Letter

Casting a vote for better health care

Many thanks for your special issue on democracy and health care (issue 55), which was extremely informative and raised all kinds of issues you never see discussed elsewhere.

As was widely predicted, the elections to foundation hospital boards appear to have been a complete sham, with only a tiny proportion of the electorate even aware of the process. A number of alternatives suggest themselves.

First, if the government was really serious about a locally accountable and democratic NHS, it might extend the vote to everyone in a constituency and use existing elections as an opportunity to vote for foundation board members at the same time as local councillors.

Second, why allow people to vote for trust boards, but not for PCT boards – who, after all, are the ones who are supposed to be commissioning care to meet the community’s needs. That makes far more sense.

Third, and perhaps better still, why couldn’t PCTs simply be held directly accountable to our existing local democratic bodies, the local authorities?

If, for example, the police force can be held to account in this way then why not the health service too? Our existing democratic structures might get a new lease of life, and it would avoid adding yet more ballots to an already confusing electoral process.

Perhaps the people who run the NHS don’t really trust the democratic process. After all, as Churchill famously noted, ‘democracy is the worst form of government – until you consider the alternatives.’