Changing the culture in healthcare - part 2

The outcome was a service determined to keep consumer power as weak as possible. Consumer committees were required to be established by policy handed down from above. But, by ensuring that they had no clearly defined and attainable goals, the committees inevitably became self-absorbed. This has been a very effective means to render them impotent.

Since their inception around 1994, the area health services’ consumer participation programs have not raised the quality of health care by one iota anywhere in this country. All that happened was that significant money was sucked out of the health budget by this useless arrangement.

Now the reform becomes blatantly dishonest

Dates vary from state to state but from about 2005 began a shift away from the magnanimous open door approach where everybody was welcome to join a consumer committee. Consumer committee seats have now to be applied for.

This would have been the right move if an established community organisation such as Rotary made the selections. But, it was the self-serving health care bureaucracy which made the selections. Applicants looking suspiciously like potential boat-rockers are screened out.

The voice of the people is to be under the complete control of the organisation. The threat of criticism is to be subdued by bringing the people’s “representatives” inside the tent.

And - the system remains determined that there will be no use of the Internet to engage the mass of the people with online workshopping of health service concerns (or even simple blogging).

Where can we go from here?

All existing public health service consumer committees funded by the taxpayer must be scrapped.

Also, community “representatives” sitting on advisory councils and service committees must be removed. They cannot understand the shop-talk and desperately spend their time trying to think of something intelligent to say. They are there because they want to tell their friends that they sit at the same table as doctors.

We must have structures similar to citizen juries which can fearlessly follow through on staff and patient grievances that the system is either incompetently or dishonestly processing.

Hands-on health care is too technical for laypersons to pass judgment upon, but anybody can recognise the improper processing of a grievance.

Every employee grievance (such as intra-service bullying, overwork, unfair rostering) is evidence of a potentially dangerous service.

Every patient grievance (such as feeling abandoned by staff, being discharged while still unwell, having scheduled surgery rescheduled) is evidence of a potentially dangerous service.