchdog on health and social services matters, asks why the authorities are not more open about the big changes ahead

IT may sound bizarre but the Information Commissioner’s Office, which is the UK’s independent authority set up to promote openness by public bodies, appears to be saying it is alright to plan changes to health and social care in Oxfordshire and neighbouring counties in secret.

At least, that is my interpretation of a ruling as a result of Healthwatch Oxfordshire’s attempt to find out what was happening in the biggest health and social services shake-up for many years.

We raised the query in July last year under the Freedom of Information Act with the Oxfordshire Clinical Commissioning Group (OCCG), which has been tasked by the NHS to save money and change the way services are delivered.

The main reason for this was that a new authority was introduced by the NHS: the Buckinghamshire, Oxfordshire and Berkshire West (BOB) area, which was supposed to create savings by joining up services from several areas.

Secondly, our view was – and is – that the public should have been involved earlier in the detail of the plans.

However, our request was turned down by the OCCG on the grounds that ‘releasing the information into the public domain at this time would be likely to inhibit the ability of public authority staff and others involved to express themselves openly, honestly and completely…..’

But what really got me going was the fact that the OCCG claimed that the new BOB organisation was not a statutory organisation and therefore the Freedom of Information Act did not apply.

That means that BOB could – and still can – take decisions in secret. I still think that is wrong.

They appear to want their cake and eat it by claiming it is not a statutory authority but at the same time giving it enormous powers to change the health service over a large area of the country.

The final version of the plan was published and the first explanations were made available just before Christmas last year – six months after we asked for information.

The Information Commissioner’s Office backed up the OCCG just a few days ago, 14 months after we queried their secrecy.

In effect it rather belatedly backed up the OCCG by saying it was alright to consider matters in secret as long as the proposals were published at a later date.

So what was the problem in giving out the information earlier?

When it was finally published the BOB transformation plan, which includes Oxfordshire, promised that there would be “meaningful engagement and consultation activity on services, such as those at the Horton General Hospital in Banbury and community hospitals in Berkshire West to help inform commissioning of future services”.

So why did it take so long to get round to it? Why not involve the public earlier?

The outcome of some of the changes in services at the Horton is that the question over the downgrading of the maternity department has been referred to the Secretary of State for Health after pleas from thousands of people to keep it as a consultant led service were ignored, and there is still no detail about what is to happen to the rest of the hospital site.

In effect the resulting judicial review is holding up the whole of the other services referred to in the first phase of consultation, although some of them are not contentious.

I hope the OCCG will learn from this and tell the public what it is thinking about in relation to the rest of the county much sooner.

In fact, now would do.

They should, in my view, form advisory bodies in each market town and Oxford as they did when creating the new “health campus” in Henley so that local people can have a greater say in designing the services.

It is an opportunity to involve the public through voluntary organisations and GP practices participation groups among others.

The BOB plan talked about the risks involved in changing the services, among them public sensitivity and cynicism.

It says grandly that “people view the programme as a money saving exercise which has no positive effect on health services in their community. “

It adds: “Stakeholders need to be openly engaged and involved in the process so that they are able to develop a proper understanding and can become ambassadors for the programme.”

I think it follows that if they practised what they preached and told us what is going on at an earlier stage they would stand more chance of getting a reasoned reaction and discussion for a plan which may have some potential merits.”