Socialist Health Association
Scotland
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Socialist Health Association Scotland
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SHA Scotland’s response to the Scottish Government consultation on the Local Healthcare Bill Introduction SHA Scotland welcomes this opportunity to submit a response to the consultation on the Local Healthcare Bill. The SHA was founded in 1930 to campaign for a National Health Service. We are a socialist organisation committed to the NHS and have a long history of support for creating a more democratic NHS. This is reflected in the SHA Scotland charter principle: · SHA Scotland supports an extension of democratic accountability at all levels. This is more than simply electing representatives, important though that is, to public bodies. It means encouraging full participation in decisions with a statutory duty to involve users, staff and the community. It also requires genuine freedom of information, effective communication and transparency of all contracts and partnerships. SHA Scotland therefore supports this Bill in principle as we believe it provides an effective means to achieve greater democracy for health boards in Scotland. General Approach SHA Scotland supports the general approach to direct elections in the consultation paper. We believe that health boards should be open, transparent and democratically accountable and should encourage active participation from users, the community, staff and their trade unions. We believe that democratic structures help create health boards that are more open and transparent in their dealing with the public. Scottish Health Board expenditure will be around £8 billion in this year; Local democratic accountability is essential for expenditure of this level. Government at all levels must explain and accept responsibility for its actions. There have been many high profile campaigns about hospital closures and related issues in Scotland that demonstrates clearly that members of the public not only want to be part of the process of planning health care in there areas but that they are willing to give up their time to do so. These campaigns also demonstrate that the public is sceptical about current consultation processes and do not believe that they are meaningfully involved in the decision making process. In contrast to the current arrangements direct elections provide an opportunity for the public to participate in and influence the policy making process. It will allow individuals to become board members, create a debate about health care in local communities via the election process and make boards directly accountable to the people they serve. But most importantly we believe that direct elections will help change the culture of health boards from organisations that are perceived as being top down ‘we know best’ organisations to one were the public are partners in the development of health care. We also believe direct elections will complement recent legislation including the Freedom of Information (Scotland) Act 2002 and the NHS Reform (Scotland) Act 2004 that promotes the involvement of service users. SHA Scotland also believes that direct elections will introduce greater democratic accountability while still retaining NHS expertise. It offers the prospect of developing genuine local partnerships with greater understanding of the complex issues facing the NHS in Scotland among the public. It is essential that a longer term dialogue is developed with communities so that they better understand the challenges facing health care in Scotland. At present this is largely limited to proposals to close facilities that inevitably engender knee jerk reactions to individual proposals. Practical Issues SHA Scotland supported Bill Butler MSP’s attempt in the last session to introduce direction elections to health boards. We believe the method of election as set out in that Bill is the most appropriate way to introduce democracy into our health boards. The key elements should include:
We do not see the need for a pilot scheme. However, if such an approach helps to build a parliamentary majority for democracy then it should be piloted in at least two boards, one rural and one urban. The pilots to be evaluated after two years. Conclusion SHA Scotland supports direct elections as an effective means of developing greater involvement of communities in their local NHS and ensuring that quangos that spend large amounts of public money are more democratically accountable.
March 2008 |
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