FairPlay cover 4 26/9/05 10:30 am Page 1 Fair play <strong>and</strong> foul? John Elder The Nordic countries remain unique in independently managing <strong>and</strong> operating their health care complaints mechanisms <strong>and</strong> 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 <strong>and</strong> 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, Finl<strong>and</strong>, Norway, Sweden <strong>and</strong> Icel<strong>and</strong> 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 <strong>and</strong> 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 <strong>and</strong> nurses remains in the h<strong>and</strong>s 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 <strong>and</strong> those who attend to their clinical needs are provided for, collectively, via legislation, case law, set ethical criteria <strong>and</strong> health service policy rules. However, the proposals for a patient compensation <strong>and</strong> 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 <strong>and</strong> then not of the all-encompassing, no-fault variety. Fair play <strong>and</strong> foul? examines all these issues in some detail <strong>and</strong> 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 <strong>and</strong> raises matters that question the body’s seemingly high st<strong>and</strong>ing. In the process of examining the subject at h<strong>and</strong>, the book accepts that healthcare is not the only part of public life in Britain where self-regulation still prevails, <strong>and</strong> 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 <strong>and</strong> 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
FAIR PLAY AND FOUL? JOHN ELDER A book of revelations about patients’ rights, complaints h<strong>and</strong>ling <strong>and</strong> compensation in the United Kingdom <strong>and</strong> elsewhere in Europe