Plans to hold misconduct hearings for nurses and midwives in private are part of a “pattern of moves to limit the public’s right to know” about safety problems within the National Health Service, the Campaign for Freedom of Information has warned.
The proposals, unveiled by the Nursing and Midwifery Council (NMC) last week, would mean that the vast majority of fitness to practice hearings – those in which a nurse of midwife admitted an error – would be held in secret.
NMC chief executive Jackie Smith told the Daily Telegraph that she wanted to replace the “cumbersome and adversarial” conduct and competence procedures.
Under the draft strategy, nurses and midwives who could otherwise expect to be struck off could continue working if they were able to convince the NMC that they had learnt their lesson.
Currently, nurses or midwives must face a three-member independent panel, aided by a legal assessor, with the case being put by a barrister or solicitor acting as a case presenter for the NMC.
The new approach could be applied in the most serious of cases, including those which resulted in patients’ deaths, the Daily Telegraph reported.
Smith said the plans were an attempt to protect patient safety without “punishing” midwives for mistakes.
Full public hearings would take place only in the most exceptional circumstances, she said, adding: “This is not about doing deals behind closed doors.”
The proposals are due to go to a public consultation.
In its mission statement, the NMC says; “We believe in people, we believe they matter; we value fairness, we are consistent and act with integrity; we value transparency, we are open and honest.”
The NMC deal with around 5,000 cases of misconduct each year – or about 0.7 per cent of all nurses and midwives on the register.
About 23 per cent of misconduct hearings result in the registrant being struck off.
But the Campaign for Freedom of Information said the NMC’s proposal to do away with most public hearings echoed Government plans to keep evidence about safety incidents secret, which the Government published last year.
Although reasons for decisions would be published, no transcript of the hearing would be, the Campaign said. It said: “The risk is that failings at a hospital – or by the NMC itself – will be obscured, undermining public confidence in the NHS.”
It added: “The same philosophy underpins Department of Health proposals for a new body to investigate significant NHS safety incidents.
“The Health Service Safety Investigation Body would report on its investigations but be prohibited from revealing unpublished information in response to freedom of information (FoI) requests.
“The Department says this would allow staff to speak freely to investigators without fear of being unfairly blamed.”
Campaign director Maurice Frankel said: “The secrecy would not be limited to information provided by staff involved in safety incidents – it would apply to any information from any source obtained during an investigation, including information from the NHS trust itself, independent experts or a drug or medical device manufacturer.
“Even test results on equipment or anonymised accounts of previous incidents would be kept secret indefinitely.”
Only limited disclosures would be allowed, for example, to the police, regulatory bodies or other NHS bodies.
Journalists or campaign groups would have to persuade the High Court to order disclosure of information which is currently available under FoI.
The campaign said the NMC’s proposals “reflect the same disturbing philosophy: that patient safety is best served by addressing problems in private”.
The NMC’s proposals are in a draft consultation paper to be discussed by the NMC board on Wednesday.
Picture: Reuters/Stefan Wermuth