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Patients' Rights Bill for users of the NHS in Scotland
Consultation Analysis Report
The Scottish Government wants to make sure that people know what they have a right to expect when they use NHS health services and what the NHS can expect from them.
The Scottish Government agreed ideas on eight different rights for a Patients' Rights Bill and asked people to comment on them. Hundreds of people in Scotland gave their views. These included members of the public and people in organisations.
This paper explains what we have learned.
- Overall, people thought that a Patients' Rights Bill is a good idea.
- People also felt that the eight rights the Scottish Government suggested made sense. Look at the next pages for the eight rights.
- Some people thought that new laws are needed for patients' rights but some were less keen that new laws are created.
- Some were concerned about what might happen to people if they are unable to keep hospital appointments.
- People asked what health services are covered by the Patients' Rights Bill. For example, does it cover care provided by local authorities?
- Some people felt that extra money would be needed from the Scottish Government to help NHS health services meet patients' rights.
- People thought that some patients would need extra help and support to be able to have the same rights as others, for example someone who can speak up for them at a meeting with their Doctor.
- Some people said it is important for patients to be helpful to the NHS and act responsibly. The Patients' Rights Bill should encourage this.
Background
In 2007, the Scottish Government said it would ask people their views on Patients' Rights.
Members of the public and organisations were asked to give their views on eight different rights.
Overall, most people who gave their views agreed with the ideas. People's views on each of the eight rights are shown below.
1. Access to health services
People said it is important that access to health services is fair for everyone.
People liked the idea of a waiting time guarantee where some patients would not have to wait longer than 12 weeks for their treatment to start. Of course, if you are very sick you will start treatment much more quickly. If it is an emergency you will go into hospital at once.
Some people were concerned about what the right of access would cover, for example, whether it would apply to mental health services and NHS dentistry.
People, especially disabled people, felt that some health service buildings were difficult for people to use.
2. Your right to be treated with dignity and respect
People thought that being treated with dignity and respect is very important. Overall, they said this was the most important right in the Bill.
Some felt that health services are sometimes so focussed on medical problems that they do not pay enough attention to people.
Some people thought that health workers could be helped by having more training in how to work with patients from different cultures and backgrounds.
3. Your right to safe and effective care
People thought that providing safe and effective care is the main purpose of NHS health services and a main part of patients' rights.
Some organisations thought it was important for the Patients' Rights Bill to be clear in what it means by safe and effective care.
People felt it important that safe and effective care covers a person's health care throughout their life and not just health services in hospitals.
People also thought that hospital cleanliness is an important part of safe and effective care.
4. Your right to be communicated with in a way that you understand
People agreed that clear, accessible and appropriate communication is important.
People knew this involved translation and interpretation services, for example for people whose first language is not English or for people who are deaf that use British Sign Language and help for people who are hard of hearing or have difficulty seeing.
Some people had concerns about the extra money that might be needed by health services to improve communication.
5. Your right to information about the services you use
People felt this right about information is important but some people thought it was very similar to the right about communication.
People thought it was important to have access to their health records. But there were concerns about who else should have access to their health records.
Some people thought it was difficult for patients to know everything that they need to know about their own care. And without knowing this information it can be difficult to discuss health matters with health workers.
6. Your right to be involved in making decisions about your care and the services you use
People thought it was important that they are involved in the decisions about their health care and the health services they use.
Some people saw this right as closely linked to the right about information.
People were worried about the difficulties some patients would have in being involved in decisions about their health care.
Because patients are not medically trained like health professionals, some people felt that this makes it more difficult to question the opinions of health professionals.
7. Your right to privacy and confidentiality
People thought the right to privacy was important. They also thought it was closely linked to the right on dignity and respect.
Some people said that there are already laws about privacy and confidentiality and wondered whether any new approaches are necessary.
But some felt that some things could be better or stronger, like data security.
Some people thought it was difficult for health services to provide a high level of privacy. There were concerns about some things that happen, like when your name is shouted out in front of a full waiting room.
8. Your right to comment about your care and have any concerns dealt with
People thought it was important for patients to be able to comment on the health care they receive and have their concerns dealt with.
Some people did not think it was a good idea to have a no-fault compensation scheme, if health care mistakes were made. A no-fault compensation scheme is when people are paid compensation without the need to go through the courts. People thought this might lead to more compensation claims.
Some people were also concerned about the amount of money that might be needed for a compensation scheme. And they were worried that this money might need to be taken from health service provision.
Conclusions
Looking at what people have told the Scottish Government, there was overall support for a Patients' Rights Bill, and support for the eight suggested rights.
People's views suggested there are five areas which could be developed more in the Bill. These are:
- The question about whether new laws are necessary for the Patients' Rights Bill, or whether existing laws are enough.
- The question about what health services the Patients Rights' Bill should cover and what services it should not.
- How much money will be needed to make sure that all the ideas in the Patients' Rights Bill happen and where this money should come from.
- How health services can help ensure patient privacy and confidentiality, especially for those patients who need the help and support of their family or carers.
- What patients can do to help health organisations provide services to patients more effectively.
Scottish Government response to the report on a Public Consultation on a Patients' Rights Bill for users of the NHS in Scotland
Overall
Our proposals for the eight rights received overall support.
Law
We do not want to change or repeat existing laws, but we want to make it clearer to patients and to staff what patients' rights and responsibilities are.
Services covered by the Bill
We think that the Bill should apply to all services offered by the NHS in Scotland. We think it should cover all people who use the services, including children and young people. Care in the community is not covered by our proposals, but we know that the NHS works closely with local authorities on this.
Funding
Our ideas included a waiting time guarantee for some patients. We have already made £270 million available for health boards to deliver the 18 weeks total journey waiting time target. We expect that the waiting time guarantee will be achieved using that money.
Support for patients
We know that some patients will find it difficult to ask for their rights, if they need to, and also to take responsibility for their own health. Patients who need it should be offered support to make sure they get the same rights as everyone else and take the same responsibilities.
Patient responsibilities
There was support for setting out the responsibilities of patients when using health services. However, we may not do all this through a Bill. There were some specific points raised about patient responsibilities which we are still considering.
1. Access to health services
We are keen that people are offered a choice of appointment times. Some people were worried about dentistry. The amount of funding we have put into NHS Dentistry has increased, to help give people more access to this service.
2. Your right to being treated with dignity and respect
We think that a Charter of Mutual Rights and Responsibilities could help with both patients and health workers having a right to be treated with respect.
3. Your right to safe and effective care
Patient safety is a key priority for this Government. We are providing £5 million extra funding for 600 new cleaners for hospitals.
4. Your right to be communicated with in a way you understand
NHS Health Scotland is helping us to develop a communication, translation and interpretation plan. They are thinking about whether we can buy these services at a national level. The Scottish Government has funded some organisations to increase the number of Sign Language interpreters.
5. Your right to information about the services you use
We want to make sure that patients have access to information that they understand. This should include using plain English.
We want to make sure that people know they have the right to see their health records.
6. Your right to be involved in making decisions about your care and the services you use
We are working on a Participation Standard. This should help NHS Boards to involve people in making decisions about local health services and to involve patients in decisions about their own care.
7. Your right to privacy and confidentiality
We believe it is important that health services should respect patients' privacy and their confidentiality.
8. Your right to comment about your care and have concerns dealt with
Some people were worried about how a no-fault compensation scheme would be funded. We have set up a working group to look at the idea of a no-fault compensation scheme for injuries as a result of medical treatment.
Conclusion
People's views have helped us understand what is important about health services. This will help us to finish our proposal for a Patients' Rights Bill, which will take us closer to a health service that is answerable to the people it serves.
This document, along with full report of the project and full government response can be
viewed on the Scottish Government Website at: www.scotland.gov.uk/publications
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