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When patient choice extends to children When patient choice extends to children
(about 7 hours later)
By Graham Satchell BBC News The letter from their GP left the Dakins feeling perplexed By Graham Satchell BBC News
Shani Dakin and her GP talk about her hospital appointment
Patient choice is meant to be revolutionising the NHS in England - but at what age should you be making the decisions? One 12-year-old was surprised to receive a letter asking her to sort out her own hospital appointment.Patient choice is meant to be revolutionising the NHS in England - but at what age should you be making the decisions? One 12-year-old was surprised to receive a letter asking her to sort out her own hospital appointment.
NHS patients in England can choose any hospital they want to be treated at and book the appointment to suit them.NHS patients in England can choose any hospital they want to be treated at and book the appointment to suit them.
The government says the system will create competition and improve the standards of poorer hospitals in England.The government says the system will create competition and improve the standards of poorer hospitals in England.
Shani Dakin lives with her grandparents, John and Margaret Dakin, in North Somerset.Shani Dakin lives with her grandparents, John and Margaret Dakin, in North Somerset.
She went to the GP last month with her grandmother with a relatively minor complaint, the details of which she does not want to reveal.She went to the GP last month with her grandmother with a relatively minor complaint, the details of which she does not want to reveal.
Her GP said she should see a specialist at hospital, but what happened next surprised the whole family. If it's going to involve my health then I'm not sure I'm ready to make those kinds of decisions Shani DakinHer GP said she should see a specialist at hospital, but what happened next surprised the whole family. If it's going to involve my health then I'm not sure I'm ready to make those kinds of decisions Shani Dakin
Shani got a letter in the post asking her to book her own hospital appointment.Shani got a letter in the post asking her to book her own hospital appointment.
At just 12 she was surprised and a little perplexed.At just 12 she was surprised and a little perplexed.
"I don't think I have the right kind of responsibility to be able to deal with it because I'm quite young," she said."I don't think I have the right kind of responsibility to be able to deal with it because I'm quite young," she said.
"If it's going to involve my health then I'm not sure I'm ready to make those kinds of decisions. I don't know what I'm getting into.""If it's going to involve my health then I'm not sure I'm ready to make those kinds of decisions. I don't know what I'm getting into."
"I found the letter confusing.""I found the letter confusing."
Her grandfather said: "Quite frankly I think it's ridiculous.Her grandfather said: "Quite frankly I think it's ridiculous.
"I can't conceive that a 12-year-old is capable of sorting out the whys and wherefores of that appointment system.""I can't conceive that a 12-year-old is capable of sorting out the whys and wherefores of that appointment system."
'Patient confidentiality''Patient confidentiality'
Choose and Book is one of the key reforms of the NHS in England.Choose and Book is one of the key reforms of the NHS in England.
The idea is simple. Instead of a GP deciding which hospital you go to, it is up to you.The idea is simple. Instead of a GP deciding which hospital you go to, it is up to you.
You can research different hospitals on line and book the appointment. It is your choice.You can research different hospitals on line and book the appointment. It is your choice.
So why did Shani's surgery write the letter?So why did Shani's surgery write the letter?
Were they right to expect a 12-year-old to choose her hospital and book an appointment?Were they right to expect a 12-year-old to choose her hospital and book an appointment?
Jose Tarnowski, the practice manager at the Wrington Vale medical practice, just outside Bristol, said it was all about protecting the confidentiality of their patients.Jose Tarnowski, the practice manager at the Wrington Vale medical practice, just outside Bristol, said it was all about protecting the confidentiality of their patients.
"We've taken the view in this practice that anybody aged 12 and above may well have issues that they want to discuss with members of the clinical team that they do not wish to share with their family parents or guardians," she said."We've taken the view in this practice that anybody aged 12 and above may well have issues that they want to discuss with members of the clinical team that they do not wish to share with their family parents or guardians," she said.
"I can see that a parent or guardian might say it's silly to send a letter to a 12-year-old, but if we have a policy which says we want to, at all costs, avoid breaking the confidentiality that a 12-year-old may well have entrusted to us, we have to have a blanket policy.""I can see that a parent or guardian might say it's silly to send a letter to a 12-year-old, but if we have a policy which says we want to, at all costs, avoid breaking the confidentiality that a 12-year-old may well have entrusted to us, we have to have a blanket policy."
Patients' maturityPatients' maturity
The General Medical Council's guidance says doctors need to judge the maturity of their patients before deciding to exclude parents or guardians. This is standard practice and would apply whether or not Choose and Book was being used to make a referral Department of HealthThe General Medical Council's guidance says doctors need to judge the maturity of their patients before deciding to exclude parents or guardians. This is standard practice and would apply whether or not Choose and Book was being used to make a referral Department of Health
A Department of Health spokesman said: "It is the responsibility of the referring clinician to assess the child's maturity to understand all the issues involved and their ability to make a decision on their own behalf.A Department of Health spokesman said: "It is the responsibility of the referring clinician to assess the child's maturity to understand all the issues involved and their ability to make a decision on their own behalf.
"This is standard practice and would apply whether or not Choose and Book was being used to make a referral.""This is standard practice and would apply whether or not Choose and Book was being used to make a referral."
But the Dakins have had a rather difficult time.But the Dakins have had a rather difficult time.
They tried to book Shani's appointment on the phone but were told there were none available.They tried to book Shani's appointment on the phone but were told there were none available.
Shani's grandmother says the old system was better.Shani's grandmother says the old system was better.
"I do not want choice. I would like the GP to choose for me what he or she thinks is relevant for my condition," she said."I do not want choice. I would like the GP to choose for me what he or she thinks is relevant for my condition," she said.
Shani still does not have an appointment and her family are now considering going private.Shani still does not have an appointment and her family are now considering going private.