I am not just a patient – and I’m losing my patience
IWENT for years without seeing a doctor. Nowadays, while it’s much more likely I’ll see a nurse practitioner, or someone else, I’m in fairly regular contact with our local practice.
There must be millions of us, reaching a similar stage. I’m a child of the early days of the NHS, just like thousands of 1950s Northumbrian children, born at the Mona Taylor maternity home at Stannington. There are so many of us, with so many reasons to thank the NHS.
The Mona Taylor is a housing estate now, but I returned there more than 40 years ago, after it had been re-named Hepscott Park and turned into a residential home for older people. At that time I was embarking on a social work career, based in Bedlington, with a generic caseload containing many older people, so I became a frequent visitor to the place. Sometimes I’d pause to wonder, where, among all the renamed buildings, I’d seen the first light of day.
One of these visits was to a redoubtable lady, who I’d persuaded to try the warm bed and regular meals of residential care, for a short time. After a week I arrived to discover that she was intent on my taking her straight home, right there and then.
I’ve never forgotten that day, nor my supporting role on her ‘great escape committee’. Mrs B was an extraordinary woman and it turned out she was of greater assistance to me than I think I was to her. She helped me decide that helping people do what they really want to do, in the best way possible, is definitely a job worth doing.
All this came back to my mind last week, with a letter which I received from my local medical practice.
‘Dear Patient, ‘we are writing to inform you about some changes we are making to the management of your GP practice.’
Apparently my GP practice has joined something called Northumbria Primary Care which is ‘a wholly owned subsidiary of Northumbria Healthcare NHS Foundation Trust’. As a patient I ‘can be assured that this management change will only have a positive impact on the services that I access and the care I receive.’
Please don’t get me wrong, I don’t doubt anyone’s good intentions.
Nor, having looked at their websites and the ‘outstanding’ rating from the Care Quality Commission (CQC) do I doubt the competence of these organisations, or their directors. Moreover, I am reassured that while this is all being run in a business-like way, that it’s all ‘not for profit.’
Perhaps it’s just, like Mrs B, that it all makes me feel so powerless, and actually quite annoyed.
I’m not just a ‘patient’ I’m larger than that – I’m a person. I’m also a citizen, I pay for the NHS though my taxes. As one of the great public services of the United Kingdom the National Health Service is surely owned by all of us.
Moreover, as someone who lives in the community which these organisations serve, I have a compelling interest in the well-being of my neighbours as well as myself and in the quality of what should be well integrated public services. As someone who lives in a democracy, I don’t just want to be informed, I want to be properly consulted and actually I’d like to vote; I want these important public services to be accountable to all of us.
After umpteen top-down reforms of the NHS, it seems that decision making has become more and more remote from the people the NHS is supposed to serve. No service with people at its heart would require everyone who wants a doctor’s appointment to ring up at 8am. If we really knew how to make our voices heard, how could the absolute scandal of a dearth of NHS dentistry possibly go on?
I want an NHS which is run efficiently, providing best value for our precious public money and I want an NHS in the forefront of technological and bio medical change. However, I also want an NHS which taps the common genius of ordinary people to tackle our health issues in our communities.
If you empower people, you raise confidence and self-esteem, you improve mental health and wellbeing.
If you engage people in decision making instead of regarding ‘patients’ as some sort of nuisance to be passed over as quickly as possible, you might actually find that engagement in preventive strategies, in public health systems improves. You might learn something really useful about how to arrange and develop and integrate key services by tapping into the local knowledge and experience of people who are experts in their own community.
If we build a culture of NHS democracy and participation, we might find that public co-operation improves. When people start to have influence, when we can see what’s happening to our community year on year and we can work together to tackle issues.
Perhaps, when we stop being assured out of the blue, by people we don’t know, about changes that we haven’t been able to consider, that all, somehow, will be well.