Monday, 25 October 2010

NHS Reform – Consultation overload?

How many of us have, when questioned by our children, answered – ‘because I say so’ ? I’m sure that most of us have fallen into that trap!

The theme running through the US Healthcare Reform Act is ‘because I say so’  or, as the Act puts it - ‘mandatory’ – so although the interpretation of many of the aspects of this complex document still need clarification – the intent is clear – the new regulations WILL be implemented.

In the UK, the NHS outcomes will defined in terms of cost savings and quality initiatives, but where the axe will fall and how the measures will be introduced are subject to a comprehensive consultation process.

The government White Paper outlining the changes stresses that it ‘puts people in the driving seat, putting them in charge of making decisions about their health and care’  Fine words. The coalition is hot on ‘people power’. But how does this become reality and should it?

Several consultation processes were launched soon after the publication of the White Paper. Two public consultations ‘An Information Revolution’ and ‘Greater choice and control’, have both just been launched setting out proposals for ‘what we think is needed and asks how people think we should approach this huge task so we can start making shared decision-making a reality. We are seeking the views of the general population, NHS and care professionals, patients, service users, their families and carers.’  These consultations close in January 2011. In the meantime, four other consultations have already closed:
  • Transparency on outcomes - a framework for the NHS
  • Liberating the NHS: Local democratic legitimacy in health
  • Commissioning for patients
  • Regulating healthcare providers
But what does all this actually mean? NHS administrative staff, patients, clinicians, voluntary and patient organisations will all have had their say. But how is this translated into actions? Who makes the final decisions? Should the patient voice be louder than that of a clinician who is expert in his chosen field? And how can one be objective with these sensitive and significant decisions that will shape not only patient care, but healthcare professionals’ futures too?

I have absolutely no idea – but I suspect that, like in the USA – it will be ‘because we say so’


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