Concern over reluctance to complain about the NHS: it is only where low standards are highlighted that lessons can be learnedOctober 10, 2013
The Times reported on the view expressed by the new patient champion Anna Bradley, chairwoman of Healthwatch that we will need to be more assertive in order to see change in the NHS.
People should stop behaving like “grateful patients” and start demanding their rights to improve standards of care, she says. High satisfaction ratings for the NHS are a “paper-thin veneer” because many people say they are happy despite dreadful experiences, she will say in her first report to Parliament. She told The Times that it is extraordinary that one in three people has “had an experience that is extremely poor to actually dangerous”.
She added: “What one also hears is that most people, at first glance, say they’re satisfied with the service they get, and we talk about the NHS as a kind of treasure.” She said people should not be afraid of offending doctors and nurses or criticising the cash-strapped health service.
She said that misplaced loyalty meant people do not raise problems. “An awful lot of people have reason to complain, but most don’t,” she said. She added that people “are reluctant to criticise health and social care services. You understand the pressure services are under, and are grateful for what you get. As a result, satisfaction levels are reported as high.
“Our research also shows that if one looks a little deeper, a different picture emerges. The actual experience of consumers, users and their carers is not as positive and the vast majority of people believe change is needed.” She added: “This paper-thin veneer of satisfaction is stopping us all getting to grips with the widespread failures across our health and social care services.”
People need to sharpen their elbows and insist on consumer rights just as they do on the high street, she said. “We all need to stop acting like grateful patients and care users, and start to see ourselves as savvy consumers.”
Some of the examples of what people would put up with and still say they were satisfied were “quite extreme”, she said. “When you ask about health and social care they think about hospitals where the gravest of personal crises are played out. If your loved one survives and is better, no matter what else happens you are grateful and happy, and that dominates your reflections.
“When you then prompt them about some of the other health and social care services that aren’t top of mind, perhaps particularly primary care, all of a sudden a floodgate opens. Access to GPs was a very, very considerable issue which it was quite difficult to stop people talking about because it just so dominated their lives.”
She added: “We also heard tales of individuals who’ve had really, really difficult experiences, even where their loved ones have died, but where they want to be grateful to those who have played a positive part. So you can hear people tell tales of the wrong things happening but the final days of someone’s life being hugely supported by nurses and that’s what dominated their recollection.”
Mark Porter, chairman of the British Medical Association Council, said that “the NHS in general is not good at listening to patient or indeed staff concerns, and deals with complaints in a bureaucratic way without learning real lessons. That’s why we need to create a culture of active listening for patients and staff. This goes beyond simple consumer relations to engage patients as true partners in the planning and delivery of care.”
Norman Lamb, the Care Minister, said: “Without real and meaningful input from patients, it is impossible for health and care services to improve.”
Unfortunately, as a solicitor working with a number of patients in claims for medical negligence, many of whom have had a delay in diagnosing cancer and other serious conditions, this is sadly not news to me. I think it is part related to our culture and also to how we relate to the NHS.
I do think that a system of providing medical treatment that is free to the user is fantastic and of huge value. However where the treatment provided in itself causes serious injury or a fatality I think that patients should not shy from complaining or seeking redress for this. In this country we aren’t very good at this, and don’t want to ‘make a fuss’ or ’cause trouble’. However, raising concerns openly is the only way for lessons to be learned and to hopefully prevent others having the same experience.
If you have concerns about the medical treatment which you have received, I would be happy to advise you on making a claim for compensation for medical negligence. Please contact me on 0207 288 4834 or firstname.lastname@example.org to discuss the matter with no obligation and free of charge.
Suzanne is a Partner and is head of the clinical negligence department.