Education and debate

Modernising the NHS

Patient care (empowerment): a local view

BMJ 2000; 320 doi: 10.1136/bmj.320.7250.1663 (Published 17 June 2000)
Cite this as: BMJ 2000;320:1663

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  1. Marie Taylor, manager
  1. PASS (People's Advocacy and Support Service), Dumfries DG1 2AT

    See also p 1660

    The prime minister's proposal to draw up a national plan for a National Health Service sets out five challenges to health service professionals—on partnership, performance, the professions, patient care, and prevention. As a former health and social services employee now working for an advocacy organisation I would like to make five suggestions which would empower patients in their dealings with health services.

    Summary points

    Joint working between health and social services needs to supported by real joint funding

    The NHS should support advocacy services because not all health professionals are able or willing to take patients' views fully into account

    Health professionals too often deny patients a real say in their care, and are often very skilled in disempowering patients

    Just as clinicians need training in working with all types of patients, so patients need support in playing a full part in consultations

    Real joint funding

    Since the introduction of community care the term seamless service has been much bandied about. There are even some social services departments located in the same building as health boards. But does this mean that the service user receives a seamless service delivered by professionals who work in partnership with each other? Unfortunately joint location and joint documents and guidelines do not always mean joint working at the point where it matters—the service user. There is still a culture difference and a disparity of funding between the health service and its poor relation, social services. For the user in need of a complex care package this can pose serious problems. The funding issue aside (resources are always going to be an issue), the service a user receives depends entirely on the personality of the professionals involved and the local politics of the day. In other words, it's a lottery.


    Embedded Image

    (Credit: ULRIKE PREUSS)

    The partnership challenge …

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