Behind the headlines

Even staff will be able to breathe more easily in the new
atmosphere of openness and consultation within the NHS. At least,
that is message from chief executive Nigel Crisp, who says that
everybody’s views are essential if service users are to have good
access to high quality health and social care.

Crisp has invited social care staff, alongside their NHS
counterparts, to participate in a national consultation exercise to
consider ways in which the delivery of health and social care can
“offer more choice, become more responsive to patients and tackle

He added: “As we grow, we have the opportunity to offer people
more choice over their care and more involvement in
decision-making.” He emphasised that it was important to think
about social care as well as health staff “because so many people
use both services”.

The consultation project, which runs until November, will be led
by Harry Cayton, who is currently chief executive of the
Alzheimer’s Society.   

Karen Squillino, primary prevention co-ordinator,

“This is a good place to start but the thinking needs to be wider.
Consultation is only a small aspect of participation. If health and
social care services are to improve the voices of users and staff
should be heard and acted upon throughout the process of change,
not just at the beginning. In my experience, consultation can be a
disempowering experience if not executed properly. Short timescales
for response to jargon-filled weighty papers are not the way to
encourage people to offer their views. It would be good to see the
NHS offer methods of consultation that are creative and

Bill Badham, development officer, National Youth

“This story is told with the permission of its owner. When my son
was five he had interminable hearing tests. A senior doctor
consistently spoke over his head, didn’t call him by the right
name, ignored him and his parents, prodded and poked him without
warning or asking him. Then a junior doctor happened to see him,
listened, engaged and responded. It doesn’t take a massive
consultation to work out the difference. It does take a huge change
in attitude to bring it about.”

Felicity Collier, chief executive, Baaf Adoption and
“This is a tall order and there will not be simple
answers. It would be easy to rubbish this as tokenistic but it is a
real chance for social care professionals to talk about the
powerlessness of their users and think creatively about what could
make a difference. We all agree patients should have a choice of GP
and hospital but what about a choice of social worker, home care
assistant or, indeed, of council? Well, why not?”

Bob Holman, community worker at a project in Easterhouse,

“Ill health is closely linked with poverty. If there were more
material equality there would be more health equality. We must not
be deceived into thinking that the delivery of services is the
whole answer. I would like the NHS to become a pressure group for
greater equality in our society generally. Perhaps Nigel Crisp
would like to recommend that no one should earn a salary of more
than £60,000 or less than £25,000.”

Julia Ross, executive director for health and social care,
London Borough of Barking and Dagenham

“Choice and engagement in decisions that affect you are fundamental
to human rights and dignity, let alone a good way of keeping the
users of health and social care happy. It’s good news for us all
that this is going to be given greater attention in the NHS. In
many areas, choice and engagement are a way of life and this now
needs to extend to all parts of the NHS. There has always been an
acknowledgement that we’re good at this in social care and we
should build on that. This has the potential to revolutionise
services in the NHS the way it did 10 years ago with the huge
growth in diversity of provision in social care.”

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