In late 2016 and in the early part of 2017, the UK media has been full of reports about there is medical issues. Quite rightly middle aged Brits have been exhorted by the government’s Chief Medical Officer to exercise and eat a healthy diet. The same official has expressed concerns about stated governmental intentions to introduce a seven day GP service. Right at the end of 2016 the Secretary Of State for Health briefly became involved in public debate about the introduction of medicinal product coding, and its cost implications. The Patients Association has expressed concerns about the alleged use of private companies to monitor healthcare provision and more recently significant concerns have been expressed by the British Red Cross.
One particular and, in my view, very important medical development is that in recent years, very significant advancements have been made in the field of brain injury treatment and rehabilitation. This is not just in respect of conditions such as strokes and Alzheimer’s disease but also in reaction to brain injuries that are acquired e.g. have come about as a result of victims being involved in incidents such as road traffic accidents.
A number of these developments are brilliantly documented in the first, Winter 2016 Issue of Neuro Times*. One article in this journal explains that researchers at the University of Manchester are working on a potential new drug that reduces the number of brain cells destroyed by stroke and could also repair was has been lost or damaged. Another reports that the American rehab network pioneered by the Superman actor Christopher Reeve which develops and delivers therapies to promote functional recovery for people with paralysis has expanded into the UK. Amidst all the NHS related politicking and often divisive political controversy that one so often reads about, I found these articles to be both optimistic and uplifting.
However, although very reluctant to sound a cautionary note, I cannot help but wonder whether the British NHS which is beset by controversy and the most terrible litigious culture and costs burden has the wherewithal to meet the very positive challenges that these developments pose. They may not be warmly welcomed in every sphere of medical and political life. There may be disagreements about funding and costs benefit analysis. A number of different governmental/public organisations including NHS commissioning bodies and NICE** will have input and it is distinctly possible that different NHS trusts will adopt standpoints and that not for the first time something of a postcode lottery may ensue.
What mechanisms are there for those such as injury victims who feel they may benefit from new developments to pursue their grievances against sceptical or costs conscious officials? As things stand, those who are aggrieved may have to resort to the time “honoured” process of very costly litigation with all the attendant delays and uncertainties.
The threat of litigation also puts additional pressure on governmental/public sector decision makers many of whom also have to cope with the very intrusive and sometimes less than objective UK and international media. One wonders if public officials who are subject to these ever present threats can always be truly objective and whether in truth, their objectivity is sometimes compromised.
Although public decision making must be transparent and accountable, mediation of any associated disputes in respect of issues such as provision of medical treatment would help ensure objectivity, reduce intrusiveness and ultimately help to ensure that the decision making is of the very highest order. The decision maker or manger who has acted in complete good faith and will understandably wish to avoid displeasure in the full public glare may be much more forthcoming in mediation.
Although the NHS is belatedly giving some consideration to using alternative forms of dispute resolution and some NHS trusts are considering change, it nonetheless seems that the organisation as a whole has quite some way to go. Rather than continue to sanction, often wasteful and counterproductive litigation, surely the NHS should take the opportunity afforded by the new dawn heralded in by the change of government last year to grasp the mettle, implement real mediation oriented changes in its dispute resolution processes and generate a constructive, forwarding thinking ethos.
This would enable scientists and researchers undertaking more important work in brain injury recovery and other medical fields to work effectively and would help to ensure that their techniques and discoveries are made available to the people that desperately need them. If not, it could well be that in a sense their work adds to the existing burden rather than reducing it.
* Published by Aspect Publishing in conjunction with UKABIF(The United Kingdom Acquired Brain Injury Forum)
** The National Institute for Health and Care Excellence
Principal Director of ASM PLUS, civil/commercial, workplace, employment, family and educational mediator and trainer with a judicial/legal background. He has knowledge and expertise in dispute resolution in a wide range of areas and disciplines and mediates online.