Giving patients a say on how their healthcare is provided should be at the heart of Labour's health and care policy, but the party’s policy review consultation ‘Your Britain’ currently lacks focus in this area. 65 years ago, Labour won the moral argument with the British electorate for a National Health Service. Labour’s policy on ensuring the health service is truly accountable to, and owned by, the British people needs to be just as innovative if the ideals of the NHS are to survive in the 21st century.
Though it is important to offer specific positions, Labour’s policy on health should be used to shout about its principles on patient voice and how they should be put into practice in the future.
The operational and logistical rejigging of services is important, but pivotal to everything is authentic patient participation. What use is investment in world-leading medicinal research and development if patients continue to take only 50% of their medicines? What use is overhauling emergency care if the general public aren’t empowered to look after themselves more effectively? What use is it suggesting the elderly can be treated at home if they cannot be meaningfully engaged in the design of local services? Purposeful patient accountability and ownership should be at the heart of Labour’s health and care policy.
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. 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.
The Labour Party is right to suggest the Government adopted a pick-and-mix approach to the Francis Report’s recommendations, as the coalition failed to go much beyond the usual ‘lessons must be learned, procedures should be tightened’ platitudes. Furthermore, Labour is right to suggest the redirection of £3 billion from frontline care risks causing more failures in the future. Whichever unfortunate hospital scandals one references (Winterbourne View, Mid Staffordshire) Labour must continue to press home the message that regardless of the human failings, NHS staff have not gotten worse; the financial burden has.
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 the 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 offers unique problems, there are lessons about transformational change Labour can learn from and apply to the NHS.
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 and help reduce the burden of bureaucracy on the NHS. In a time of financial constraints, policy ideas can lean more on ‘patient voice’, turning patients and their communities into active partners in planning and managing their own care. With smartphones and tablets becoming ubiquitous, and social networks connecting us more and more, a true fusion between healthcare and technology is on the horizon.
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 practical challenges to encouraging an increased patient voice, particularly as not all patients can, or want to be empowered. And though a more engaged patient will never be a substitute for professional acute care, meaningful and innovative policies in this area can speak volumes to the British public.
In the long-run, the extrinsically competitive, free-market notion that drives right-wing ideology advocates for individuals to provide their own healthcare. Against this, 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. An appreciation of this evidence could got a long way to securing the future of the NHS.