Board meetings in public make for greater transparency?

Baroness Murphy

We had a brief discussion during the Health and Social Care Bill committee last night about whether the new healthcare economic regulator, Monitor, will meet in public. It will apparently. I have always supported having meetings in public and chosen to have them in public whenever there was a choice. But I have realised over the years that public meetings tend only to make decisions that have been previously debated in private. If a public body has public board meetings it will have ‘briefing meetings’ or ‘seminars’ in private where the main business is thrashed out and deals are done. Health Boards are not local authorities with ‘representatives’ shouting for their corner; they are corporate bodies making joint corporate decisions that everyone has to sign up to and be accountable for. Private dissent is too often buried in the urge to be seen to have a united front in public.

Transparency and full public accountability appear to be strengthened by public meetings but are often not. Board behaviour is affected by the presence of the public; the level of challenge and scrutiny is diminished and behaviour tends to be more compliant than in private. There are also major anxieties about raising patient safety issues and discussing serious untoward incidents, for fear of producing public alarm. Decisions that should be taken by the board have a tendency to get sorted out in private sub-committee meetings when it would have been better to have full discussion with the main board.

On the other hand public meetings increase public trust and understanding of the issues and there’s no doubt that the quality of reports are improved when they are going into the public domain. Business sensitive and patient confidential matters can be reserved to private parts of a meeting from which the public is excluded. As so often a fudged position is probably the best…the Chair has a responsibility to ensure that dissenting views are expressed to a wider audience and worked through in the public arena but should make sure they know the outcome of a decision long in advance!

 

 

25 comments for “Board meetings in public make for greater transparency?

  1. Dave H
    14/12/2011 at 12:41 pm

    Part of the problem with public meetings is that it is necessary to raise the unpopular or unacceptable simply so it can be discussed and rejected. The downside to doing this in public is that the media will often run with banner headlines that XYZ is looking at doing something bad even when that was never the case. Parliament seems to handle this to some extent with the concept of probing amendments which are then withdrawn, but I suspect this works because the language of the amendment is mild and reporting the minutiae of committee meetings is not high on the editors’ lists and so most people are unaware of it.

    Someone needs to sit down in private and work through concepts and ideas, and inevitably will often ask others for input before a proposal suitable for the public is produced. At what point does this become a private sub-committee?

    • Gareth Howell
      14/12/2011 at 4:15 pm

      At what point does this become a private sub-committee?

      ‘flippantly’, hackers must have something to do with it. I am dubious that ANY private meeting in a political place, is in fact, private.[The word forensic is used in crime investigation]

      Journalist ‘stringers’ who have been with us for generations, but about which the public knows all too little, have ways of finding out the details of more or less any meeting
      you care to mention, if they want to.

      Quite apart from the fact that many “private”
      parliamentary committee meetings are private simply because the chairman can not be bothered with the public gallery/press intrusion in to the discussion, silent as they may be.

      will often run with banner headlines that XYZ is looking at doing something bad even when that was never the case
      which may be Dave’s way of saying that “pumping” takes place in the public domain as well as the private one. Somebody will respond by saying it was the case Ya!boo!

  2. Croft
    14/12/2011 at 12:58 pm

    What about minuting private meetings and releasing them with a sufficient delay like the BoE.

    • Lord Blagger
      15/12/2011 at 1:53 am

      Why not video them all live?

      We can do the same with all phone calls.

      They work for us. It should all be public knowledge

  3. Gareth Howell
    14/12/2011 at 1:02 pm

    http://www.monitor-nhsft.gov.uk/

    “also major anxieties about raising patient safety issues and discussing serious untoward incidents, for fear of producing public alarm”

    The big problem with being a patient in a system which deals with vast numbers of people; a political problem, and yet the individual patient has to assert his own self respect either with/without understanding the politics of the ‘health’ service.
    The private Health sector uses the system for its own advantage accordingly.

    The above comments apply to nearly all parliamentary committees. As one new Lady MP remarked some years ago,not in so few words.

    “It is a pity that
    when we legislate, it applies to everybody”!

    I can see huge pitfalls in the ‘instantaneity’ of the newly commissioned
    system. There is surely the world of difference between the approach to health, and life, (sickness and death) of the local GP, and the hospital surgeon, but if it is all linked up in the twinkling of an eye, the patient will be run in to the ground, with regard to his own perception of his own needs, based on a complete history of his former lives, that nobody in their right mind, would consider as relevant!

    This would be one of the discussions taking place in the local Pathfinder groups.

    I’ve got an amusing digital copy of “Confessions of a GP” Benjamin Daniels, which highlights many of these problems from the Gp’s patient point of view.

    He does also think, 7 years ago, that it is crazy to be able to link up to mail from a friend in Hackney whilst on holiday in Morocco, without being able to link up to med records three miles away in the local hospital instantaneously.

    It may have seemed like that seven years ago, but when you reconsider the POLITICAL implications, one of which pointed to by Baroness Deech, with regard to people threatened abroad, they are
    moderately sinister today!

    A patient may not want his medical record to be considered when surgeons’ decisions are being made!

  4. maude elwes
    14/12/2011 at 2:07 pm

    I had to laugh at the minuting policy suggested. When you receive the minutes covering government or council meetings they are altered to suit the desire of those who run the show. As are mmost business minutes. Pleeese! Oh, yes I know they are not supposed to.

    The trick, Baroness, is to let the Public know how much their voice is considered by those in power. Make it clear to them what is taking place, what the outcome will be in any given situation and why the question is being asked in the first place.

    Once it is known they have a voice that counts, you will find more and more will want to be involved. That way, no one can say they didn’t know what the outcome would be in any given circumstance.

    Then we would ‘all’ be accountable.

    Now that should be a great relief to those in the position of having to lead the country. Wouldn’t it?

  5. Senex
    14/12/2011 at 4:45 pm

    Talking of ‘public alarm’ I had a dental appointment a while back and feeling somewhat peeved that all of the waiting room magazines were for women my gaze wandered to settle upon a small poster imparting awareness of mouth cancers and symptoms.

    What was alarming was a statement at the bottom of the poster that said “5 people every hour die” and how important awareness was.

    This happened to coincide with some thoughts of mine on what the size of England’s population should be. By working to lower the population to say 55 millions we could see an upward trend in GDP per Capita whilst earnings fell.

    It did occur to me that perhaps we need to hire more dentists?

    • Gareth Howell
      16/12/2011 at 6:21 pm

      ” perhaps we need to hire more dentists”

      Or cut out sugar entirely, then you would scarcely need dentists at all,and all live longer.

      Mouth cancers are a development from Piahorroea(?) and can effect the jaw as well.
      I doubt whether they gain a hold rapidly, but
      people who have teeth removed and not have the gaps sewn up, would run a very big risk of developing it, through the jaw literally rotting within, through food becoming lodged there permanently. As the food rots, so does the jaw.

      Not all dentists are conscientious about the future health of the patient, as to do the sewing required, and even then…… why should they bother if the patient does not do so himself and has lost his teeth?

    • ladytizzy
      16/12/2011 at 11:06 pm

      Senex, magazines in waiting rooms tend to be donated. I’ll leave it there, sweetie!

      A dental anecdote, painfully true:

      Quite some time ago, my dentist was trying to work out the problem with my receding gums. I helpfully suggested that I was a scrubber.

      I didn’t have to pay.

  6. DanFilson
    14/12/2011 at 9:14 pm

    Baroness Murphy raises an interesting point, and I tend to sympathise with it. I don’t know the answer. It’s a thorny problem. Whereas pre-meetings are commonplace in council circles, it seems inappropriate for a regulatory body which may want a frank discussion uninhibited by the presence of press and public, though still governed by the laws of slander and libel, and of necessity aware of the possible commercial and market sensitivity of what they discuss.

  7. MilesJSD
    15/12/2011 at 5:38 am

    To reach any effective government-by-the-people, you need to put both win-lose debating and media-hyping on hold;
    whilst you implement a seqúential timeframe of
    (1) total information sharing/distribution to all of the People;
    (2) cooperative public Discussion, sequentially-tiered throughout the People
    (3) the Method III for Needs & Hows Recognition and win-win-Win Cooperative Problem Solving;

    and then
    (4) a Three-Way “cooperative public debate” to immediately precede the temporarily on-hold
    (5) Politically-Competitive Win-Lose two-sided Debating process & the similarly ‘on-hold’ one-way Media-Manipulation-of-The People and of the Public-Mind.

  8. baronessmurphy
    18/12/2011 at 10:02 am

    I was interested to read yesterday that the outgoing Cabinet Secretary, Sir Gus O’Donnell had serious reservations about the publication of minutes from cabinet meetings as a result of the Freedom of Information Act for rather the same reasons I expressed doubts about public board meetings, the risk that people will not express serious doubts about a policy when they know it will be exposed to critical scrutiny by the press and public. This is perhaps the answer to Croft’s suggestion. Minutes can be ‘neutered’ as Maude Elwes says, in fact they are usually poorly written and unclear. They record decisions but not individual views. Probably minutes should be made public where public bodies meet in private but at a significant time delay. JSD Miles makes some important points about how to do open Government and encourage real participation but for me there are other forums where this can be done and other means of getting dialogue.
    I didn’t get the dentist points; perhaps they’re for another post?

  9. Lord Blagger
    19/12/2011 at 10:40 am

    I can tell you why he has reservations. I made an FOI request for his credit card spending on his government procurement card.

    They (the cabinet office) and GD fought tooth and nail to keep that secret.

  10. Lord Blagger
    19/12/2011 at 10:41 am

    ie. Secrets are for the likes of Gus O’Donnell, MPs and peers.

    Secrets are not for the plebs. The state demands to know all, but will hide its crimes, protect its members from prosecution for fraud, it will keep the criminals in its club, …

    • maude elwes
      19/12/2011 at 3:57 pm

      @LB:

      I have every reason to believe your assessment. And how did you get into FOI?

      This Gus O’Donnell, shortly to retire, as the papers say, is very well into the idea of spending tax payers money and keeping his suggestions quiet. In other words, secret.

      From what I read lately he was the instigator of the suggestion that tax payers should fund the wife of the PM. Apparently he feels Mrs Cameron doesn’t get enough per annum to satisfy her needs. He suggests that we should all be willing to hand wages to wives of the PM for their having given up a career to support their husbands. Yet, my understanding is, this lady remains in employment. Does this smack of greed to you? Or, is it just me?

      I nearly fell to the floor from that idea. Here is this wealthy woman in her own right, with a good job, which takes up very little of her daily routine and for which she is no doubt paid in excess, as she is into product placement activites, akin to the Beckhams. Yet it is still felt the tax payer should be willing to fund her for her excellent ability to choose a husband who was able to make it to the top.

      Now, as Mrs Cameron is a likeable lady and keeps her head down nicely, O’Donnell must have felt this would go over well. But, you have to look at it in the round.

      What if our Prime Minister had had the poor judgement to choose, or, had been hoodwinked into a wife, the equivalent of Mrs Bercow. How would the general populous feel about giving her a regular stipend with a golden parachute, or, hefty pension?

      This is obviously a way to throw out ‘the spouse should have some money too’ lark, for the lot of them. Then, they will be able to shout they must take in same sex partnerships and any other deviant ‘family affairs’ that is now floated around as popular with the voter. So all the layabouts who cling on for grim life will be financed by the already hard pressed middle and lower middle classes.

      Can you see a type like Jackie Smith’s husband on a nice little earner, enabling him to pick up his porn without worry to the cost, and all at tax payers expense.

      Are we going to see these ‘wives’ on TV, (fortunate for Milliband he got in there with his concubine in time) for we know Clegg’s Mrs will be in there for the main chance, in a choose ‘me’ debate? Aping the selection of leader campaigns we have adopted from that superpower across the pond. Although I think they bung Obama’s wife as she is prone to nag.

      Well, is that going to result in, he doesn’t get in if we don’t go for the wife pageant? Think about it. Is she up to that kind of scrutiny. And will they accept the outcome in the event they let down their man/woman?

      Can you see Denis Thatcher being propped up with his glass on the posdium as he hit the newsnight audience. A Charlie Kennedy re-run.

      A spouse has no right to money for marriage. The earning spouse must be willing to commit their funds to the upkeep of the chosen one. They decided this was their one for life, we, the tax payer did not. So they must foot the bill for their own lover. After all that is the romance they wanted, isn’t it?

  11. Twm
    28/12/2011 at 8:39 pm

    Looking at the number of Peers, their maximum fee per day, the number of weeks per year worked, and the amount claimed, it would appear that, either all peers claim 2/3 of their maximum fee for the year, or 66% of peers claim all their fees for the whole of the time.

    Quite a lot.

    Max £300 per day
    no. 820 peers
    working weeks 28
    assuming four day week
    Bill last year £18m

    • Lord Norton
      Lord Norton
      29/12/2011 at 4:01 pm

      Twm: You can check as all expense claims for each peer are published.

    • Lord Blagger
      29/12/2011 at 4:31 pm

      Except the bill to us, is far higher Twm.

      The cost of running a peer for a day, to the people who pay for the lark, is 2,700 pounds.

      Now the lords want you to believe that the cost to us, its what they take out. It’s smaller.

      • Lord Norton
        Lord Norton
        29/12/2011 at 4:59 pm

        Lord Blagger: As has been pointed out frequently, that is not the cost of a peer.

        • Lord Blagger
          29/12/2011 at 5:50 pm

          It is the cost of running the lords, divided by average attendance, by the number of sitting days.

          It’s the cost to the public of keeping you in the style to which you have become accustomed.

          Rather embarrassing, which is why you don’t like it mentioned. It’s why you prefer the measure to be what you take out of the system. That shows the priority of Peers. What can they get out of the system is the measure you want to use, rather than the cost to society.

      • Dave H
        29/12/2011 at 5:36 pm

        Look at it from another perspective. If the Lords was abolished in its current form, what would replace it and how much would it cost to run? Excuse me for being sceptical that a replacement would be cheaper.

  12. Lord Blagger
    29/12/2011 at 4:29 pm

    No you can’t. Some of the lords haven’t got expenses claims published.

    • Lord Norton
      Lord Norton
      29/12/2011 at 4:58 pm

      such as?

      • ladytizzy
        29/12/2011 at 9:29 pm

        Lord Blagger?

  13. Twm
    31/12/2011 at 9:02 am

    A museum of legislatures would replace it.
    It’s true that some museums have living actors in costume but the cost would still
    be negative.

    Going on the number of people outside wanting to get in, at certain times of year, it would bring in far more than the £18m a year, in senile actor expenses, currently claimed.

    Democracy should be a lively thing!

    Turning it in to an old folks’ day centre would be ideal for minimum disruption, even having a senility specialist on hand already, in the form of the noble Baroness Murphy.

    My own expenses to get to parliament run in to the tens of thousands. Why should the wealthy not do the same to get to the old folks home for the day? For one, on a pension of £130 a week, that takes some dedication.

    1) Old Folks Day Centre (charging high fees)
    2)Museum to legislatures (very profitable)

    The profit on the museum could pay some of the expenses for the new Welsh and Scottish legislature/assembly since there is less government for the house of commons to do as well, since they devolved.

    Some sort of dialogue between what Lord Norton describes as those (to paraphrase)with very special expertise, and lot to contribute)would be helpful.

    They would have their own dedicated electronic chambers, to discuss all the Bills
    in exactly the way that they do now, except electronically, from the comfort of their own home offices.

    Chair Moderation would be done with specialised video and audio links.

    This technology would be beyond quite a few of the octo/nonagenarians attending,for the money alone at the moment. It would take time to establish, but could be inaugurated now.

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