Report to the People
2nd February 2004
Taking the Con out of Consultation
Powerful
media figures facing up to the toughest challenge of their lives; a rare insight
into how those who are normally so self-assured react under intense pressure;
the drama of seeing them leave one by one, until only a single winner is left.
But if you could tear yourself away from “I’m a Celebrity, Get Me out
of Here” last week, you might have noticed that the Hutton Report got the odd
mention in the news.
Despite
the inevitable barrage of media coverage sparked by the publication of Lord
Hutton’s findings, however, a few interesting stories did make it under the
wire.
One
such story was the leaking of a document which confirmed that the Health Board
plans to bypass public opinion and centralise all inpatient gynaecological
services at the Royal Alexandria Hospital in Paisley. Unless this is done, it threatens, the service at Inverclyde
Royal will collapse at the end of March.
Now,
I can’t pretend to be amazed by this. I
repeatedly warned that the salami slicing of our services was inevitable if
consultant-led maternity services were centralised. Unfortunately,
even when I exposed secret Health Board documents which spelt out the severe
impact in black and white last July, my concerns were dismissed.
What
does astound me, though, is how the Board can circulate a document such as this,
while publicly claiming to be embarking upon a clinical review “in partnership
with staff, patients and public.”
Equally
perplexing is how they can plan to put this review out for public consultation
over the summer, when they say there won’t even be a service after March.
Another,
more fundamental, question all this raises is one which the Parliament’s
Health Committee has been discussing during our examination of the new NHS
Reform Bill – what exactly do we mean by “consultation” in the NHS?
In
my view, when professionals are agreeing best practice, or users of a service
are being asked how it could be improved, the consultation system we have at the
moment is appropriate. But when you
come to difficult issues – service reviews being the prime example – what is
actually happening is that Boards are not seeking views on the way forward, but
are explaining what’s going to happen. Calling
that a consultation exercise is misleading.
There
is a need for a bit more honesty here. If
Boards have plans, they need argue their case, not hide behind kid-on public
consultations. It’s time to take
the con out of consultation.
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