Citizens’ ability to influence NHS services is undermined by the complexity and ceaseless reform of systems for patient and public representation

Unlike many other public services, the NHS is not subject to local democratic control. In this post – an extract from a new Democratic Audit ebook – Sally Ruane explores the recent history of patient and public involvement in the NHS, including the impact of the coalition government’s reforms

Democratic engagement in the local NHS

Any examination of democracy in the health service is troubled by confusion and complexity. In this essay, Dr Sally Ruane of the Centre for Health and the Public Interest writes for Democratic Audit about the recent history of patient and public involvement in the NHS, and those elements of the health system lying outside the NHS. Dr Ruane identifies the barriers to democratic engagement and sets out ways in which accountability can be strengthened, particularly through Healthwatch and local authorities

Expanding the resources and powers of Healthwatch and Overview & Scrutiny Committees would improve the local accountability of health services

Unlike many other public services, the NHS is not subject to local democratic control. In this post – a second extract from Democratic Audit’s new ebook – Sally Ruane examines the barriers to local democratic engagement in the NHS, and identifies ways to improve accountability through local authorities and Healthwatch

Adoption talk and the social construction of motherhood.

SIGLEAvailable from British Library Document Supply Centre- DSC:D173886 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Mercado reforma y privatización en el Sistema Nacional de Salud inglés

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.El artículo examina la evolución de la mercantilización y la privatización del Sistema Nacional de Sanidad (SNS) en Inglaterra, sobre todo desde 1997. Explora el uso de la competencia y la subcontratación de servicios auxiliares y el uso en los servicios públicos de financiación privada para desarrollos de capital a través de la Iniciativa de Financiación Privado. Una parte sustancial del artículo examina la repetida reestructuración del sistema de sanidad como un mercado de servicios clínicos, inicialmente como un mercado interior sino posteriormente como un mercado creciente apertura a la participación del sector privado. Algunas de las implicaciones de los procesos de mercado para el personal del NHS y de creciente privatización se discuten. El artículo examina un episodio de la resistencia popular a estas tendencias, es decir, el movimiento de oposición a la salud y las propuestas legislativas del SNS en 2011. El artículo concluye con una discusión de las consecuencias de estas reformas fundamentales del sistema nacional de sanidad y la sostenibilidad del servicio

Report on the Sustainability and Transformation Plan For Leicester, Leicestershire and Rutland

The report identifies a range of concerns relating to the draft Sustainability and Transformation Plan for Leicester, Leicestershire and Rutland, published on 21st November 2016

Las campañas contra la privatización: causas de sus éxitos y fracasos

The article examines contributory factors to successes and failures in anti-privatization campaigning around the English NHS

Submission from the Leicester Mercury Patients' Panel to the House of Commons Health Select Committee in response to its Inquiry into Integrated Care: Organisations, Partnerships and Systems

The Leicester Mercury Patients' Panel submission to the Committee raises a number of concerns regarding engagement of the public in the STP process in Leicester, Leicestershire and Rutland

Can the government’s new Integrated Care Systems deliver for children in England?

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.The creation of Integrated Care Systems in England is proving challenging as local ICS leads attempt to create structures which enable NHS and Local Authority services to work in a more joined-up way. Concerns around the complexity of the new ICSs have increased following the publication of a second White Paper on integration while the legislation associated with the previous White Paper on integration has yet to complete its passage through Parliament. The second White Paper adds further complexity, and potentially contradictions, particularly in relation to accountability structures in the new ICSs. Paediatricians may question whether the energies going into ICSs will serve to support child health care or impede it