Healthcare

Baroness Hussein-Ece Excerpts

Thursday 28th October 2010 Lords Chamber

[Baroness Hussein-Ece]

My Lords, I, too, will focus on what we mean by patient-led healthcare, which others have mentioned before me. In November 2005 a best-practice document called Now I Feel Tall: What a Patient-Led NHS Feels Like was published. It said:

“I strongly encourage all NHS organisations to take a close look at how they deliver their services and to ask their patients if their emotional needs are being met as well as their physical ones”.

It goes through what patients should look for. This includes,

“getting good treatment in a comfortable, caring and safe environment, delivered in a calm and reassuring way … having information to make choices, to feel confident and feel in control … being talked to and listened to as an equal; and … being treated with honesty, respect and dignity”.

The core and developmental standards for the NHS were set out in seven domains, the fourth of which is patient focus. It says:

“Health care is provided in partnership with patients, their carers and relatives, respecting their diverse needs, preferences and choices, and in partnership with other organisations … whose services impact on patient well-being”.

It therefore requires,

“healthcare organisations to have systems in place to make sure that staff treat patients, their relatives and carers with dignity and respect”.

Healthcare organisations must monitor their performance with regard to treating patients and carers with dignity and respect. The evidence has always been clear that if the NHS listens to what patients are saying, it can result in new ideas, better value for money and better care. How do you measure targets in an area such as patients being treated with dignity and respect, and being listened to, when trusts will point to the often relatively low number of complaints as a measure?

There have been numerous inquiries and other pieces of legislation setting out how to empower both individuals and communities in shaping health and social care services. Since community health councils were abolished in 2003—a great mistake in my view, and I declare an interest as I previously worked as the chief officer of a community health council—we have seen numerous attempts to make the NHS more meaningful and accountable. The establishment of local government overview and scrutiny committees with new duties went a long way to bringing accountability to healthcare services and in my view, as a previous chair of an overview and scrutiny committee, shone a welcome light into areas of healthcare services that had not previously been scrutinised. It brought about the need for greater partnership and collaborative working between local government and health. However, again, it relied on local PCTs and other healthcare trusts welcoming and being open to this scrutiny and accountability.

I welcome the Government’s plans to create local government health and well-being boards, but there have been problems on the ground in the way local government and the NHS have to work to bring about greater public and patient involvement in the NHS. In my own area, the local PCT last year took the decision to close a much loved and important health centre, in the most deprived part of the borough—the Finsbury Health Centre. The health and well-being committee scrutinised this decision in some detail and at considerable length, hearing evidence from patients, the public and clinicians. Eventually, after careful consideration, it presented its findings to the PCT, which fairly quickly rejected them. It found itself at loggerheads with the whole health and well-being committee, the council and the overview and scrutiny committee. It did not allow, for example, the chair of the committee to address or present its findings to the PCT board. As a result, the relationship between elected councillors and an unelected board of rather anonymous people, led by the chief executive, who had no accountability to the public, suffered. So, too, did local community confidence in the PCT.

People increasingly want to be able to exercise choice and control over their care. To do this it is clear that people must have the right to reliable information to help them make choices. Things have improved dramatically in some areas over recent years but what has not improved is the consistency across the NHS. My family’s experience of the NHS has been patchy. Three years ago my father spent seven weeks in hospital, suffering from terminal cancer. I saw at first hand how this 87 year-old man was gradually stripped of his dignity. While some of the nursing staff were enormously professional and provided excellent healthcare, others did not. He was not treated with the respect and dignity he should have expected. He was left in pain, with bed sores, little personal care, and alone on the floor after a fall in his room. This was a proud man, who would not leave the house without a shirt and tie, reduced to tears of humiliation just days before he sadly died. After my father’s death, I decided to complain formally about the senior member of nursing staff who had been so unprofessional to my father and my family. I was perhaps not surprised to learn that there had been a number of complaints about this individual, but none had been taken very far, due to the sheer difficulty, time and bureaucracy involved. This is not an easy time for families and carers.

I welcome the fact that patients will have more choice in terms of their GP. I hope the reforms will underpin not only greater choice but more consistency across healthcare services, so that people like my father have a better experience of the NHS.

[Baroness Northover]

I remind noble Lords that this is a time-limited debate. There is another important debate following ours. We need to give noble Lords in that debate the courtesy of being able to start and finish on time. I remind people that when the clock reaches four minutes, noble Lords have spoken for four minutes. There is also somebody who wants to speak in the gap.