WHEN Stuart Shaw faced a six-month wait for a hip operation on the NHS, he felt there was no way he could endure his pain that long.
Instead, Shaw flew to India to undergo the operation for less than £4000 – around half of the price charged by UK private hospitals – and the 69-year-old from Edinburgh is delighted with the outcome.
Soon, however, the NHS may have to foot the
bill for patients like Shaw. A consultation paper on a Patients' Rights Bill will be launched this week, and one of the key measures is the right to free treatment abroad when hospitals miss waiting time targets.
Health Secretary Nicola Sturgeon wants to let patients have more influence over their treatment and give health boards more incentive to meet waiting time targets.
Health systems in other countries, including Norway, already have patients' rights enshrined in law and the SNP believes Scotland should follow this example.
But are the proposals right for Scotland? How effective will they be? And will it make a real difference to the hundreds of thousands of patients who pass through the NHS every year?
The Scottish Government believes the move will give patients "real clout". A source said: "This is all about encouraging health boards to deliver for patients and provides for a series of fallback positions."
Scotland already has an NHS Patients' Charter, which guarantees access to personal information, gives patients the right to see a GP and allows individuals the right to decide whether to participate in medical research.
But the proposed Patients' Rights Bill goes further.
Its main aim is to strengthen the rights of patients to ensure they are seen and treated quickly, and treated as "partners" whose "expertise is respected".
Under the Bill, if a board could not treat a patient within a certain time frame, and the patient felt they needed treatment sooner, the board would have to pay for it elsewhere – another board, the private sector, in England or abroad. It is believed this would be a "safety net" rather than normal practice.
Patients would have to be told about the treatment and medication options open to them, including possible risks and benefits, putting greater pressure on doctors to give patients as much information as possible about groundbreaking new treatments.
Norway's patient rights laws have been in place since 1999. Among other things, Norwegians can choose a hospital, and they have the right to get an evaluation from a specialist within 30 days of receiving a referral from a GP.
However, there are some concerns about the SNP's proposals. First, there are no specific sanctions being enshrined in law to punish those who fail to deliver. Although patients can already complain to the Public Services Ombudsman and ministers have the power to take over the running of failing health boards, there are no extra penalties being introduced in this consultation with which to threaten poor performers.
There are also worries over how boards will meet the next set of waiting time targets. By March 2009, the longest wait for a first outpatient appointment is to be 15 weeks and the wait for inpatient or day case treatment to 15 weeks. Currently, boards are meeting an 18-week target. There is also the question of cost which cannot be worked out without finalised proposals.
Dr Jean Turner, chief executive of the Scotland Patients' Association, said of the plans: "This is going in the right direction. But we have to get away from targets and start dealing with people. I think ultimately a Patients' Rights Bill should encourage doctors and nurses to listen. Sometimes patients don't know who's treating them because the staff don't even introduce themselves."
The proposals, which are being officially unveiled tomorrow, are bound to spark further debate and a 17-week consultation period has been set aside for interested parties, including patients' groups and health staff, to air their views.
Dr Claudia Pagliari, an expert in health care system evaluation at Edinburgh University, said: "These policies have not been rigorously evaluated. There is no evidence currently on who uses them or how effective they are. However 'soft' evidence, including focus groups, shows patients want this and think it's a good idea."
