It may have slipped your notice but in February 2011, government provided you with some rights in relation to the NHS. They are tucked away in the unexcitingly labelled Patient Rights [Scotland
I reckon they must have sweepstakes in the civil service to see who gets to give government Bills their titles. How else to explain the title of this Act, which introduces no new rights at all, got a serious kicking as it made its way through Parliament, and is simply yet another fine example of the smoke and mirrors trickery frequently used by government to pretend that it is doing something ?
Way back in 2009 when government was first consulting citizens over what should be in the Bill, I offered some analysis and commentary. A sample of that is reproduced here :
It is believed the basic concept of the planned Bill is fatally flawed as it refers to ‘rights’ many of which already exist in the context of other existing legislation but which government chooses to ignore and instead places these rights in a new [Woolworths?] shop window and attempts to pass them off as new goods. They are not, and other than causing confusion to people who use the NHS and those who work in the NHS, it is likely that the cynicism which has affected political life in Scotland for so long will be further deepened by these proposals once it becomes clear that there are few if any real and new rights.
If you want to read more in that vein, follow this link to open up my January 2009 comments on the Bill.
Even if you think my critique was harsh then, there is no escaping the reality that government has taken citizens for a ride with this Act.
No matter what it says in the 10 or so pages of hollow promises and IOUs on how things can only get better, when you get to section 20 on page 11, you will find the health service has been given a permanent ‘get out of jail’ card to play when it comes to these ‘rights’ of ours. Here it says :
Nothing in this Act gives rise to—
(a) any liability to pay damages,
(b) any right of action for specific implement,
(c) any right of action for specific performance of a statutory duty,
(d) any right of action for interdict,
(e) any right of action for suspension.
In other words, government not only tries to sell you a pup, but it adds in a killer catch-all which ensures that even though you might have been persuaded you have been given some new ‘rights’, this makes sure that in law you can’t use the courts to get your health board to deliver them. This is the closest I have come to understanding just what it must be like to be persuaded to have unprotected sex with someone who promises to respect me in the morning but when peeing on the stick shows up blue, finds them backing out of the door and my life faster than goose-shit off a shovel.
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| You might want to tell Nicola Sturgeon that you have now pee'd on your stick |
You might want to tell the Cabinet Secretary for Health & Wellbeing, Nicola Sturgeon, that you have now pee'd on your stick and want to know why she went to all this bother of giving you these ‘rights’ and then added in her own version of Catch-22 to make sure you couldn’t use the courts to force the NHS to deliver them.
I am reluctant to admit it Wlad,but I am in complete accord. I wrote a piece called "What Do I Do with My Rights?", because I felt it was more a half baked idea than Policy. Had it been full legislation it would have cost a fortune.
ReplyDeleteHowever, on the Quality Strategy front, my findings from my paper indicate that such a policy (if it is accessible) radically changes quality of life. Unfortunately, few know how to convert it to practice,or what is required, except the patients.
As I wander round the NHS Board reviews,and breathlessly listen to their exciting accounts for the Cabinet Minster, I have yet to see any meaningful patient involvement.
This is the most worrying trend of all: that something that is so patient centred does not appear to require the patient's voice to be heard. "Patient centred" means that the patient is accepted as an individual, and is encouraged to contribute and can even control under professional guidance and supervision.
I have advocated a "Patients' Matron" for want of a better term. Someone who is able to engage with patients and has the ability to verbalise the patient perspective. Such a person would have the necessary clout to argue for change: and the most instructive part of such a post is that I visualise that it could be done on occasion incognito! The MATRON MOLE, is what is really required to bring managers up to speed.
I have mentioned it to several people, who consider it an idea with potential. But that is as far as it gets.
Yet, properly managed, and with a new focus, this could even mean the patient and doctor working together - co-production!
Is this all too much? Maybe I'll wake up soon.
Thanks for the writing: brilliant as usual!
Linda
Linda
ReplyDeleteYour analysis is on the nose.
To an extent it matters not what the post is called.
What does matter is that it and the post-holder has to have the power to blow the whistle and for that whistleblowing to be a trigger for an investigation which is not buried by the NHS Board or senior civil servants or minister.
The concept of patient rights holds as much credibility as does the concept - now died quietly in a corner - which was the buzz phrase du jour not long ago - the 'mutual NHS'.
I do believe if patients were allowed a real partnership stake in the NHS that we would find some services closed and some of the 22 Boards merged, so that resources could be properly applied where needed - real person-centred care for patients who have real medical needs.
As for 'co-production', give in now. It has been the jargon du jour for the last couple of years and is already fading. Does anyone really know what it means?