By David Scott in Edinburgh
A leading Scottish think-tank has called for radical changes to the NHS, including the creation of a legally binding charter setting out the care and treatment patients are entitled to receive.
A leading Scottish think-tank has called for radical changes to the NHS, including the creation of a legally binding charter setting out the care and treatment patients are entitled to receive.Reform Scotland said the charter, or NHS constitution, would make public health care more answerable to patients and help end the anomaly of ‘postcode lottery’ treatment.
In a report, Patient power, published on April 10, the think-tank emphasised the need for more choice for patients and greater competition between health care providers.
It called for the replacement of NHS boards with new health commissioning co-operatives, and urged the scrapping of centrally imposed performance targets.
The charter would make the health service in Scotland more accountable, the report argued.
‘It [the health service] should act more like the insurance-based systems in other countries by defining patient entitlement so that patients know to which drugs and treatment they have access,’ it said.
‘By giving patients legal entitlements, it ensures the system is accountable to them, not government. And because entitlements would be set at national level, the constitution should help overcome the problem of patients in some parts of the country having access to treatment which others do not.’
The report said the scrapping of centrally imposed targets would give NHS managers and doctors much greater freedom to use their expertise and local knowledge to improve services for patients.
According to Reform Scotland, health services in other comparable European countries, such as Sweden and the Netherlands, whether taxpayer-funded or insurance-based, are designed with strong incentives to meet the needs of the patient – a major driver of innovation and quality.
It claimed that public health care in Scotland continued to lag behind other European countries, including England, despite a 55% increase in health spending over the past ten years.
‘The reliance on central control and management of performance within the NHS in Scotland, through an array of centrally imposed targets, has not delivered good value for money,’ the report claimed.
