Reinventing the market?

Andy Burnham, the Health Secretary has apparently said that he is determined to make the NHS patient focused, and to this end he will set up a system whereby increasingly and up to 10% of hospital funding will depend on declared patient satisfaction with the service offered.

(This is a reflection of the fact that hospital finance will be tight, if not cut, over the next few years. Hospitals will thus have a major incentive to satisfy patients.)

This is a revelation, perhaps late in the day, that a Health Secretary has recognised that the aim of the NHS is patient service. This is something,- so often the impression is that the service is run in a Sir Humphrey Appleby way with the main objective administrative efficiency.

How will he achieve this - questionnaires filled in by patients on discharge - if so what are the view of those who die from MRSA, or whatever, - are they recorded as "generally unsatisfied"? What of patients families, are they to have no input?

How will the hundreds of thousands of in- and out-patient's views be analysed? It sounds like more bureaucracy. What criteria will be employed to distinguish between very dissatisfied and very satisfied and all the fine differences on the range between? If someone is broadly happy but feels that some aspect is poor, - tea service, books, telephone, a particular member of staff, etc., how will these reservations be recorded, without making the questionnaire a massive booklet?

What he is attempting bureaucratically, and at great expense, could be solved much more easily if everything was done to allow patients to "vote with their feet". If they had choice, and consulted friends and neighbours about their experience, and even figures produced by the hospital, it would become clear which hospitals or departments were delivering good service and which not.

People choose their supermarkets and other shops. They are likely to be more careful and informed in choosing a hospital, so why not let them?