Courier and Advertiser, 10 April 2009
A legally-binding patients\’ charter should be introduced in the NHS, a leading think-tank said today.
The report by Reform Scotland also said that the NHS should become more like "insurance-based" health systems in other north European countries.
Scotland still lags behind comparable European countries despite a 55% incrase in health spending over the past 10 years, the report, entitled Patient Power, claims.
A new NHS contiution would set out the relationship between the health service and patients – and clarify the role of the Scottish Government.
"By giving patients legal entitlements it ensures the system is accountable to them, not government," the report says.
Report author Geoff Mawdsley said today the proposed charter goes further than provisions in the SNP government\’s Patients Rights Bill because it defines entitlement to care in the same way as happens in the Netherlands.
But measures in the forthcoming legislation could be adopted to minimise court action from disgruntled patients, Mr Mawdsley said, adding that he did not want to "feather the nest" of lawyers.
The "public sector monopoly" enjoyed by the NHS has not provided value for money, according to the report.
"Insurance-based systems provide clear accountability to patients, while other countries routinely offer patients a greater choice of GP or where they are treated," it says.
Health services in other comparable European countries such as Sweden and the Netherlands, whether taxpayer-funded or insurance-based, are designed with incentives to meet the needs of the patient.
It also calls for health boards to be scrapped and replaced with new bodies solely responsible for commissioning treatment from separate providers.
Hospitals themselves would be run by independent non-profit making trusts under the new set-up.
The overall budget for the NHS would come out of general taxation and be distributed to the new health commissioning co-operatives.
"That should give patients a much wider range of choice and should mean we can get rid of performance management through targets and central control," Mr Mawdsley said today.
Centrally imposed performance targets for waiting lists and times would also be scrapped – with local NHS managers and clinicians given greater freedom to improve patient services.
While these have seen patients treated quicker in recent years, this system will ultimately "hit the buffers" and a new approach is needed, Mr Mawdsley said.
"I think we\’re getting to that stage now," he said.
Patients should also be free to take out supplementary insurance for treatment and drugs not provided on the NHS, the report says.
It comes after health secretary Nicola Sturgeon issued advice last month which would allow patients in some circumstances to pay for new cancer drugs which are not available on the NHS, without turning themselves into private patients.
Liberal Democrat health spokesman Ross Finnie has breanded the report "a play book on how to privatise the NHS" in Scotland.
"It calls for patients to be given a right to opt out of the NHS and top up their health care with insurance payments if they can afford to do so," the former minister said.
"This will lead to a two-tier system that will be ultimately detrimental to patient care.
"The NHS can always be improved, but Liberal Democrats will not support a system that runs contrary to the NHS\’s founding principle of equal provision for all."
But Tory public health spokesman Jackson Carlaw said "anti-private sector rhetoric" in relation to the NHS has increased since the SNP came to power.
Mr Carlaw called for the "political dogma" to be ditched.
"The time has now come for the SNP to stop painting the private sector as a threat to the NHS," he said.
"People working in the private and independent sectors do a fantastic job and should not have to put up with being depicted as the bogeymen of our NHS for ideological reasons, especially at a time when they are being increasingly called upon to deliver NHS treatments."