Remember when the government rolls out the fallacy of ‘If you have nothing to hide then you have nothing to fear’? They normally do this when talking about the ability to spy on all our emails and phone calls, install CCTV in our homes and other such privacy busting measures. After all, the argument goes, if we are all open and honest about everything then crime, terrorism and pedophiles will no longer exist.
(I’ll not delve too deeply into that particular fallacy)
Well it seems that they have not taken this motto to their own breast. Instead the government has decided to veto the information commissioners order to reveal the NHS Risk Register.
Let me explain the risk register, because part of the reason the government says it wants to keep this secret is because it is awfully complicated and it is unlike us mere members of the public could ever understand it.
The NHS risk register is how to measure the risk of something bad happening due to to governments changes. It does this by measuring two things – how likely something is to happen and how bad it would be if that something did happen. It measures both of these elements on a scale of 1 to 5 with 5 being the worst.
So for example – rating the likelihood of something bad happening, you would give ‘Being hit by a meteorite’ a 1 because it is incredibly unlikely. You would give ‘Being hit by a bus’ a 2 because it is more likely (though not common), and you would give ‘catch a cold’ a 5 because it is really quite likely.
Then you rate the impact that a bad thing would have, again on a scale of 1 to 5 with 5 being the worst. So ‘Being hit by a meteorite’ would be a 5 because it’s likely to kill you stone dead. ‘Being hit by a bus’ is probably a 4, it’s likely to do some lasting damage to you. ‘Catching a cold’ would be a 1 because it’s unlikely to do very much harm to you.
You then multiply these two numbers together to get the relative risk. So ‘being hit by a meteorite’ would be a 5 (1×5) because while it is really nasty it’s unlikely to happen. ‘Being hit by a bus’ would be a 8 (4×2) and ‘Catching a cold’ would be a 5 (1×5) because although it is likely in the wet and cold climate of the UK the actual harm is quite small.
These numbers are actually based on science, previous evidence and clever predictions- unlike what i have just done these numbers are not just plucked out of thin air. It’s a good way of managing and mitigating the harm of the risks involved in any activity.
That is the risk register in a nutshell. It’s the equivalent of buying a car after kicking the tyres and checking that it’s not two cars welded into one.
As the NHS reform bill went through the various stages of being voted on by the commons and the lords, a number of people who were to vote on it asked if they might actually look at the risk register – kick the tyres as it were. At each request the government refused. Why would the people voting for this legislation need to see if this car is a ringer? Don’t you trust the government? You must be some sort of Trotsky.
At one point in the lords, they actually voted against seeing the risk register. I believe this is the lord’s version of sticking their fingers in their ears and humming loudly.
The information commission, after a freedom of information request, ruled that the government should publish the risk register, the government then went to a number of different courts in an effort to not do this. However, none of the courts agreed with the government because, well, they aren’t idiots.
Yesterday the government invoked the nuclear option – a veto for ‘exceptional circumstances’. Stating that the reason for this veto was because ‘otherwise the civil service might tell lies if they realise that the plebs might look at their working out’.
Essentially the government is admitting that the risk register is full of 4×4 and 5×5 risks and that if the public were to see this then they might start questioning if the NHS reform bill was actually worth the risk. Why else would you work so harm to hide something if it’s contents were not explosive to your governing of the UK?
In the Queens speech today one plan was for ‘businesses to have less inspection’. Ostensibly so that they can get on with the business of making profit rather than, I dunno, being in compliance with the law. I suspect that this will apply to all those private companies taking over parts of the NHS – After all, actually inspecting them might show that the companies involved may not have their patient’s best interests at heart. And that would be damaging to the government.
I would be willing to put money on the risk register containing a 4×4 risk of ‘Private healthcare companies break the law and provide sub-standard service’…
This blogpost was written while listening to Rob Dougan ‘Furious Angels’
One thought on “Nothing To Hide (Apparently)”
Couldn't agree more, Brian, about the NHS Risk Register! Firstly, the determined refusal of the government to actually make the Register publicly available is a disgrace. This is a democratic country; such protectionism by the government is shameful, against the UK's moral principles, and erodes their credibility. Erosion of credibility is enhanced when remembering the "bromance"-style speeches by both the conservative and lib-dem "leaders".
Ok, I've had my hissy fit, folks. I really note your last paragraph, Brian. That is, the Risk Register giving "4×4 to Private Health Companies breaking the law and providing a sub-standard service." I got evidence of this. Sobering stuff. A fairly close relative of mine went to a private hospital to have a lamenectomy to reduce his back problems. He went to a major, and reputable private healthcare company's hospital. The operation, and post-op care was good, he reported. He had the op in January, a couple of years ago.
Orthopaedic lamenectomies work by accessing bone joints, and stabilising them, typically by fusing them together or inserting rods to immobilise the joints. [Any orthopaedic specialists/surgeons, please feel free to correct me if I am in error, however.] Essentially, the operation can be very invasive, working on major skeletal structures, directly on the bones. Bones can become infected; they're living entities, with own blood supplies. My relative – about a week after the operation, was found in bed at home, in alot of pain, very high temperature, yet cold and sweaty to touch.
His wife took him back to the private hospital; they admitted him straight away, and began to treat the problem. Obviously, I do not know their diagnosis, but relative's signs are suggestive of ?major infection, ?sepsis. They didn't admit him to their HDU, just used intravenous antibiotics. He remained in for about a week.
He was discharged with an arterial catheter insitu, that required frequent management visits from the NHS district nurses. He is a self-employed HR consultant. He was too sick to work and support his family for 6 months, and thereafter has remained on a reduced business level until now.
The way the private hospital managed the relative's post-op crisis makes me angry; for all the company's good reputation, were they actually keeping my relative safe?? If he was going into sepsis, did they recognise it?? If yes, surely he needed the minimum of High Dependency; ?Intensive Care? If he needed Intensive Care, could they provide it? [If not; fine; I have nursed in a private hospital that rapidly transfers ICU level patients to the local NHS district hospital. Pre-proceedure, they clearly inform the patients of this possibility.] If they couldn't provide the level of care, systems support and monitoring he needed, why the #### didn't they transfer him?
My relative went in for a routine back operation. He finally ended up with circulatory catheterisation, needing support, and too sick to work. Could the NHS Risk Register assess private healthcare providers for the level of care? This example, allbeit DETAILED, surely prompts this assessment. Angry, Dissilusioned, of Surrey