Transparency and accountability are two sides of the same coin when it comes to the operation of democratic government. They are recognised as essential components of a rights-based social protection system.
The RHI inquiry shone a light the extent of the culture of secrecy and cronyism within government in Northern Ireland and the fundamental lack of either transparency or accountability.
The then head of the Civil Service, David Sterling, admitted that there was a practice within Stormont departments to ensure that ‘embarrassing or controversial material’ was not placed on the record.
Acknowledging the huge damage to public confidence in the mechanisms of government, the New Decade New Approach deal included a package of measure to strengthen transparency and governance arrangements in the Assembly and Executive. It remains to be seen the extent to which these measures actually improve transparency and accountability.
But what of non ‘embarrasing or controversial’ material? Like workforce data on locum GPs? Which GP practices have an in-house counsellor? Waiting times for accessing counselling? What percentage of the health budget is spent on mental health? What the NI Executive Working Group on Mental Health, Emotional Resilience and Suicide Prevention have been discussing? How easy is it get such information in 2021?
The answer is -very difficult! 123GP mental health campaigners have found it incredibly difficult to access all kinds of data on mental health and suicide prevention, including the examples cited above.
For all of this information, and much more besides, they have had to resort to using Freedom of Information legislation to access data that should be readily available.
Access to data is just the first hurdle. The second one is being able to compare data sets across the various administrative boundaries; first and foremost, across the five Health and Social Care Trusts. Trusts also tend to use acronyms and coding systems that are often difficult to decipher.
Other barriers include data not being collected at all. One such example is the impact of government systems and policies like Universal Credit and the ‘hostile environment’ asylum policy on the mental health of vulnerable people and data on the links between these systems and deaths due to suicide.
In March of this year PPR made a submission to the Office for Statistics Regulation ( OSR), a body within the UK Statistics Authority, which provides independent regulation of all official statistics produced in the UK. Following on from its review of mental health statistics in England in September 2019, the OSR initiated a review of mental health statistics in Northern Ireland.
Among the issues explored by this review were the following questions: what statistics are produced and made publicly available? Are there any issues with the current statistics, such as data gaps, coherence, accessibility? Is there any user unmet need? What are the challenges? Where can improvements be made and how should they be prioritised?
Questions that should have been addressed in the context of the development of the 10-year Mental Health strategy, but which were not. The limited reference to data within the final Strategy is in the context of the planned Regional Outcomes Framework and the need to have robust data sets across Trusts to measure performance and to determine what works.
We look forward to the publication of the OSR’s Review this week. We hope it will bring forward much needed, robust recommendations that are in turn acted upon by the Department of Health and all of the relevant health agencies.
Keeping vital data on mental health and suicide out of reach of those who need it, including campaigners but also journalists and researchers, and in the process, creating additional burdens for civil servants already stretched as a result of the ongoing pandemic, is an old and discredited way of conducting the business of government.
Let’s hope the OSR Review provides the impetus for a much needed shift towards greater transparency and accountability in relation to mental health data in NI.