Report to the People
23rd June 2003

Putting Patients First

A friend tells the story about the time, back in the olden days, when his neighbour up the stairs went into hospital for a kidney stone and came out with a wooden leg.  She never dreamt of pointing out the error, of course, as this would just be “bothering the doctor.”  And, besides, her leg might have needed replacing in a year or so anyway, so she should be grateful she’d had it done now.

This story might seem ridiculous today, but it does highlight a problem we’re still trying to solve: how we make sure the NHS puts the interests of its core market and paymasters – or, as they’re otherwise known, the patients – first.

Indeed, exactly how we, to use the jargon, place “wider public involvement at the heart of a modernised NHS” is the subject of a major forthcoming NHS Reform Bill.

As I said when we came to debate the issue in the Parliament last week, we have all felt at some point ill-informed about our treatment; or patronised by a GP’s secretary; or intimidated by an overbearing surgeon.

And I have met many doctors, nurses, patients and for that matter MSPs who have at some point been frustrated or enraged with NHS bureaucracy.  Services it, perhaps unfairly, seems, can be put under threat with little more than the stroke of a bureaucrat’s pen.  Just look at the ongoing Rankin Maternity saga.  The unit has been under threat for years and has already been subject to a supposed public consultation, which was run so badly its report had to be downgraded and the exercise started again from scratch.  

It is therefore good news that NHS bureaucracy is set to be slimmed down and new safeguards to ensure public involvement introduced.

But I would argue there is room to go further.

I would like to see serious consideration given to two recently tabled Private Members Bills which would require direct elections for the public to the majority of places on Health Boards and require Boards to consult when proposing to change the use of health service premises.

And if we are looking at making Health Boards more efficient and more accountable, why not also look at the other unelected bodies and QUANGOs which hold much sway over the delivery of health services?

We are right to aim to put patients’ interests at the heart of the NHS.  But if we are to make the warm words a reality, all areas of outmoded working, protectionism and vested interest must be addressed.

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