NHS constitution is bitter pill to swallow for critics

A National Health Service “constitution” that sets out rights and responsibilities of patients and staff was published last month to wildly divergent reactions.

Gordon Brown, the prime minister, declared the launch “historic” but critics dismissed it as a waste of resources on “a document of platitudes”.

The 12-page constitution, backed by a 140-page booklet giving more detail, contains no new rights or responsibilities and introduces no fresh sanctions or incentives. But it draws together in one place the rights and duties created by years of NHS legislation and administrative fiat.

It includes patients’ limited rights to be treated abroad; to receive services based on clinical need, not the ability to pay; and to be treated within waiting-time targets. It also warns those patients who do not keep appointments that they may not be treated within those targets.

Some patient groups and NHS bodies warmly welcomed the constitution.

Others were much more sceptical. Katherine Murphy, the director of The Patients Association, declared: “We do not expect this document to make any difference to the care patients are receiving.”

NHS organisations, and the growing number of private and third-sector organisations contracted by the NHS, will have a legal duty to “have regard” to the constitution. But Ms Murphy said there were no incentives or sanctions to ensure staff acted on that.

The Department of Health’s official impact assessment says the overarching document will help “guard against future changes” that could “undermine the efficiency and equity” of the NHS.

Andrew Lansley, the Conservative health spokesman, said that in spite of the so called constitution, decisions on what the NHS would and would not provide still remained within the discretion of the health secretary.

Drawing it up has cost just over £1m – a sum that Alan Johnson, the health secretary, called “small beer” in the £90bn NHS budget. But Mr Lansley said it seemed “an enormous amount of effort to define what I would have thought was already pretty clearly defined”.

Norman Lamb, the Liberal Democrat health spokesman, dismissed the constitution as “a document of platitudes”.


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