Headlines: March 13th, 1998

Health Minister Alan Milburn believes that restoring public confidence is the key to modernising the NHS and this involves empowerment of patients. He said: “It is the public’s health service. And it has to respond better to public views. I want to see the NHS opened up to greater public scrutiny and patient involvement than ever before.”This move to patient empowerment represents a significant challenge and a major change in culture. The internal market demanded a degree of secrecy with decisions taken behind closed doors. The message from Mr Milburn now is that “The NHS needs to listen more. The new NHS will reward openness.”

The ‘openness’ strategy will be taken forward through three initiatives involving publicity, consultation and involvement. A start on publicity is being made with publication of findings from reviews by the Commission for Health Improvement on trouble-spot investigations and making available annual reports on quality in hospitals.

The consultation process will be beefed up with a new emphasis on ensuring that patients’ views help in shaping the future of the NHS. A national annual survey of patients’ was announced last month. It is now proposed that the public should become involved when changes to local health services, resulting perhaps from spending plans or hospital reconfigurations, are being planned. Other possibilities for getting views include opinion surveys and citizens’ juries.

Opening Trust boards to the public and improving community representation are starting to bring greater involvement of patients. There are also plans for representation on key bodies eg. Primary Care Trusts, the National Institute for Clinical Excellence and the Commission for Health Improvement. A proposal has also been made to set up an independent panel which would give Ministers impartial but expert advice on the clinical quality and safety of controversial changes. This is being discussed with the Association of Community Health Councils of England and Wales, and other interested bodies.