Unbiased Analysis of Today's Healthcare Issues

NHS Constitution

Written By: Jason Shafrin - Jun• 29•08

The Telegraph reports that Britain’s National Health Service (NHS) has enacted a constitution.  “[The constitution] will set out the rights and responsibilities for patients and what they can expect from the NHS in the 21st century.  It is being seen by ministers as a chance to reiterate the founding principles of the health service, emphasising that care should be universal, free at the point of access and based on clinical need, not ability to pay.”

The document includes a list of patient responsibilities which includes keeping appointments and treating minor ailments at home.  The question is, what will happen if a person does not keep an appointment?  Will there be a charge?  Sometimes missing an appointment may mean the patient is irresponsible, while other times there may be a family emergency or a child who needs to be picked up from school.  There is no sense of responsibility unless there is some reprocussion to missing an appointment.

Will the constitution significantly change how health care is provided in the UK?  I doubt it.  The constitution does not explicitly determine what services, drugs, operations and treatments the NHS will provide.  Thus, if the NHS does not provide a given service to a patient, the patient will still not have legal remedy. If the NHS Constitution is simply a wish list of how health care within the NHS should look, it may serve as a motivating mission statement for employees and politicains.

The document will only be powerful if a patient can receive a remedy when their rights are violated.  For instance, if there is a long wait for services, will the NHS pay for treatment overseas?  The consitution allows patients the right to register with a GP, but will this be a true choice or will there be a long wait to register with all the best GPs?

In 1991, John Major instituted the Patient’s Charter which also set out a number of rights entitled to NHS patients, however the Patient’s Charter was ineffective since it had no power.

NHS Blog Doctor write about how the NHS Constitution creates an illusion of choice.

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