Dr Brian Fisher responds to the Francis Report
February 12, 2013 | Filed under
- We need a powerful statutory patient voice, undiluted by relentless organisational change. Small, virtually self-selected volunteer groups are unlikely to be effective.
- Healthwatch funding should be ring fenced.
- The public should be able to compare relative performance of services through open, honest and transparent information.
- Patients should be able to read and comment on their records in real time. The hospital would have found it harder to offer poor care with records open to patients and carers.
- There should be a CCG membership system so the public can be involved in and contribute to the work.
- Scrutiny committees should have powers to inspect providers.
- More consultation and surveys should be carried out.
However admirable and useful these suggestions are, they remain to some extent paternalistic.
We need to go well beyond more surveys and lay people on boards. We need to develop a proactive, dynamic approach with a continuous dialogue face-to-face and on social media so that local citizens and patients become an integral part of commissioning. This implies support for community development linked to primary care and to hospitals; lay leaders; experience-based design approaches.
The NHS Alliance’s soon-to-appear Manifesto for Primary Care will explore many of these approaches.
Feedback and information is not enough. Honesty is not sufficient. The Trust was not short of information from patients and staff about poor standards. What seems absent from Francis’s thinking is the notion of responsiveness. That NHS organisations must not only hear and listen to patient experience but they must act on it.
We need to ensure that every part of the NHS, from the Constitution through to staff job descriptions, sees that its role is to listen and respond to patient views and recommendations.
Marketisation and competition central to healthcare erodes our moral stance. This is not necessarily the view of all executive NHS Alliance members but we are an organisation that celebrates diversity of opinion and encourages robust debate, and personally I believe this is a debate that must continue. Financial rigour will never go away. It would be unethical to allow NHS organisations to waste money. Marketisation makes society more unequal and it corrupts. The things that matter in life should not be bought and sold. We drift from having a market economy – a tool for organising productive activity – to being a market society – a way of life in which market values seep into every aspect of human endeavour. Where social relations are made over in the image of the market.
by Dr Brian Fisher, our Patient and Public Involvement lead