Wednesday 23 February 2011

NHS reforms: Patient choice may have positive side-effects

Patient choice is a key element behind Lansley's reforms. The idea is that choice will help health services will improve without the need for central management. Patients will "vote with their feet" and only use good services, leaving those NHS providers who aren't good at what they do to either improve or close down.

I'm not too sure what I'd feel if I was one of the poor patients who had to suffer bad treatment before the rest of us all cottoned on and ran screaming from the hospital, but that aside, this idea of patient choice may actual have the knock-on effect of being beneficial for our health.

To help manage my Cystic Fibrosis, I constantly self-monitor my health. Off by heart I know my hospital number, weight to 0.1 of a kg, height, average pulse rate, average oxygen saturation in my blood, and all my lung function stats. I actually know when I'm more ill than my lung function stats would suggest and I get to have a big say in what treatment I have. For example, my hospital constantly tell me to put on weight so I've just asked them to send me a clinical study of the long-term health benefits for CF patients if they are over a BMI of 19.

It may seem weird that I like to know the medical facts and figures behind everything, but the more I understand the importance of my medicine the more likely I am to make the extra effort to take it all - and believe me, there is a lot to take.

So it made me realise that the idea of informed choice behind the NHS reforms might actually improve our individual health as well as the performance of health providers. If we feel actively involved in our own treatment we may be more likely to take our drugs and take note of all the other bits and pieces we can all do to help our treatment work more quickly: eat better, exercise more and sleep regularly.

Moreover, if we feel like we are in control of our treatment it might make us feel more positive about coping while ill and motivate us to get better as soon as possible.

Working out how to get us to self-manage our health better is definitely a shift that the whole of society needs to make. With obesity levels and alcohol abuse on the rise, the whole country needs to recognise that good health starts with us. Any NHS system that advocates public health awareness but simultaneously fails to provide a choice in treatment of specific health-problems is sending out mixed messages to us all.

Patient choice may not prove effective at deciding which companies should provide our NHS care but the drive to provide greater information and choice to patients could be an interesting way to get us to think again about our own responsibility towards our individual health.

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