Why the NHS needs to be more like Tesco for young people

The National Health Service (NHS) was born not very long before I was and, along with Queen Elizabeth II, is one of the cultural narratives of my lifetime. The NHS’s meaning in society reaches far beyond its functions to being a statement about some moral absolutes that we want to see exemplified in our community. Karl Marx’s no longer oft quoted belief, “from each according to his abilities, to each according to his means”, is exactly what we think the NHS does. We pay our taxes so that those in need of health care get it without the dread of unpayable bills.

So what’s this got to do with the Office of the Children’s Commissioner for England report, which found that young people feel they can’t complain about poor-quality health services for fear of getting inadequate treatment? The NHS - perhaps above all other public services – is based, in a rather Patrician way, on the concept that health professionals’ practice rises above ordinary commercial exchange and reflects an unerring ethical certainty that protects us. In this conception we will, in consequence, always be treated in the most sympathetic, considerate and effective way irrespective of cost, our state of mind, our intellect or even cooperation. That is the contract between the NHS and society.

However, the NHS is not like a library or Tesco. If a young person doesn’t want to go to either of these they, by and large, don’t have to. A young person is liable to need the NHS at some stage in their life and has no choice but to access it. It is true to say that once the Patrician contract has been shown to be less than perfect, then the idea that if a service isn’t good enough it will have no customers requires real, serious and robust complaints procedures – and one that young people believe in. Everyone who runs a supermarket knows this.

The message to the health services that succeeded in generating the report’s rather depressing findings concerning young complainants is therefore straightforward. Good services depend in large part on effective feedback. Reluctant patients, be they young or old, have to be engaged if they are to feel confidence in those offering them treatment or support. Engagement results from listening and the great merit of an effective complaints system is that it is a listening service.

A habit of meek obedience to professional guidance is a prerequisite to accepting a Patrician service. We have gone beyond that, and young people need to feel they are being listened to.

Andy Lusk is director of autism services at Ambitious about Autism. Follow Ambitious about Autism on Twitter https://twitter.com/#/ambitiousautism