It’s time for an information revolution

“We do not hold this information” is a response I receive frustratingly often from the Welsh Government.

One of the first sets of written questions I submitted to the Welsh Government upon taking up my new role as Shadow Cabinet Secretary for Health concerned the ambulance service in north Wales. I asked a series of Written Ministerial Questions to get a better idea of what the problems are, where resources are tied up or being used inefficiently, and where perhaps we could identify gaps in capacity. Written questions are usually questions members ask the government when the purpose is to obtain information regarding a particular subject. So it was extremely disappointing to have the familiar two line response to my questions which stated:

“We do not hold this information centrally.  This type of operational information would be held by the Welsh Ambulance Services NHS Trust.”

Now the Welsh Government has the resources and influence to pursue this so a simple phone call or e-mail should have been enough to obtain the data I was asking for. That the Welsh Government did not ask an official to pick up the phone, or even press forward on the e-mail, shows a lack of respect to Assembly Members and to the principle of open and transparent democracy. Furthermore, directly asking the ambulance service for the information requires a Freedom of Information request (which I have made), which imposes additional costs and requires a more formal response from the service than would have been the case had a civil servant just picked up the phone.

Unfortunately there is something of a pattern in these responses. A search of written questions in the 4^th Assembly (2011 -2016) show that on at least 67 occasions the Welsh Government avoided answering a question by using the phrase “we do not hold this information”. Enquiries that received this response include questions about the number of children on fostering lists, the number of breast cancer and prostate cancer specialist nurses, or the cost of work carried out on trunk roads.

Indeed, the poor quality of data collection and publication was highlighted in no less than 18 of the 22 Health and Social Care committee enquiries that occurred in the 4^th Assembly.

This lack of transparency is not just confined to Wales, it also affects our ability to compare performance between Wales and other nations in the UK. The Nuffield Report of 2014 noted the poor availability of comparable data, and the effect this had on transparency and scrutiny, making better data the central recommendation of that report:

“Our first recommendation is that there should be better comparative data. This is not about curbing the freedoms of governments to pursue different policies. However, it is right to require that data be collected to enable the impacts of different policies to be compared, particularly when these policies appear to be increasingly divergent… As one of the main purposes of the governments in Belfast, Cardiff, Edinburgh and Westminster is the running of devolved services, it can legitimately be argued that proper electoral accountability ought to require data to be published on their comparative performance in running these services.”

The Nuffield Report noted that in most federal systems, the federal government mandates what data is collected and how it is published precisely so that poor performance can be identified, exposed and corrected. It also helps to encourage innovation because when one government implements a policy that is successful, their success is identified. For example when the initial data on the impact of the presumed consent system for organ donation was published, it was immediately followed by calls for Scotland, England and Northern Ireland to adopt this system.

Unfortunately, the trend in Wales has actually been away from publishing comparable data. For example, the Welsh Government’s changes to the ambulance service targets and collection of data was intended to make it more difficult to compare Wales’ poor performance with other nations.

As Plaid Cymru’s new Shadow Cabinet Secretary for Health, I say this is not good enough. Policy development should be fact and evidence based. Scrutiny makes for strong democracy and better governance, and this should be embraced. I want an information revolution in the Welsh NHS. To this end, I suggest:

1. That all written questions from Assembly Members should be effectively treated like Freedom of Information requests to the government, with a legal obligation to answer honestly and accurately – if they don’t have the information centrally, then the obligation should be on the government to obtain it unless the cost of doing this would be prohibitive.
2. That the NHS needs to invest in its information collection services to at the very least ensure areas of concern highlighted by the 4^th Assembly committee are addressed. Furthermore, it must publish this data in an open manner – including access to entire datasets for independent statisticians to be able to audit.
3. All devolved governments, and English public services, should seek ways of collaborating on the collection and publication of data on, but not limited to, staffing, waiting times, and financial information.

At the moment it appears as if we have a 20^th century government that is still resisting the information age, when what we need is a 21^st century government that realises large data offers great potential for public service improvement. It’s time for an information revolution.

Image credit: OpenData.com