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Patient Involvement � NHS debate 18.6.03
Rob Gibson MSP

The National Health Service is correctly identified as a key indicator of how a civilised society is working. It is the most cherished service our nation possesses as it gives all citizens a right of access for treatment at the point of need. In European and World terms those countries with such integrated health services show stronger social mobility and less extremes of wealth and poverty. Yet welfare provision has to be participative. It isn�t a sales counter, take it or leave it. That�s why we in the SNP are so frustrated with New Labour and its Lib Dem partners for the six year delays in setting patient consultation and involvement in a workable framework for this age. Why has it taken over fifty years to reach this stage?

It was no accident that the Citizens Advice Bureau had to evolve after WW2 to give people help and advice about the services they have rights to. As the government machine became all powerful to win the war, the right of people to information and redress developed its own momentum in response, independent of the service being investigated.

Holding bureaucracies to account yet keeping trust in medics who serve us is a delicate balance. That�s why more rights to involvement for patients is long, long, overdue. People correctly welcomed the NHS as a milestone in state welfare services but a better quality of service began to be sought at an early stage. That�s why the Health Council element have to be independent of the NHS system and not just bean counters in the annual accountability review process of another NHS department.

The SNP�s long-held policy is to democratise Health Boards through a directly elected element. This could include members from Local Authorities and directly elected members of the public at the same election times as the four year councillor election cycle. Also the need for Community Councillors to sit in on the management decisions of each LHCC could go a way to opening lines of communication with health professionals.

Statistics show the decreasing satisfaction rates in recent times while communication problems between staff and patients form a core of complaints. NHS staff must be given clear lines of action to handle errors, record them and explain mistakes to patients as early as possible. The longer the process, the less satisfaction patients feel.

A good example of a tortuously slow improvement in consultation can be given from the experience in the past year of Caithness dental patients deprived of NHS dentists by retirements and recruitment problems of NHS Highland Primary Care Trust. Initially the outrage at lack of NHS dentists led to calls through the independent Caithness Local Health Council for a meeting with the Trust. Eventually the volume of complaints led to a Help Line being installed. This was proved to be totally inadequate and inaccurate in detail. Further public outrage led Thurso Community Council to invite the Trust to an open meeting on 24th April. No Trust personnel were available, though two party politicians answered the invite to hear a hundred people let off steam.

By 2nd June the Trust finally held a consultative meeting on the way ahead attended by MSPs, Councillors, and local community representatives 100 miles away in Inverness! That is the timetable when a whole community is up in arms, what about the treatment of individual patients?

The SNP does not wish to fuel the blame culture, we do not believe that a �complaints department� is the answer, we think about the least pushy patients, such as the elderly who have often suffered in silence. The tardy and bureaucratic proposals proposed in this motion do not suggest urgency or having learned any lessons so that far flung Board areas, such as Highland, can receive rapid lessons in communication skills. The Partnership for Care proposals debated here today do put local people first but pretend that a new Scottish Health Council with a local presence is the answer. I beg to differ.