West Yorkshire & Harrogate NHS Slash Trash and Privatisers blunder deeper into mire of secrecy

Build bridges not walls! This is our NHS – don’t try and lock us out!

On the day that Trumpery entered the White House, the West Yorkshire and Harrogate chief NHS Slash Trash and Privatiser slammed the door in the face of  NHS protectors’ requests for information.

We shall appeal against this refusal to provide the information we asked for.

West Yorkshire and Harrogate Sustainability and Transformation Plan was published in early November without any of its appendices or related documents.

This means that although  the big picture is clear  – to reduce the NHS to a funding stream and a logo as a UK version of US Medicare, run largely by global American health companies – it is basically impossible to find out any detail of what the STP actually proposes to do.

This is no accident.

What the Sustainability and Transformation Plan team, NHS England and NHS Improvement are saying in private is unspeakable in public

The West Yorkshire & Harrogate Sustainability and Transformation Plan (STP) leader Rob Webster has refused to publish the STP appendices and financial information, on the grounds that if the STP team and “external partners” knew that what they discussed and planned was going to be made public, this would inhibit what they said and did.

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In bureaucratese, they found our request is

“exempt under section 36(2)(ii) (the free and frank exchange of views for the purposes of deliberation)”

Because publication of the information could:

“discourage free and frank discussion during deliberation, or could discourage free and frank provision of advice.”

In other words, what the STP team, NHS England and NHS Improvement are saying in private is unspeakable in public.

This bears out what North Midlands Director of Commissioning Operations, Wendy Saviour, told a meeting of Shropshire Clinical Commissioning Group back in the summer of 2016:

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The letter sent to us on Trumpery Day, 20th Jan 2017, adds that publishing this information:

“would also lead to unnecessary public alarm or confusion as premature disclosure would likely to prejudice scrutiny or release sensitive issues still on the internal agenda or that are evolving.”

West Yorkshire Joint Scrutiny Committee meeting can’t scrutinise the Sustainability and Transformation Plan without knowing what it’s scrutinising

Rob Webster thinks both the public and our elected Councillors are too stupid to understand that the STP team are still working things out, and we would take work in progress as the finished article.

But the West Yorkshire and Harrogate Joint Health and Overview Scrutiny Committee meeting on Monday 23rd January is to scrutinise aspects of the West Yorkshire  & Harrogate  Sustainability and Transformation Plan.

How can they do that, if they don’t have full information about the STP?

Our request for full information is supported by Councillor Tim Swift, who is Calderdale Council Leader and Chair of Calderdale Health & Wellbeing Board.

I copied him  into my initial request for the missing STP appendices and related information, and in turn he copied me into his reply to Rob Webster:

“In general I support the view that any key information necessary to understand the STP should be either published or available in request. I would welcome your agreement to this, and also your views on whether the list identified and requested by Ms Shepherd is a fair summary of what information is and should be available.

I hope it may be possible to respond to this promptly given the concerns surrounding the current discussions on contracts and operational plans.”

We shall tell the West Yorkshire and Harrogate Joint Health and Overview Scrutiny Committee meeting on Monday 23rd January  that the West Yorkshire & Harrogate STP Leader thinks they cannot be trusted with the full information that he sent to NHS England.

We shall ask them to demand of NHS England, NHS Improvement and the STP Leader that they provide this full information to the Joint Scrutiny Committee, because scrutiny is impossible without access to the evolving STP plans and proposals.

The absence of information is far more prejudicial to scrutiny than the provision of information.

What we now know for sure, by the STP Leader’s own admission, is that the STP as it stands is based on hidden documents that are works in progress, and that these works in progress include things that they wouldn’t say if the STP team, NHS England and NHS Improvement knew the public would hear them.

The West Yorkshire and Harrogate Joint Health Scrutiny Committee should send back the STP proposals that it is considering at its Monday 23rd January meeting, and postpone their scrutiny until they have been provided with the full information that Rob Webster is withholding on the grounds that they can’t be trusted to scrutinise it.

In November the STP leader said he was all in favour of transparency

In November, STP Leader Rob Webster told the Kirklees Health & Wellbeing Board meeting that he was all in favour of transparency and would check with NHS England about releasing these additional documents.

So what happened?

Was he lying and playing for time? Or have NHS England and NHS Improvement put the boot on his neck?

In December – weeks after the Kirklees Health and Wellbeing Board meeting, when no additional STP documents had been released – I asked him to publish these documents. He replied:

“Unfortunately some of the financial material between commissioners and providers was both provisional and potentially‘commercial in confidence’. It has also been superseded by information from NHS Improvement and NHS England on financial allocations and transformation.”

He also converted my email into a Freedom of Information Request to be handled by Wakefield Clinical Commissioning Group – which meant 20 working days could pass before a reply was required.

When I questioned this, he replied

“We treat all requests as FOI as a matter of course, particularly when information may have to be withheld for legitimate reasons.”

On Trumpery Day (20th January 2017) the Freedom of Information reply admitted that it would be in the public interest to disclose the information – but

“in the reasonable opinion of a qualified person, disclosing it would prejudice or be likely to prejudice the effective conduct of public affairs.”

Here is some of the longwinded explanation

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If you can bear to read such verbose bullshit, here is some of the rationale for STP secrecy:

“Although we do hold the information that you have requested, unfortunately we find it to be exempt under section 36(2)(ii) (the free and frank exchange of views for the purposes of deliberation) of the Freedom of Information Act and will not be released.”

NHS Wakefield CCG believes this exemption applies because releasing the information would likely to inhibit the CCG’s future strategy for the Sustainability and Transformation Plan.

The disclosure of initial financial plans could undermine or prejudice West Yorkshire and Harrogate Sustainability and Transformation Plan ability to carry out its STP work effectively and could discourage free and frank discussion during deliberation, or could discourage free and frank provision of advice.

Disclosure would prejudice the effectiveness with which the West Yorkshire and Harrogate collaborative achieves its objectives across all of its business areas to the detriment of the public interest. There is a strong public interest in public authorities being able to carry out and use frank assessments and maintain useful and candid assessments of progress and effectiveness, both whilst individual projects are being delivered and in assessing the general operation of business areas. In maintaining oversight of the effectiveness with which the process is being delivered, the process is enhanced when any contributions/assessments produced or submissions made by the STP team and external partners are unrestrained frank and candid. The prospect of disclosure would be likely to undermine or restrain this work and reduce the frankness of the plans leading to less effective recommendations.”

Links to emails and documents

The 20 Jan 2017 FoI Reply is here and the two heavily redacted documents sent with the letter are here and here – effectively meaningless as a result of the redactions, although we shall have a close look to see what we can glean.

Here is the email I sent to Rob Webster on 20 December 2018

20-12-16-js-email-to-rw-please-publish

To be clear about what the West Yorkshire and Harrogate STP leader has refused to disclose, the full appendices published by the South West London STP are here.

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