NHS Exposed September 2001
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Campaign for Health Service Democracy Why are we campaigning for Health Service Democracy? b y Sheila Porter-WilliamsOn a hot Saturday afternoon in July 1997 my mother was left without food and water in a ward at Coventry and Warwickshire Hospital awaiting a hip operation, which at the end of the day was cancelled. She was seriously under-weight, and could not communicate because of Alzheimer’s disease. She was dehydrated and looked very weak. I thought she had been left until last because the hospital had calculated that when her turn came she would no longer be alive. I had difficulty finding a doctor to discuss what would happen next. Eventually I spoke by telephone to a doctor, but he would not give any assurance that the operation would be performed the next day. After my intervention, my mother was given food and drink. I felt my mother was being neglected and would probably die as a result. I needed urgent action. Who was there to contact? I had spoken to the only available doctor. Hospital management did not work weekends or publish ways of contacting them at home. Trust board members were appointed for business management skills, and not meant to represent local residents. The Health Authority was tied in an arms’ length contractual relationship with the Trust, with no day-to-day influence. The Community Health Council also lacked power, and I did not expect any of its members to be able to get quick results. The following morning I wrote to my Member of Parliament. Later that day a stop-gap operation was performed. The following Friday Midlands Today television reported a similar case where a woman had twice had a hip operation cancelled when she was immobile in the same hospital. I contacted the BBC and spoke on local radio about my mother’s case a few days later, mentioning that I suspected the hospital had a policy of compulsory euthanasia. I also contacted the relatives of the patient mentioned on television. Their interest was in getting compensation to pay for private treatment. I felt I must get redress for my mother in a way that would benefit other patients and not further undermine the NHS, and I knew that would have been my mother’s view before she developed Alzheimer’s disease. From this stage the hospital management realised they had a problem and tried to put right any complaints that I could identify, then and later. But nurses on the ward where my mother was still having physiotherapy were openly hostile to me, and, when later in the year my mother needed a half-hip replacement after the repair had failed, the consultant was arrogant and refused any useful treatment. When, eventually, my Member of Parliament replied, it was that he had raised my concerns with the Secretary of State, who said the problem was widespread and he had no available solution. I knew there was a solution. Emergency treatment for life-threatening conditions, including broken bones, must be given priority over treatments where postponement is less damaging. So priorities must be determined to use most effectively the resources in each hospital. The existing top-down management structure had failed to provide enough resources for emergency surgery. So elected representatives of the local community, available day and night to constituents with problems, must be given the power to direct hospital management to ensure that the hospital’s priorities are the community’s priorities. In the short term the resources are existing staff and equipment. Over a longer period it may be possible to buy extra resources. Democratic elections would give an opportunity to link the level of taxes to the level of health services available locally. I am sure most voters would vote for better health services rather than keeping taxes at their present levels, which in total are lower than in the rest of Europe. Democratic accountability should apply to all staff working in the health service. Arbitrary decisions, whether to refuse treatment or to provide inappropriate treatment, and arrogant refusal to discuss treatment options with patients or their relatives, should be held to account. Democracy is the only solution to the problems of the Health Service. Other proposed solutions have failed.
I started this Campaign by trying to mobilise existing Community Health Council members, with some success. Activities of Community Health Councils, such as sampling activity in Accident and Emergency Departments, have attracted publicity as never before. Their national association set up the Hutton Commission, whose recommendations are similar to our proposals. The Government’s response was to propose the abolition of Community Health Councils, which are currently reprieved awaiting new legislation because controversial clauses had to be dropped from the Health and Social Care Bill to get it through Parliament before the General Election. Clearly Government ministers are interested not in real democracy but in preserving a system of government in which they are central, even if they are ineffective. Governments cannot be trusted and must be pushed before any progress is made. I have collected on the Campaign website a set of ideas on improving democratic accountability, along with a library of press reports on health policy, on failings in the NHS, and on democracy. I hope to be a regular contributor to NHS Exposed. Campaign for Health Service Democracy. |
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Sheila
Porter-Williams |