The NHS Constitution has arrived. I hope you feel better for it.
I opened my copy with eager anticipation, having heard so much about it from Ministers and spinners at the public expense. I am afraid it turned out to be a bit of a let down.
The first surprise is it does not seem to be a Constitution in the normal sense. It does not set out the structure and rules governing the complex web of Trusts, Boards, Complaints procedures, surgeries and hospitals that comprise the modern NHS. It’s not as close to a Constitution as the “non constitutional” Lisbon Treaty turned out to be!
It came as no surprise to discover it is written in that same deadening mixture of bureaucratic mumbo jumbo, legalese and the blindingly obvious that characterise much of this government’s propaganda, Green and White papers and so-called consultation documents. Let me give you a flavour:
1. Bureaucrat English addressed to staff “to play your part in sustainably improving services by working in partnership with patients, the public and communities”.
2. Legalese addressed to all of us: “Pledges go above and beyond legal rights. This means that pledges are not legally binding but represent a commitment by the NHS to provide high quality services”.
3. The blindingly obvious: “You have the right to access NHS services. You will not be refused access on unreasonable grounds”
One of the main things my constituents want is the reassurance that if they have to go into an NHS hospital for an operation they will not pick up a deadly hospital acquired infection. So what does the Constitution tell them – and me as their representative – on this crucial issue?
At first my hopes rose. It says “ You have the right (presumably legally enforceable) to be treated…in a properly approved or registered organisation that meets required levels of safety and quality”. Presumably contracting MRSA or c dif would mean the organisation had fallen short of that standard?
When I read on my hopes sank. The lawyers had spotted that snag. We learn that “The NHS also commits (I fear not legally enforceable) to ensure that services are provided in a clean and safe environment …(pledge)”
Ministers and their legal advisers have decided they cannot solve the hospital infection issue anytime soon, so we have no rights on that score.
There is also a studied ambiguity, or a contradiction, in the overarching principles and aims. Item One in the document tells us “it has a wider social duty to promote equality through the services it provides, and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population” – a fine aim. Yet Item Two tells us “Access to NHS services is based on clinical need” which would be blind as between people from different social backgrounds with differing life expectancies.
If you haven’t read your own copy yet, it’s not compulsive bedtime reading. It filled in a short tube journey for me yesterday, but left me in despair at how much money might have been spent on what turned out to be another spin game. This “Constitution” will not cure a single patient.