§ 10.47 p.m.
§ Lord Haskel rose to move, That the order laid before the House on 20th November be approved [15th Report from the Joint Committee].
§ The noble Lord said: My Lords, I welcome this opportunity to introduce the proposals which require National Health Service trusts to hold their board meetings in public. The order seeks to ensure that National Health Service trusts in England, Wales and Scotland are added to the schedule of bodies to which the Public Bodies (Admission to Meetings) Act 1960 applies. NHS trusts will then join local authorities, parish councils, education committees and health authorities on the schedule.
§ The Public Bodies (Admission to Meetings) Act sets out the provisions. The five main provisions are: any meeting of a body shall be open to the public; the public shall be given at least three days' notice of time and place of the meeting; agendas and papers shall be provided; newspapers shall be enabled to report the meeting and be given the agenda and papers; committee proceedings shall be treated as proceedings of the body in question and public access be given to them.
The Act includes important provisions for the discussion of confidential business. It enables bodies to exclude the public from a meeting or a part of a meeting:
whenever publicity would be prejudicial to the public interest by reason of the confidential nature of the business to be transacted".
§ Such an exclusion needs to be made by a formal resolution of the board taken in public.
§ My right honourable friend the Secretary of State for Health has already told chairmen of NHS trusts that he does not expect that provision to be abused. Public board meetings should enable those attending to see the real decision-making process and not a performance rehearsed earlier behind closed doors. Use of closed sessions should be limited to those areas of board business where real harm to individuals might result. 849 Those occasions will be infrequent and limited to discussions on patient or personnel matters where individuals might be identified or, occasionally, to legal or some operational matters where there are strong grounds which must be tested on each occasion.
§ My right honourable friend the Secretary of State for Health wrote to all trust chairmen last summer, advising them that they should begin to open up their board meetings. A substantial minority of trusts already hold their board meetings in public. Others welcome the proposed order. They share the belief that by embracing openness in that way, the public will be able to understand the opportunities and constraints confronting their local health services and contribute to their development. This order is a key part of the strategy to ensure that the NHS is more open and accountable locally to the people who use its services.
§ I can also inform your Lordships that that commitment to openness has been endorsed by the Committee on Standards in Public Life under the chairmanship of the noble and learned Lord, Lord Nolan, in its fourth report and it has endorsed our intention to amend the Public Bodies (Admission to Meetings) Act to apply to NHS trusts as set out in the order before us. This order is necessary and long overdue and I commend it to your Lordships. I beg to move.
§ Moved, That the order laid before the House on 20th November be approved [15th Report from the Joint Committee].—(Lord Haskel.)
My Lords, I thank the Minister for introducing this order and for the clear way in which he has explained its purpose and effect. I say immediately that I have no difficulty with the principle of the order. Moreover, I have no difficulty with the principle of the 1960 Act which governs it. It would be quite surprising if I had, in view of the fact that that particular Act of Parliament was introduced as a Private Member's Bill by no less a person than my noble friend Lady Thatcher not long after she was first elected to Parliament. Unfortunately, my noble friend is not in her place tonight to give us her views on the appropriateness of this order, but for my part I believe that it is entirely right that the proceedings of NHS trusts should be open, as a general rule, to the public and reportable by the press. I say "as a general rule" because, as the Minister made clear, exceptions should be made if such publicity is likely to prove prejudicial to the public interest.
The Minster referred to guidance issued by the Secretary of State as to the circumstances in which a board may feel that proceedings should be conducted in private. Will the Minister clarify the status of that guidance? Am I right in thinking that in law it will be a matter for a particular trust board, entirely at its discretion, to determine whether a set of circumstances are or are not of a sufficiently confidential nature and, therefore, whether the public should be excluded from the proceedings? I have not had sight of the Secretary of State's guidance, but will the Minister confirm that the provisions of the 1960 Act have been or will be explained to those chairmen in full so that it is quite clear to them what they are legally empowered to do?
850 Discussions relating to individual patients or personnel are obvious instances when a closed session might be appropriate. But what of business which is confidential by virtue of its commercial sensitivity? What of matters which may give rise to a preliminary discussion in the board about something which, if wrongly reported, could cause unnecessary alarm and despondency among the general public?
Clause 1 of the 1960 Act gives to the public body considerable latitude on the types of matter which might be considered confidential and, as far as I can determine, virtual carte blanche to exclude the public by reason of such confidential business. I should be grateful if the Minister would confirm that interpretation because it seems to me that it is important that that provision is properly understood.
My second question relates to a matter of detail. I thought I heard the Minister say that, where a trust board meeting was open to the public, agendas and papers had to be provided to any members of the public attending. I have read the Act, which refers in Section 1(4)(b) to the right of a newspaper to be furnished with a copy of the agenda and supporting papers upon request and upon payment of postage. However, is there an equivalent requirement in relation to members of the public? Similarly, I also thought I heard the noble Lord say that three days' public notice must be given of the time and the place of a board meeting. Will he confirm that that requirement is without prejudice to the ability of a board, if it so chooses, to convene a meeting at shorter notice?
My next question relates to the territorial coverage of the order. I note that it covers England, Wales and Scotland, but do the Government have any plans to extend the scope of the measure to Northern Ireland? I realise that the 1960 Act could not be the vehicle for that, but perhaps there is another legislative route available.
As the Minister said, for a number of NHS trusts this order merely serves to rubber stamp current practice in that the public are already admitted to a good many trust board meetings. However, as I stressed earlier, it is important that trust boards should be allowed to exercise the full measure of discretion afforded to them under the 1960 Act. If they do not have such discretion, or rather if they are encouraged not to exercise it, the danger is that the real business of the trust board will be conducted outside the boardroom. That would not be in the interests of the trust nor, indeed, of the local population. Subject to those points, we on this side of the House support the measure as a useful further step in promoting transparency and accountability in the NHS.
§ Lord Haskel
My Lords, I thank the noble Earl for welcoming the order. He asked about the way in which the resolution is taken for the board to meet in closed session. The resolution has to be taken by the board in public; in other words, the board has to give its reasons in public as to why it is going to move into closed session. Therefore, there is some protection for the public in that way.
851 The noble Earl also asked about the three days' notice and whether there are rules for convening such a meeting at short notice. I shall have to write to him about that because I do not have such details with me this evening. He also raised the matter of agendas. Agendas and papers will be provided to those members of the public who ask for them, in the same way as they are supplied to newspapers.
On the question of the status of the guidance, I can say that my right honourable friend the Secretary of State has written to all the chairmen of NHS trusts to explain the provisions of the 1960 Act. However, I am not sure of the terms in which he has written, but we can perhaps send the noble Earl a copy of the letter that was sent to enable him to see the nature of those terms.
I thank the noble Earl for explaining the historical significance of this public bodies Act; indeed, it is something that I had not realised.
As regards Northern Ireland, I understand that there is a different system of health management in the Province. That is why it may not be appropriate for this order to be extended to cover Northern Ireland. However, I shall write to the noble Earl regarding the precise reasons why the order does not extend to Northern Ireland.
I am most grateful to the noble Earl for his comments. It is always useful and instructive to have the benefit of his experience. I commend the order to the House.