Printed from: https://www.cmf.org.uk/advocacy/submissions/?id=55
Published: 28th October 2008
The Christian Medical Fellowship (CMF) is an interdenominational organisation with some 4,500 British doctors as members. All are Christians who desire their professional and personal lives to be governed by the Christian faith as revealed in the Bible. Members practise in all branches of the profession, and through the International Christian Medical and Dental Association are linked with like-minded colleagues in over 100 other countries.
CMF regularly makes submissions on ethical and professional matters to Government committees and official bodies. In 2008, for example, we have made submissions to:
All submissions are on our website (www.cmf.org.uk). As can be seen, these submissions are wide-ranging, and we were disappointed therefore not to receive early notification from the Department of Health about its consultation on the NHS Constitution. We note that the circulation list included 'Voluntary Organisations' but would have thought that regarding a 'declaratory document' that included consideration of the 'principles and values' of the NHS, groups like Christian Medical Fellowship would have been included.
Having only just become aware of this consultation, we have therefore only been able to hold limited discussion, at our Medical Study Group on 13 October, and consequently this submission is necessarily preliminary and brief.
Our members all feel privileged to work within the NHS, and we strongly support its foundational principles; perhaps in particular the concept that 'Access to NHS services is based on clinical need, not an individual's ability to pay'. It therefore goes without saying that we find much to endorse in the draft Constitution; indeed it would in general be difficult to criticise its content.
We can understand the question of some: 'Why after sixty years do we need a Constitution?' but as there is to be a declaratory document of principles and values, then we draw attention here to some key issues which we regard as omissions. We argue that inclusion of these would add significantly to the value of a document which will underpin much service delivery in the years to come. Before that list of omissions, we have a couple of specific comments:
We express concern that under '2b. Patients and the public – your responsibilities' the expression 'You should participate in important public health programmes such as vaccination' seems unduly terse and does not sit comfortably with the emphasis elsewhere on informed choice.
We are of course supporters of vaccination (subject to the usual scientific and medical safeguards), but draw attention to an underlying sense of coercion some might feel.
We note that it is proposed that the Secretary of State for Health would be accountable within Parliament for the ten-yearly revisions of the Constitution, but there appears no indication concerning accountability for the content of the Handbook, in its three-yearly revisions.
As the NHS depends on public willingness to fund through central taxation, on a sense by the public of responsibility (and we welcome this emphasis in the Constitution), and on the commitment of its huge number of staff, 'ownership' of the interpretive detail will be important.
We believe there should be a much stronger statement about the intrinsic value of all human life, whose innate significance does not seem to us adequately represented under 'NHS values…Respect and dignity', despite expressions like 'as an individual…aspirations and commitments…priorities, needs, abilities and limits'.
Allied to this, we believe there should be a stronger statement about protection for the vulnerable – eg, the unborn; the newborn; those with learning difficulties, mental health problems or dementia; the unconscious; the dying.
We are surprised that in 2a under 'You have the right not to be unlawfully discriminated against in the provision of NHS services including on grounds of…' there is no mention of discrimination on grounds of age.
Noting a brief mention in 2a of 'learning disability or mental illness' we believe there should be greater emphasis on mental health issues .
We note no mention anywhere of spiritual care.
Noting mention in 3a of 'to act in the interest of patients' we are surprised there is no emphasis anywhere on 'best interests'.
Noting that the General Medical Council has recently acknowledged that all doctors have personal beliefs which affect their practice, we believe there should be express recognition that all NHS staff have personal beliefs which should be respected
Related to this, because all staff should be encouraged to practise with integrity, conscientious objection must be protected.
When whistleblowing is appropriate, it should be acknowledged that it is a duty for all staff.
Noting that 3a mentions 'access to appropriate training' only as a pledge, and that in 3b 'You should strive to take up training and development opportunities provided' the onus is on the staff member, there should be greater emphasis on the responsibility of the NHS to provide staff training.
We note no mention of the importance of research.
We note in 3b 'You have a duty to accept professional accountability', but are surprised there is not more emphasis on accountability to, and responsibilities with, professional organisations such as the General Medical Council, British Medical Association, medical royal colleges, Royal College of Nursing, etc.
There is much that we endorse in the proposed Constitution, but recommend the addition of these subjects omitted or not sufficiently emphasised. This would make for a more useful basis for service delivery in the National Health Service.
We wish the Department of Health well as it responds to this consultation, and are willing to help further if requested.
Christian Medical Fellowship - 17 October 2008
Steven Fouch (CMF Head of Communications) 020 7234 9668
Alistair Thompson on 07970 162 225
Christian Medical Fellowship (CMF) was founded in 1949 and is an interdenominational organisation with over 5,000 doctors, 900medical and nursing students and 300 nurses and midwives as members in all branches of medicine, nursing and midwifery. A registered charity, it is linked to over 100 similar bodies in other countries throughout the world.
CMF exists to unite Christian healthcare professionals to pursue the highest ethical standards in Christian and professional life and to increase faith in Christ and acceptance of his ethical teaching.
