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Public access to NHS financial information: From a freedom of information regime to full open-book governance?

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Abstract

This article investigates the access that health professionals, researchers, journalists and, ultimately, the public have to review spending in the English National Health Service (NHS). The ability of news organisations to inform debate and decision-making, particularly when hospitals face financial constraints, relies on accessible data. Theorists such as Patrick Dunleavy have suggested that developments in information communications technology induce a dialectical movement, involving changing governance and increasing transparency. Drawing on this premise, the article reviews the extent to which the NHS has moved from a ‘freedom of information regime’ to one of ‘full open-book governance’. Its methodology includes a combination of documentary and freedom of information data analysis, as well as in-depth interviews with directors of commissioning and provider services and national agencies. It argues that, while increased dissemination of information might be consistent with the government’s digital agenda, the NHS’s quasi-market operation and its relationship to the Freedom of Information Act mean that significant data remain inaccessible or costly to obtain.

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Notes

  1. Bhaskar debates whether this is the case (2008).

  2. This is a finding echoed by the businessman Sir Philip Green in his 2010 Efficiency Review conducted for the UK’s Coalition government. He found that: ‘The government is failing to leverage both its credit rating and its scale’ (Green, 2010).

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Acknowledgements

We are very grateful to our referees and to colleagues at the London School of Hygiene and Tropical Medicine, and the Universities of Roehampton and Sussex for their helpful suggestions and insights. We would like to thank all the interviewees who gave so generously of their time. Funding source: We are grateful to the British Academy for small research grant SG100525.

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Authors and Affiliations

  1. Department of Media, Culture and Language, University of Roehampton, London, SW15 5PU, UK

    Sean Tunney

  2. The Department of Sociology, School of Law, Politics and Sociology, University of Sussex, Brighton, BN1 9SP, UK

    Jane Thomas

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  1. Sean Tunney
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  2. Jane Thomas
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Correspondence to Sean Tunney.

Appendix

Appendix

Level of data availability:

1. Live streamed open-book data

2. Routinely published

3. By freedom of information request

4. Not available by freedom of information request, research finding/tribunal tested.

5. No longer collected.

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Tunney, S., Thomas, J. Public access to NHS financial information: From a freedom of information regime to full open-book governance?. Soc Theory Health 13, 116–140 (2015). https://doi.org/10.1057/sth.2014.19

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