/ Health

Politicians must empower people on public services


Conference season is coming to an end. So we’re calling for political parties to give people a more powerful voice in public services. But also to offer public service choice, and make sure these services meet people’s needs.

Our research has discovered mixed impacts for recent policies that are supposed to give people more public service choice and a greater say.

Two thirds of people feel they have real, meaningful choice when choosing childcare or a university. However, only one in five feel they have a choice of hospitals and three in ten when choosing GPs.

Even when people do have a choice, in most cases they don’t base their decision on information about the quality of services.

Public service choice

We found that only one in five people think about quality when choosing a service. Interestingly, people most often go to friends and family to help them decide. Location is by far the most important factor. This means people are unlikely to move around if they’re unhappy with a service.

A new initiative was launched by NHS Choices last month offering ‘open data for better services’. The idea is, you can see a number of different details to help choose your hospital or adult social services.

In the hospital category, you can see Care Quality Commission ratings alongside reviews of staff and a friends and family test score. NHS England Medical Director, Sir Bruce Keogh, says that service is committed to:

‘Making sure information about the quality of our services is available and accessible to all. Making information readily available in one place allows people to hold us to account, not just for the amount of money we spend providing care but for how it is spent and what it delivers for the public.’

Making this available is a good start. But more needs to be done to make these kind of data sets easier to access and more useful. But could information like this influence the decisions you make?

Quality of care homes

We know people recognise that quality of services does vary. For example, 67% think there is a big difference in the quality of care homes. However, people feel much less confident about how to tell what a quality service looks like. Only 56% of GP users and 57% of hospital users know what ‘good’ should look like from their provider.

If public services are to be truly responsive to the people using them, people need to talk about their experiences.

With the general election approaching, all parties should commit to giving people a more powerful voice in public services. To put people in control of their decisions.

We need to see meaningful quality data that’s easy to grasp. This will help people feel more confident about their choice, alongside services that encourage and act on feedback.


As this seems to point at the health service it seems to me the public are in a difficult position to judge on the main criterion – whether the medical intervention you are given is appropriate and of high quality in combatting your complaint. Only a medical expert could decide whether you were appropriately treated to a high standard. So to make a judgement we need specialist information on, for example, successful outcomes from different hospitals and GPs (taking account of those that take the worst cases). Who will provide this unbiassed information?

We, the public, can only judge such things as e.g. hospital attentiveness, cleanliness, efficiency in dealing with you, and whether your GP is proactive and seemingly interested and knowledgable about treating you.

None of these public involvements – medical, education, care homes as examples, are easy for us to properly assess. What we need are public services that are run by the professionals – doctors, teachers, nurses for example – without the unnecessary interference from layers of beaurocracy.

Professionals are often good at their job but not at organisation, and using highly trained professionals to do administrative work is not good use of resources.

I don’t dispute that there can be unnecessary layers of bureaucracy but I don’t believe that this is universal.

It’s a balance between managers supporting the organisation, but not determining medical policy, isn’t it? I remember when matrons ran nursing for example – they knew the day to day needs of their patients and staff. I get the feeling that management has become the tail wagging the dog – and from people who really do not understand the objectives of the “business”.

From my experience in universities, the academics usually manage to outwit the administrators so that they can focus on the main activities that generate income – research and teaching.

My own GP surgery is clearly managed to make the best use of the time of the doctors and nurses and that is reflected in good patient care and excellent feedback.

There has been a lot of new public access and opinions being requrested on a large number of health topics by the new local CCGs however one has to break down the language barrier first to actually understand what they are referring to. They use so many short terms for the various services one cannot understand them. Whilst they ask for input it invariably ends up a “gold” standard level which we all would love however they will not address the biggest of all elephants in the room there is no money in the kitty to deliver a gold service. Just wish they would be realistic and deliver a well resourced professional service and stop over stating the delivery promise which money will never be available to provide. Integration of Health and Social Services is a good start to something that has an out of the box feel something that until now local and central government have not been brilliant at……

Things hit a downward spiral since Thatcher abolished Middle management & continued to use averages to fund institutions & LAs .Ask for those in charge, especially in a hospital, & you get Security ,then labelled as abusive & attacked having appointments taken away.
One of fundamental problems is Deregulation and the taking away of Trading Standards who could act immediately if a business was acting inappropriately now it is Public Institutions with Police not letting you sign their recordings or adding to .I often said did not know what would do if Trading Standards assistance taken away, it now has been .Then Brown gave overall control to Bank of England & MPs go along with fact do not have intervene & represent .They can act unfairly blaming Europe.
To run the Telecare System[ press button emergency assistance] like automated call centre is asking for troubleie: calling out ambulances inappropriately as no Doctor to oversee like 101 service .Raise the issues & your health monitoring[ cardiac] is taken away .What is going on?

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