The Health and Social Care Act 2012 has always had my support. All my concerns were addressed in the final Act. The thrust of the Bill remained intact. However, like many other people I was dismayed by the strength of opposition from healthcare professionals, patients and journalists. The Government failed to win the hearts and minds of the electorate. The media must accept some blame for having misrepresented the true aims of the legislation.
This week there is at last real hope that the tide is turning. The NHS Constitution was first published in January 2009. It is a document intended for patients and NHS staff. It sets out in a readable form the principles of the NHS; the rights and responsibilities of patients, the public and staff; and the pledges that the NHS is committed to achieve.
In March 2012 Andrew Lansley asked the NHS Future Forum – which includes representatives from trade unions, professional bodies, and NHS employers –to make recommendations on how to strengthen the NHS Constitution. The Forum replied to the Government in a letter dated 31st October and made public this week. The Forum letter concludes by saying:
“The Constitution encapsulates what makes the NHS so special. Its opening paragraph is a wonderful, emotive description of what the NHS is all about – it is a really powerful statement, while its principles and values provide the basis for driving real cultural change on the ground throughout our health service. This opportunity to embed the Constitution must not be lost. All organisations must play their part. But we also look to you, as Secretary of State, to champion the NHS Constitution and challenge the service to live by it in everything it does.
Given that we have found huge support for the Constitution from NHS staff and patient organisations, we believe that concerted action on increasing awareness and giving the Constitution greater traction offers you an excellent opportunity to turn a widely supported idea into a powerful reality that can bring major benefit to the NHS and the people it serves. It is an opportunity that the NHS cannot afford to miss.”
The Forum has suggested many minor drafting changes, all of which seem perfectly sensible. The Forum’s two main suggestions are that patients and staff be made much more aware of the Constitution and that how to complain about breeches of the Constitution should be made absolutely clear with appropriate follow-up guaranteed.
Norman Lamb, Minister of State, has responded very positively to the Forum proposals. He has written on behalf of the Government:
“I am grateful to Professor Steve Field and the NHS Future Forum for their letter of 31 October 2012 to the Secretary of State, making recommendations for strengthening the NHS Constitution. I agree with their conclusions and can accept their recommendations in full.
This Government believes in and fully supports the NHS Constitution. The Constitution should be woven into the fabric of everything the NHS does so that the expectations of patients, staff and the public can be met first time, every time. We will safeguard the NHS Constitution now and in the future.”
The Minister concluded his response with the words:
“I am happy to take on the challenge set by the Future Forum of championing the NHS Constitution and holding the service as a whole to account for living by its values.
We now look forward to hearing from patients, NHS staff, the public and our partners – including the national health charities, think tanks and professional organisations – about our proposals.”
A period of public consultation on the NHS Constitution now begins. Real hope exists that public support for the Government’s handling of the NHS has turned the corner. In recent months I have stressed the importance of everyone working together to benefit from the opportunities that The Health and Social Care Act has created.
The opening paragraph of the Constitution with which the Forum is so impressed states:
“The NHS belongs to the people. It is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most.”
Two of the most important questions to be considered during the period of public consultation are how to make more people aware of the Constitution and who should handle complaints. I like many other people will think about this and participate in the consultation. My first thought is that brief one-page summaries of the Constitution could be available in waiting rooms and handed out on discharge from hospital. They could be displayed on notice boards and made available to take away in GPs’ surgeries, hospitals, dentists, opticians, retail pharmacies, citizen’s advice bureaux, old people’s homes, public libraries and the places of work of other healthcare professionals. A major campaign could be mounted to encourage journalists to write about the Constitution. Messages could be played instead of music or silence to people waiting on the telephone. The complaints service could be established along the lines of the Financial Ombudsman but with more focus on improving substandard service and less on financial compensation. It may also be productive to publicise complaints where a pattern emerges and patient confidentiality would not be breached.
We now seem to have an important aspect of the NHS, the Constitution, where for the first time in this Parliament patients, the public, healthcare professionals, Government and the media all have the potential to agree. If Jeremy Hunt and his team can gently build on this success, the past communication failures of the Government may begin to be undone.