Patient voice and accountability should play the leading role in Labour health and care policy, but currently the party’s policy review consultation ‘Your Britain’ lacks focus in this area.
Operational and logistical rejigging of services is important, but authentic patient participation is pivotal for a positive future for the NHS. What use is investment in world leading medicinal research and development if patients continue to take only 50 per cent of their medicines, as studies have shown? What use is overhauling emergency care if the general public aren’t empowered to look after themselves more effectively? What use is suggesting the elderly can be treated at home if they cannot be meaningfully engaged in the design of local services?
The British electorate will vote for the party that elicits the right feelings about the future of their healthcare, not necessarily the party that presents the best arguments on service redesign, commissioning or market competition in the NHS. Labour’s view on personal control over care, mentioned in their policy review consultation document, needs a higher billing and should perhaps also include increasing the choices available to patients. ‘Empowering’ them means nothing if they cannot make different choices.
Given the tidal wave of abuse led by sections of the British press that has focussed on NHS failings, it appears that the case for a fundamentally flawed NHS is being set out. If Labour is to argue against this, they must recognise the public will respond to an ideologically driven agenda that signals hope and calls for a better, more modern way of engaging with the NHS.
Policy around A&E services and primary care are important sections of Labour’s health policy, but if the NHS isn’t engaging, empowering and hearing patients and their carers throughout the whole system, then the case for a modern NHS becomes harder to make.
In the policy consultation, Labour is right to suggest the government adopt a pick and mix approach to the Francis Report’s recommendations, as the coalition government failed to go much beyond the usual ‘lessons must be learned, procedures should be tightened’ platitudes.
Labour is also right to suggest the redirection of £3bn from frontline care risks causing more failures in the future. Whichever unfortunate hospital scandals one references (e.g. Winterbourne View, id Staffordshire) Labour must continue to press home the message that regardless the human failings, NHS staff have not gotten worse, the financial burden has.
65 years ago, Labour won the moral argument with the British electorate for a National Health Service that drove socialist ideals forward. Today, Labour’s policy around ensuring popular accountability and ownership needs to be just as innovative to modernise and progress the social ownership and co-operative management ideals of a public health service.
For much of the debate surrounding the NHS for the past 10 years has centred on its capital structure and how its inadequate funding impacts on quality of service delivery. Notwithstanding these critical issues, I believe that the main challenges facing UK health policy over the next few years lie not on the finance and transactional side, but on the relational, with patients.
Empowering, engaging and communicating are all strategies that other industries such as retail, mobile technology and travel use to improve the services they provide. Whilst healthcare is a unique service, there are lessons the Labour party can learn about listening and involving our patients, their carers and the public.
Giving patients greater access to information about their care and enabling them to carry out tasks, such as managing prescriptions or booking appointments, would be both informing and empowering as well as reducing the burden on the NHS. In a time of financial constraint, policy can turn patients and their communities into active partners in planning and managing their own care. With smartphones and tablets becoming widespread, and social networks connecting us more and more, health and technology security policy needs more attention.
Critics might worry that the proposed shifting of power could reduce governments’ responsibilities, but many experts argue that “we cannot afford not to self-empower”. Of course, there are also practical challenges to encouraging an increased patient voice, particularly as not all patients can, or want to be empowered. And although a more engaged patient can never substitute professional acute care, innovative policies in this area would speak volumes to the British public.
In the long term, we must consider the huge amount of evidence that shows quality of healthcare and outcomes are better for patients if they take on greater responsibility for their care, and empower them to do so.