Monday 28 October 2013

Pen and paper in 2013?

The review of NHS complaints chaired by the Labour MP Ann Clwyd has just issued its key recommendations. It's probably best I'm not told the cost of this investigation fior fear of me imploding with a cocktail of rage and disbelief. That said, the report recommends that all patients be issued with a pen and paper with which to write down their complaint.

Although it would be all too easy to collapse with mirth, this recommendation is actually fraught with common sense. Nowehere to run , nowhere to hide goes the old adage. There are pitfalls here though. What constitutes a valid complaint and how long will it take already overburdened staff to trawl their way through? This will need to be addressed to make such a system viable.

I do worry a little about the potential for patients to use the exercise as though they were the Daily Mail on the ward so to speak. "Doctor, my tea was too strong!". "Doctor, the bloke in that bed is watching Bargain Hunt but I want to watch Escape to the Country". "Doctor, that pen and paper are an infection risk!". The list goes on but the pioint is made. That said, if the NHS is to become truly accountable and bring to fruition the aims of the Francis Report, I fear that such measures will indeed become necessary. Although many of the complaints will be rather facile, some will doubtless be of a serious nature and will merit further action. It is for the latter alone that this idea will become a reality.

On a serious note though, pens and paper are indeed infection risks so this might have to be revisited. I can see that patients need a vehicle with which to express their concerns but wonder whether the associated health risk might defeat the object somewhat. It is sobering to reflect that the current system has failed to give NHS patients the voice which they deserve. Underpinning all of this is the key aspect of trust. Trust is integral to any doctor-patient relationship and failure to listen to patient concerns compromises this. Added to this is the obvious potential for patient harm so the measure being proposed by Ann Clwyd is not really up for negotiation. The format of her proposal appears to be a bit flimsy but to her credit, she has got the ball rolling so we are hopefully one step closer to restoring to trust to a badly bruised relationship.

Any relationship by definition has two sides and this is no different. Just as the patients must be afforded the right to complain if they receive poor treatment, the medical staff must also be afforded the right to highlight unacceptable patient behaviour. The latter isn't highlighted quite so often by the press. This is mainly because patient rudeness or bad behaviour seldom results in loss of life or injury. However, I would urge the report to seek more balance. It could do this by reserving the right to remove any tobacco being smoked by the front doors of hospitals. There are now nicotine replacement patches and the ban on cigarette smoking in public places was brought in for genuine health reasons. It cuts both ways...

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