On the 4th April 2018 the Herald revealed that NHS Tayside had “transferred millions of pounds” from a charity fund to “prop up its ailing finances”.
On the 24th May 2018, this very serious matter was considered by a committee of the Scottish parliament and took evidence from the Cabinet Secretary for Health and Sport, the Director General of NHS Scotland and the Director for Health Finance:
The Official Report of this meeting can be read here. The committee meeting can be watched in full here.
In what follows I will share some considerations on the language used in giving evidence to this committee. In the course of this meeting, those giving evidence, used the word “culture” fourteen (14) separate times, and the phrase “open[ness] and transparency” twelve (12) separate times.
The following are the relevant passages [the full context can be read in the Official Report]
The Grant Thornton report on financial governance in NHS Tayside, including endowment funds can be read in full here. It should be noted that it did not include any examination of the Scottish Government and its officials.
What struck me in watching this committee meeting, an impression that was confirmed when reading the Official Report, was that references to a culture of openness and transparency were presented as tied to NHS Tayside, as if the Scottish Government was somehow entirely apart. Maybe this was not the intention but I came away wondering if the Scottish Government had considered and reflected upon its potential contribution to this culture?
I have previously shared my concerns that the Scottish Government is exempt from Duty of Candour legislation. I have also pointed out that the Civil Service Code does not include candour as one of its core elements:
Professor Walter Humes has shared his concerns about public accountability and has described how he is “familiar with the various techniques used by bureaucratic organisations to avoid responsibility when things go wrong: these include silence, delay, evasion, buck-passing and attempts to discredit complainants.”
He has gone on to say: “Those who hold high office in public bodies are very adept at defending their own interests. They may claim to support openness and transparency but those principles are not always translated into practice. Bureaucratic Scotland often falls short of the democratic ideals which are said to underpin civic life”. Professor Walter Humes did not separate out the Scottish Government in his considerations.
In a recent perspective, Professor Humes has shared his concerns about a “narrative of privilege” and “bureaucratic defensiveness” in what he termed:
In a recent debate on NHS Scotland, held in the Parliamentary Chamber, Jackie Baillie, MSP began:
Jackie Baillie’s experience of communicating with the Scottish Government’s Department of Health is not unfamiliar to me and many others. I have long since stopped trying to communicate with the Scottish Government because the answers I received were routinely evasive and rarely provided meaningful content. In fact, the content was usually not even “partial”, this being an issue that our Cabinet Minister specifically highlighted as one of the concerns about the culture of NHS Tayside.
It is clear that the concerns expressed by Prof Walter Humes, Jackie Baillie, MSP, and others (many of whom may be frightened to speak up for fear of repercussions) are legitimate. The following was reported in the Times, 7th July 2017:
It is disappointing to find that the Scottish public still cannot be reassured that a “culture of openness and transparency” may equally apply to the Scottish Government and its officials.