Sunday, January 25, 2009

Staying on Course

England’s National Health Service (NHS) published the NHS Constitution this week, designed to protect and forward the rights of patients. I looked at the pamphlet that was sent out to the community for feedback during the development of the Constitution. It starts with the sentence "The NHS belongs to the people." That is a powerful statement. Imagine a health system that belongs to the people. Here is a short interview with health secretary, Alan Johnson.

While reading other comments in The Guardian about the NHS Constitution, it struck me how different these conversations are from ours here in America and here in Contra Costa County. I’ve been told that our public system in Contra Costa County was in part modeled on the British system (NHS). So I ask, what about our system? To whom does it belong? Who has a right to use it? How are we presenting it and what are peoples' perceptions of it? Speaking about his convictions regarding health care, Don Berwick in a letter to his daughter Jessica said, "we aren’t asking if it's a human right, we’re saying it is." He described an unyielding conviction to build a better world. That better world will require a great deal of change. To read more thoughts about what that change might look like and how other systems around the world have evolved you can read Atul Gawande’s article published today in the New Yorker, Getting there from here.

I posted some thoughts about Reverend Martin Luther King Jr. last Monday. The following reflection can be found on our on our medical center website:

In the immortal words of the late Reverend Martin Luther King, Jr., we are reminded that life's most urgent question is: What are you doing for others? Public hospitals like Contra Costa Regional play a critical role in providing health care, and we are proud of our role as the health care safety-net for vulnerable populations. We care about the community we serve.

As we look forward, storm clouds seem to be forming on every front. It’s tempting to head for the shelter of what is safe and familiar when the path we should take isn't well marked. While we may not be able to see the path, we must remember that we do have a compass: it is our mission, to care for and improve the health of all people in Contra Costa County with special attention to those who are most vulnerable to health problems.

Can you see it? Our mission points the way we must go. We belong to the people of Contra Costa County; we are here to serve them. With what looks to be dark skies ahead, now more than ever we must constantly refer to our compass, our mission. It tells us what to do. It tells us where our attention should lie. It tells us who we are.

1 comment:

  1. NHS Scotland has built its most recent reforms around a concept we call 'mutuality'. Meaning the health service is owned by the people but emphasising responsibilities as well as rights. We are working on a Bill of Rights for patients. The principal policy document is called Better Health, Better Care and you can see it at

    Jason Leitch, National Clinical Lead for Safety and Improvement, Scottish Government.