Friday 17 February 2017

NHS in Scotland has hung a 'DNR' on the too-long neglected concept of human rights

At any given time, the majority of US citizens are able to identify some of their rights as enshrined in their revered constitution.  Amendment 2 relates to the right to 'keep and bear arms'.  Some would argue that knowledge of this right is almost world-wide, such is the cultural impact of the US and of Holywood on the rest of the world.  



In similar terms, many people across the world are as familiar with the 5th Amendment as are most US citizens - the right to refuse to answer a question on the grounds of self-incrimination.

The nearest equivalent here in the UK is the 1998 Human Rights Act.  Sadly, the knowledge of UK citizens of their human rights is markedly less widespread than that of US citizens of their constitutional rights.  It may be of course that tabloid press coverage of human rights cases has tended to sensationalise the use of human rights laws to the extent that they are commonly, and negatively, associated in that part of the public mind informed by the tabloid press with refugees and prisoners.

It is not enough to blame the red-tops for the jaundiced view many have of human rights. 

Age UK published research in 2011 on Equality & Human Rights in Practice.  On Human Rights it found : 
Human rights are basic rights that belong to everyone simply because we are human. They are an important means of protection for people in later life, especially those who face abuse, neglect and isolation, and can be empowering tools for older people to advocate for their own rights. The Human Rights Act (1998) is, however, absent from much of government policy-making in relation to older people. Within many parts of government, human rights are so little understood that conversations using human rights ‘language’ are ineffective.
In 2010, NHS Health Scotland published a report which found that :

The overall theme within NHS Scotland was that few health boards had taken action on human rights as they were unclear about what is expected of them or wanted guidance on this. However, there was recognition of the need to comply with human rights law and good practice and a willingness to do so.

Translation ?  Senior, well-paid, staff running the 22 NHS Boards knew they should be doing something on human rights.   But because politicians and civil servants had not told them what they should do, they did nothing.  Because politicians and civil servants have mot been holding them to account on what they should be doing on human rights [like empowering service users to know their human rights], they have got away with doing nothing for the best part of 17 years. 

The Working Group behind the NHS Health Scotland report recommended Boards in Scotland should use a Human Rights Based Approach.  A critical part of this approach was commended to NHS Scotland :
NHS Scotland will take steps to ensure that everyone within the NHS (including staff, volunteers, patients, carers and families) is aware of and empowered to claim and enforce their rights.
Recent research on how much use the NHS in Scotland makes of a Human Rights Based Approach revealed that for all the claims to 'do' human rights, there is precious little evidence that Scotland's NHS service users even know what their human rights are.

Scotland's 22 NHS Boards were asked via a Freedom of Information request to provide a count of exactly how many service users they had helped empower with a knowledge of their human rights and the capacity to claim them.  Once the fluff, jargon, double-speak, confusions and digressions had been stripped from the 22 responses, the count revealed that over the last 3 financial years, Scotland's 22 NHS Boards had manged to empower exactly 0, zero, zilch service users with a knowledge of what their human rights are.

Boards were also asked to provide a count, over the same 3 years, of how many claims had been submitted to them by service users of cases where their human rights had been ignored or breached.  Keep in mind that the NHS in Scotland has at least 26 million interactions with service users each year.  Over the last 3 years once can reasonably assume that the number of interactions would have been in excess of 78 million.  During that whole time, not a single one of those 78+ million interactions was carried out in such a way as to cause a service user to claim that their human rights had been ignored or breached.

The submissions received from all 22 NHS Boards early in 2017 suggests little has changed from the findings of the 2010 NHS Health Scotland report.  It seems that since the 1998 Human Rights Act took effect in 2000, the NHS in Scotland has been keeping the concept of human rights in the NHS on the barest minimum of life support systems.  Starving service users of the oxygen of knowledge that they have human rights in a health setting is clear evidence that the NHS in Scotland has hung a 'DNR' on the too-long neglected concept of human rights, which has been dumped on a trolley and pushed out of the way and into some long-forgotten dusty NHS policy corridor leading nowhere.