The must-read stories and debate in health policy and leadership.

Health secretaries have been keen to have their say about non-disclosure agreements (sometimes called confidentiality or ‘gagging’ clauses).

In 1997, Labour health minister – later secretary – Alan Milburn told Parliament: “There can be no justification for an employer penalising staff who speak out about genuine concerns.”

In 2013, following the Mid Staffordshire report, Conservative health secretary Jeremy Hunt wrote to all trust chairs, asking them to review the confidentiality clauses they were using. And, in 2019, Matt Hancock said: “Settlement agreements that infringe on an individual’s right to speak out for the benefit of patients are completely inappropriate.”

Now, Freedom of Information responses have revealed 214 settlement agreements with some sort of confidentiality condition worth £4.6m between NHS trusts and staff between 2018-19 and 2020-21. That’s at least £1m per year.

That’s not to say that’s 214 attempts to cover up serious concerns. Some trusts’ FOI responses stressed their clauses would not prevent staff from making a public interest disclosure, and any attempt to do so would be unenforceable under the Public Interest Disclosure Act 1998 anyway. Other sources HSJ spoke to noted confidentiality clauses were a standard part of settlement agreements.

However, others warned such deals were “not really an agreement between equals”, while some raised concerns “whistleblowers are often left confused [about what they can and cannot say] when confronted by agreements with vague confidentiality terms”.

Wanted: friend and foe

The next chair of NHS England should hold the organisation to account and ensure its strategic direction is in line with wider government health and social care policy. 

So said the role description published last week as the government seeks to hire a ‘critical friend’ of NHSE whose other qualities include the ability to nurture links with the pharma industry. 

Specifically the candidate will need to “maintain strong business relationships with key private sector stakeholders who provide valuable NHS services, particularly pharmaceutical companies and other life sciences businesses who are providing the covid vaccines”.

NHS England previously announced that the incumbent, Lord David Prior, would step down early in the new year, after serving around three years and three months of a four-year term.

The appointment will be made by ministers, but the advisory panel for the appointment includes Sir Chris Wormald, permanent secretary at the Department of Health and Social Care, Samantha Jones, the prime minister’s expert adviser on NHS transformation and social care and Ron Kalifa, a non-executive director of the Bank of England court of directors.