Request
I’d be grateful if you could help answer the following question, and please consider it a request under the Freedom of Information Act.
Please could you tell me:
1/ What discussions has the SHA had either internally, or externally with the Department of Health, PCTs, GPs or other stakeholders, about the possibility of adapting patient registration rules so that patients can register with GP practices further away from where they live and/or potentially access care from more than one GP practice.
2/ What discussions has the SHA had either internally, or externally with the Department of Health, PCTs, GPs or other stakeholders, about introducing dual registration, to allow patients to register at two GP practices?
3/ Where discussions have been held as above, please include in your reply the nature of the discussions, how they were resolved and any relevant documents (eg minutes of meetings or correspondence).
Our Response
Thank you for your email regarding patient registration.
I can confirm in accordance with S.1 (1) of the Freedom of Information Act 2000 (FOIA) that we do hold some information relevant to the information you have requested. However, we are of the opinion that this information is subject to the exemptions offered by Section 36 (2)(b) and (c) of the FOIA. We have consulted our Chief Executive, as required when applying this exemption, who has expressed the opinion that, as the ‘qualified person’ identified in the FOIA, it is reasonable to apply this exemption.
On 17 September 2009, the Secretary of State announced the intention to abolish practice boundaries and improve choice for patients but the way this is to be implemented is still being worked through and will continue to develop as discussions with stakeholders take place over the coming months. The final shape and extent of the proposals are still far from clear and the policy is still very much in the development stages. It is important that in order to support extensive discussion around significant issues, those responsible for the development of the policy must feel able to communicate in a free and frank manner without any prejudice which might occur should ideas and opinions, which might subsequently be discarded, be put in the public domain prematurely.
It is important that NHS East Midlands is able to take its full part in those discussions and also that the relationship between the Department of Health and the Strategic Health Authority (SHA) is maintained. As you know, the SHA delivers Government Policy to the wider community in the East Midlands. Discussions about how the very best care may be achieved for our community must, initially at least ,take place in an atmosphere which allows a free and frank exchange of views and allows both parties to seek and receive the very best advice and guidance which is available. Premature disclosure of framework proposals, which are far from being agreed and implemented, would ultimately prejudice the effective conduct of public affairs in that it would be likely to adversely affect the relationship between individual General Practitioners and their patients, General Practitioners and the SHA and ultimately General Practitioners and the Department of Health, as well as that between the SHA and the Department of Health. Important discussions have yet to take place with the Healthcare Professionals and other stakeholders involved and disclosure at this point would demonstrably jeopardise those discussions and negotiations.
S.36 is a qualified exemption in which an assessment of the public interest test has to be made by us before final decisions can be taken in relation to the protection or disclosure of the information.Whilst there is a public interest in promoting accountability and transparency by public authorities for decisions taken by them, NHS East Midlands considers that the greater public interest is in allowing the appropriate discussions to take place in a free and frank manner between relevant stakeholders. It is important that in order to achieve appropriate discussion around significant issues, those concerned feel able and comfortable to communicate freely. We feel that disclosing this information would inhibit frankness and candour in debate and decision making on this issue to the detriment of the whole community in the East Midlands.
We are also of the opinion that disclosing the information that we hold would also prejudice the extent to which the Department of Health shares discussion papers with SHAs in the future and individuals and organisations involved in subsequent discussions about matters of comparable significance might feel less able to speak freely and frankly if they felt that their comments would, or would be likely to, enter the public domain.
For these reasons we are of the opinion that the balance of the public interest test lies with the engagement of the exemption and protection of the information.
I do hope that this information is of use to you. If you are dissatisfied with the way in which we have dealt with your request you can write to:-
Mr Kevin Orford
Deputy Chief Executive and Director of Finance
NHS East Midlands
Octavia House
Interchange Business Park
Bostock's Lane
Sandiacre
Nottingham
NG10 5QG
If at the conclusion of any review you remain dissatisfied you may complain to the Information Commissioner who can be contacted at:-
The Office of the Information Commissioner
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
