Does anyone else recoil when they hear the Tories saying that the government should leave public services to the ‘professionals’? On Wednesday evening I heard Stephen O’Brien, shadow health minister, trot out the Conservative’s latest lines including the argument that government needs to trust professionals to get on with providing public services.
By the government’s own admission, some targets could have been set with more buy-in from the front line, and workers have been over-burdened with paperwork in the past: professional autonomy and trust are important values in public services, and I’m not arguing to undermine them. But the fact that the Tories are obviously singing from the professionals’ hymn-sheet shows signs of an opposition which has been nobbled by powerful, traditional interest groups. It’s not exactly a sign that policy is being made in the interests of the many rather than the few.
At the risk of stating the obvious, more power for the professionals means less for the users. In the NHS for a start, we are nowhere near making it a truly ‘patient-centred’ service. Earlier this year The Picker Institute, a body which researches patient satisfaction, found that out of six developed countries, the UK still had the worst record for patient engagement. It cited the “paternalistic” attitude of health professionals as presenting a major barrier stopping patients from taking an active role in managing their healthcare. Figures quoted by Angela Coulter from Picker at Wednesday’s seminar also show that despite the roll out of Choose and Book in January this year, only 32% of patients know that they have a right to choose, and out of these, only 35% were offered a choice by their GP at the point of referral. The whole scheme is reliant on patients receiving clear information about their options to choose four different providers, but it’s obvious that health professionals are not fulfilling their side of the bargain.
It seems that the attitude of ‘doctor knows best’ is alive and well. Take the BMA’s response to the launch of the biggest ever Patient Experience Survey of 5 million patients, which will allow GP practices to earn £8,000 if they are responsive to patient’s views on access. The BMA stated that questions asking whether patients are satisfied with appointment times and opening hours were “biased”, and that the whole exercise was discredited as a result. They even admit that they were “reluctant” to agree to a patient survey in the first place, and this in spite of receiving a huge pay rise in the GP contract settlement last year which makes them the best paid in Europe. We know that listening to patient’s views and engaging them in decisions about their healthcare has a positive effect on health outcomes, but until healthcare professionals truly take this on board we can’t say that the NHS is ‘patient-centred’.
The Tories would be better off listening to the many patient groups who represent users of services, rather than those professionals who have a personal stake in maintaining a service which works only in their best interests.