Anthony Browne, health editor
The Observer, Sunday January 28, 2001
The Government plans to make independent scrutiny of the National Health Service a criminal offence in a move described as 'control freakery' and 'totalitarian' by health campaigners.
Health Secretary Alan Milburn wants to outlaw awkward independent reports on standards and treatment in the NHS, and rely on official studies to monitor all aspects of the service. Any group or individual trying to produce an independent report will be subject to heavy fines. The Minister also wants to disclose patients' medical records to third parties for research purposes - even if they and their doctors object. Patients' groups and doctors have accused Milburn of being 'Orwellian' and 'undemocratic' in the new Health and Social Care Bill. Clause 59 of the Bill, to be examined by Parliament this week, follows embarrassing reports into NHS care. It will mean patient and consumer groups will not be able to do spot checks on hospitals or clinics, or measure the effect of treatments. The Government will have powers to control the publication of reports into doctors' workloads, waiting times, conditions in hospitals and the quality of care. Studies into deaths resulting from infections picked up in hospital would be banned unless permitted by the Minister.
Any individual or patient group breaking the rules will be fined up to £5,000. 'It is a totalitarian approach, it is not democratic. It is total control freakery,' said Dr Fleur Fisher, chairman of the British Medical Association's Foundation for Aids and the BMA's former head of ethics. 'The immense width of these powers are scary. It's like waking up and finding you are in 1984,' she said.
The Department of Health insists it needs the powers to stop patient information being used against the interests of patients. A spokesman said: 'Use of the powers must be approved by Parliament and use of information must be to improve patient care or otherwise be in the public interest.'
Philip Stephens, of the health information company IMS Health, said the powers threatened 'the ability of patient organisations, academics and the drugs industry to undertake important research to improve the quality of patient care'.
Last week the Government abolished the Patient's Charter and the rights enshrined in it. Milburn is also abolishing Community Health Councils, the only statutory patient watchdogs. The College of Health, an advice line that helps patients avoid excessive waiting times, has lost its public funding.
Roger Goss, director of Patient Concern, said: 'Milburn wants to create the appearance of greater patient involvement, while trying to make sure there are no effective bodies criticising his efforts to smarten the NHS.'
The Community Health Councils are being replaced by much weaker Patients' Advocates, appointed by the hospital and reporting to the chief executive. The Government has replaced the Patient's Charter with ' Your Guide to the NHS '. Instead of giving 'rights', it tells patients what they can 'expect', emphasising patients' responsibilities in terms of not missing appointments, doing exercise, and practising safe sex. When he announced plans to abolish the Patient's Charter, the then Health Secretary Frank Dobson said: 'The old Patient's Charter focused too much on patients' rights. It encouraged consumerism, but made health professionals defensive.'