« Previous | Contents | Next »
Listen
Executive Summary
1. The following provides an outline summary of the outcome to the Local Healthcare Bill consultation and the steps that we intend to take next.
Overview
2. The Scottish Government wants to encourage greater public and patient involvement in the planning and delivery of local NHS services in Scotland. The Government believes in a mutual NHS. An NHS that each and every one of us is a part of. We believe that direct elections to NHS Boards in Scotland can help to change the way in which we view the NHS and the way in which we become involved with it. In light of what this consultation told us on the issue, we intend to introduce legislation that will provide for direct elections, initially on a pilot basis.
3. But the consultation has highlighted that direct elections alone cannot be used to encourage this greater sense of ownership in our NHS. The consultation has highlighted a number of issues that need to be addressed in the way in which local communities can communicate and interact with their local NHS Board.
Consultation
4. The consultation asked for views on how to enhance the role patients and the public play in decisions about how local health services are designed and delivered. The consultation paper was split into 2 sections and consultees were asked for their views on a number of questions that were designed to stimulate discussion around a number of key areas.
Section 1
Making things better - this section seeks your views on how the role of patients and communities in deciding how NHS services in Scotland are planned and provided could be strengthened through augmenting existing policies, within the current framework of appointed NHS Boards .
5. The key findings to the issues raised in this section are as follows:-
- Universal recognition that there needs to be improvement in the way the NHS and communities engage, although there were few suggestions as to how to achieve this.
- The current landscape is viewed as confusing with the number of different bodies all responsible for some part of public / patient involvement e.g. Public Partnership Forums, Community Health Partnerships, Scottish Health Council, Community Health Care Partnerships, NHS…etc.
- Some concern was expressed around the Scottish Health Council and the role it carried out.
- Independent Scrutiny was welcomed as it provides a check to the decision making process in Boards.
Section 2
A new approach - this section asks for your views on changing the current framework so that NHS Boards have directly elected members with the aim of bringing about greater patient and community involvement in planning and delivering local health services.
6. The key findings to the issues raised in this section are as follows:-
- No clear consensus either in support or against the idea of direct elections to NHS Boards.
- those in favour see elections as increasing local accountability; those against see a threat to consistent delivery of an NHS.
- It was an opportunity to let local voices be heard.
- Some felt that rather than introducing an extra layer of democracy, more local authority members could serve on NHS Boards.
7. Regardless of their views on elections, consultees highlighted the following points :-
- The current methods of consultation and engagement used by NHS Boards were not taking sufficient notice of the views of patients and public.
- Concern around the costs of elections and where funding will be drawn from to meet these costs.
- Concerns around the politicisation of Boards and that this would be unhelpful in the planning of local services and working with local authorities and Government.
- Concern that the skills that are brought to a Board by Members going through the Public Appointments process could be lost.
8. A key part of the consultation was the full debate held in the Scottish Parliament on 21 February 2008. This debate drew contributions from all parties and reflected the issues raised during the consultation by many of the consultees. On balance, the Parliament agreed with the need to change the way in which the NHS and the communities it serves engaged. Although there was relatively broad agreement on the issue of introducing elections to Health Boards, there were differing opinions over the format that this should take.
Conclusion
9. Introducing direct elections to NHS Boards would be a radical change to the way in which the NHS in Scotland engages with the communities that they serve. The consultation has highlighted a number of concerns about taking this step and many have noted the need to proceed carefully possibly through the use of Pilots to assess the impact that any changes will make on the running of Health Boards. We have been mindful of these in considering our course of action. The NHS is there to serve communities and these communities have indicated that they want a direct say in who serves upon their local Health Board. This will ensure that local voices are heard along with those of the professional Board members and decisions will be able to be taken on a mutual basis.
« Previous | Contents | Next »