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back to article NHS: Big tech might be OK for patient power

The Department of Health has released its consultations on patient rights and the future of IT. Does this mean no more security fails, privacy breaches and wastage ahead? The consultations are well-intentioned and on the right track, but according to one-time contender for the Tory leadership, MP David Davis, the NHS track …

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  1. Anonymous Coward
    FAIL

    Ah yes, patient choice . . .

    My wife relayed an amusing story about 'patient choice' recently. An associate of hers was offered three hospitals to choose from for an operation. Every question that the patient thought to ask to aid in making this choice; what are the waiting times, what are the success rates, levels of post-operative infection, etc. etc. were met with no response. Eventually the choice was made based on knowledge of the parking arrangements!

    Truly a world of wonders!

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    1. Dave Bell
      Reply Icon

      Parking?

      My own experience suggests that Parking at a hospital isn't a stupid reason for a choice, but it shouldn't be the only reason.

      Not that we get much choice in this family. 999 calls aren't like that.

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  2. Ku...

    The people who know least about the health service...

    ...are often the people who use it.

    Look at any big private company. How do they achieve success? By continual consultation, focus groups, navel gazing, risk assessment and so forth? Or by putting strong, dynamic, capable leadership in place and bulldozing ahead regardless of the comentards and nay-sayers.

    Its not "democratic" to run a public service that way you say?

    What part of "democracy" requires you to mire everything in so much red tape that the cost to the tax payer of dispensing an asprin becomes £500 a go?

    If you ask me: you will find I want access to all my NHS services online, yes, I'd love to be able to email my GP, make appointments online, renew prescriptions on a phone app, etc. if he's running late a SMS to tell me so would be great.

    If you ask my parents: all of the above is the work of satan. My parents don't even believe in direct debit.

    You can't please everyone because everyone has so many divergent views and experiances depending on their age, expectation and how they need to access the service.

    Get a vision, enact. Get voted back in or out on the basis of how it pans out. Lets have some results here and less screwing over hard working and much put upon health service professionals who have to bend and twist with every public policy review....

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    1. Anonymous Coward
      Reply Icon
      Anonymous Coward

      @Ku

      I agree with most of your sentiments but unformatunately when people pay for something they expect to get a say in how it is run (perhaps not entirely unreasonably).

      I think it is one of the great dilemmas of any publicly-funded organisation up to and including the government itself. Do you do what you were created for to the best of your ability or do you do what 'the people' want (usually the loudest mob)? I think most end up in some half-way house of doing okay at their main job while trying to keep the vociferous minority subdued.

      The BBC is probably the clearest exemplar of this; if they use the licence fee to make programmes that the commercial channels wouldn't then they are elitist and 'everyone' trumpets that they don't pay their fee for X, Y & X.

      If they make commercially viable programmes then why do we need a license fee at all since any commercial organisation could do the same?

      But on a strict question of efficiency and delivery - strong leadership and a clear vision is obviously the best way to go. <sigh>

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      1. Anonymous Coward
        Reply Icon
        FAIL

        Thats all well and good

        But misses the point that If (lets say) a company making baked beans dose something I don't like I can go somewhere else. If the NHS dose something I don't like I have no choice, and I can't do very much about it. THAT is why they have to make sure things are right. If they F up there is a lot more at risk and they may never know. Its all well and good saying people will vote on changes at the next election, but that might be 4 years away, and it is not the only issue to vote on.

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    2. h4rm0ny
      Reply Icon
      Stop

      Re: the people who know least...

      Ku, the problem is that your argument is essentially the 'benevolent dictator' argument - that the people who know best shouldn't be held back by the limited understanding of those in their charge.The problem with this is that those at the upper levels of the NHS need to be beaten back under control, not give more freedom. Look at the NPfIT fiasco and the amounts of money funnelled off to private companies in return for nothing.

      And as regards contacting my GP by email... I might be well happy with that if I thought it was secure. But thanks to the Yahoos and Gmails of this world, the chances of me sharing public-key encrypted messages with my local GP or having a decently secure authentication method, is practically nill.

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      1. Ku...
        Reply Icon

        @h4rm0ny

        Not benevolent dictatorship - electoral democracy.

        You elect a party who claim they will do "X". They should then do "X" because that is what they have an electoral mandate to do. What they should not do is be elected bereft of any ideas of what to do and spend the whole term of their elected office piddling about asking us what we want when that is actually the whole point of a general election, not to find out which party is lead by the guy with the nicest smile.

        We seem to have forgotten how to run a democracy in this country.

        Everybody is too scared of upsetting some element of public opinion or some newspaper editior that they have nothing of significant substance to offer.

        I work in the public sector and I agree entirely with the sentiment that it is "awash with intiatives and no prioritisation" and this has to stop. It wastes my money as a tax payer and wastes my time as an employee. I don't work in health but I have friends who do. Its very demoralising for them.

        If Party X says "elect us and we'll have the whole NHS online" and you want that - vote for them, if you don't then vote for someone else. Thats the way its supposed to work. It involves politicians putting together firm manifestos and the general public reading them and then bothering to vote.

        With our electoral turnout people are in a poor position to complain about not being represented, or rather, about 40% of us are...

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    3. John Sturdy
      Reply Icon
      FAIL

      Dubious assumptions

      Your post seems to be based on the assumption that those appointed to high office in public posts will be more knowledgeable, and more dynamic, than the general public.

      The evidence available to me, as a member of that public, suggests that appointment to high public office is based on shameless self-promotion, brown-nosing, lying, manipulation, exploitation of connections, and perhaps an element of being bumbling incompetents who have been around too long to fire and so get booted upstairs to get them out of the way of those who're trying to get some work done.

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  3. Martin 49
    Thumb Down

    Consultation my ****** ****

    As with all government consultations, they already know precisely

    what they are going to do and will do it regardless.

    I tried to read the documents, but I lost the will to live after about 5 pages of <puke>.

    Possibly a cure for insomnia though?

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  4. danensis

    Liberalating the NHS

    Having attended one of the White Paper "consultations" it was soon clear that the Department of Health hadn't a clue how they were going to achieve the task the new government had set them.

    At the consultation I attended I was the only one there from a service user group - most of the other couple of hundred people there were from something called LINKS, which seems to be a collection of do-gooders left over from the Community Health Councils.

    What patients want is not to have to choose between hospitals many miles apart - not everwhere is like Westminster, with several hospitals within a bus or train ride - but to know that whichever hospital they visit their care will be the best available. For that there needs to be contol and monitoring, just the type of thing the red-tops want abolishing.

    The other major issue is that this is a strategy for the articulate middle classes. Many adults cannot read, let alone understand the medical jargon, or the complicated pathways involved in patient care. For them to have choice there needs to be an advocacy system in place, and that is going to cost money that would be better spent on improved services.

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  5. Anonymous Coward
    Terminator

    return of the zombies

    The civil service have rolled the tories already. What price ID cards being abolished? They've decided to spunk GBP2bn on spying on us (http://www.telegraph.co.uk/technology/news/8075563/Every-email-and-website-to-be-stored.html) as well. You could take over a small country for that sort of money.

    Back to the story.

    The problems with online access (will we ever manage to put a stake through this one's heart?) are about privacy. Just because you don't care about yours doesn't mean that everyone else has to have their privacy destroyed.

    One big problem is coercion: you want a job? Employer sits you down in front of a terminal, says we want to see your medical records, we'll look the other way while you put your PIN in. Sooo, if you want the job the employer gets to have a gander and it's all legal, no access by anyone who wasn't authorised.

    Ditto the police, local authority (you say you're disabled and you want a ground floor flat?), schools, social workers and uncle tom cobley and all.

    My feeling is that if the NHS have got money to burn on this BS, then there need to be some real cuts that encompass the legions of the living dead in the DHSS.

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  7. genghis_uk
    Pint

    Doh!

    Am I the only one who always thinks of the Homer Simpson Doh! whenever the DoH is concerned?

    Media indoctrination or subconcious morphing to match reality???

    <Hmmmm Beeer...>

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  8. Tony Rogers
    Alert

    NHS Administration

    Relating to several health problems...cancer...heart etc, I have now clocked up well in excess of

    6000 miles to recieve treatments and check-ups.

    The nurses, doctors/consultants have all been first class in all ways.

    The administration has changed the responsibilities for services recently and are now in need

    of being given a good talking to.

    There are reasons that doctors and consultants were in charge of their own operation lists.

    However well meaning a junior or senior admin bod is in approaching sorting out some matters,

    a detailed knowledge of the medical problems affecting each patient is only likely to achieve

    the correct passage through the system with knowledge unavailable to admin bods.

    The admin now seem to view the doctors/consultants and nurses as hired hands.

    "You will work as directed by the Administration, not as is best for the patient"!

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    1. John Sturdy
      Reply Icon
      WTF?

      It's even worse in Ireland

      There was recently a scandal in which a Dublin hospital was found to be leaving referral letters unopened, to meet waiting list targets. An outside specialist estimated it was around 30000 letters, which of course the hospital denied.

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