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Fair play and foul?
John Elder
The Nordic countries remain unique in independently managing and operating their
health care complaints mechanisms and medical regulatory bodies. They are also almost
on their own in having established statutory no-fault patient compensation schemes as
an alternative to the potentially expensive and risky civil litigation route. Moreover,
these same nations (Sweden excepted) are among the few on the planet where sweeping
patients’ rights set in stone are in place.
Sadly, the enlightened example long set by lawmakers in Denmark, Finland, Norway,
Sweden and Iceland on all these issues is still not being matched by their counterparts in
the United Kingdom – or, for that matter, anywhere else in Europe.
For instance, ‘more’ rather than total independence is the theme of the latest British
reforms following the sustained public excoriation of the previous health care
complaints and medical regulatory systems – in particular the routinely inequitable
outcomes they produced for complainants. Self-regulation continues to be the
predominant force in the operation of these new procedures. As before, only a
comparatively small proportion of complaints lodged with the National Health Service
in the UK will receive the attention of the recently established independent review bodies
– where these have been set up. Furthermore, regulation of doctors and nurses remains
in the hands of their existing, albeit extensively reformed, regulatory bodies under
whose patronage the consideration of allegations about these professionals is also being
maintained.
The position about patients’ rights in the United Kingdom is nowhere near so
contrasting. Nonetheless, instead of a specific set of comprehensive legal entitlements
the interests of patients and those who attend to their clinical needs are provided for,
collectively, via legislation, case law, set ethical criteria and health service policy rules.
However, the proposals for a patient compensation and redress scheme as an alternative
to the existing system of civil damages is a big step in the right direction – even if,
initially, it turns out to be a comparatively limited arrangement and then not of the
all-encompassing, no-fault variety.
Fair play and foul? examines all these issues in some detail and also focuses on an area
that had not been in the limelight before or during the reforms that began to take effect
in Britain since the turn of the century. It seems to have always been assumed that the
Health Service Ombudsman is above reproach. But is this really justified? The book
explores vital aspects of the organization that this key independent complaints arbiter
fronts in a way that has not been done before and raises matters that question the
body’s seemingly high standing.
In the process of examining the subject at hand, the book accepts that healthcare is not
the only part of public life in Britain where self-regulation still prevails, and provides
examples of the practice elsewhere in society. Perhaps, foremost among these cases of
institutional self-regulation is that relating to the British parliament itself, the body that
holds the key to enlightened public reform in all its guises.
Fair play and foul? may not be a good read in the accepted sense, but if it succeeds in
helping to bring forward the day when British citizens are conferred with the same level
of entitlements in their relationship with health care that their counterparts in certain
other European societies take for granted, it will have achieved its end.
FAIR PLAY AND FOUL? JOHN ELDER
£12.95
ISBN 0-95346-041-X
BOOKS
9 780953 460410