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Public involvement should be backed by new rights

Encouraging public involvement in health care decisions cannot be left to managers and professionals, says a wide-ranging report from the NHS Confederation.

Citizens, communities and individual users of services need to know when they can expect to have a say in health service planning or in their own care — and this should be made clear in new statutory duties for the health service, argues Marian Barnes, the report’s author.

Dr Barnes argues that public participation is vital to ensuring that the health service remains a public service which is available to all on the basis of need.

The people’s health service? surveys the wide variety of ways in which individuals and communities have become involved in NHS decision making.

But it points out that while decisions about education, services for children at risk, for older people, for people with disabilities and those with mental health problems accessed via social services departments are subject to local democratic accountability, decisions on the provision of health care are not.

Nor is there any statement of a citizen’s right to health care, or even a ‘right to health’, which the reports suggests could provide clear direction for many areas of public policy.

But Dr Barnes highlights the practical challenges in extending public participation so that everyone who wants to can become involved.

The report calls for support for community development work and user groups so that people can develop their own ideas and agendas rather than simply being asked for their immediate views by policymakers. It also suggests changes in the way managers and health professionals are trained.

The people’s health service? NHS Confederation, Birmingham Research Park, Vincent Drive, Birmingham B15 2SQ. 0121 471 4444.