Review

Opening up the new NHS

FOR YOUR INFORMATION A REPORT OF A PROJECT TO LOOK AT INFORMATION ON DHA CONTRACTS
Nikki Joule
GLACHC, 1994

Nikki Joule is continuing her crusade to involve representatives of the people, and the people themselves where possible, in decision making about health care. This report, her third survey for GLACHC looks at the adequacy of information supplied by Health Authorities to Community Health Councils (CHCs), Councils for Voluntary Service (CVSs) and GPs. She based her survey on one of the new rights expressed in the Patient’s Charter (1992), namely ‘to be given detailed information on local health services, including quality standards and maximum waiting times.’ Response levels were rather disappointing though some of this may be explained by a perception of irrelevance to CVSs and by excessive demands on GPs’ time.

Inevitably the report largely concerns acute services which are experienced by only a few (11 per cent of population has been an inpatient in the last year), compared with the far greater number of contacts people have with primary and community services (20 per cent of population have consulted their GP in the last two weeks). Perhaps this could be pursued in the future. And would not everyone — purchasers as well as patients — like more information on clinical outcomes?

One or two results are of particular relevance to London — Extra Contractual Referral for example, no doubt because of the proximity of other purchasing authorities. Keeping databases, such as helplines, informed is a widespread problem, as is the unacceptable use of jargon, and the wasteful translation of written material into languages other than English when audio and video tapes are readily available. The proposal to use the local press in disseminating information is possible if only they can be trusted not to distort the message. The suggestion for a regular slot for a health authority journalist on local radio is more promising.

The author acknowledges the omission of GP fundholders from the study but this is an issue which must be addressed in the future since they are playing an increasing role in purchasing, while that of health authorities is declining.

Perhaps the most important points to emerge are these: what information do people actually need and what is their preferred means of gaining access to such information? It will come as no surprise to the reader that a community development approach is seen to be as effective as any.