What makes our health services great?

I began as an intern at Patient Opinion three weeks ago and have learnt a lot working alongside Kate Ebbutt, learning how the organisation works and how our old friends, Facebook, Twitter and Blogging can help to redesign the way patients interact and gain feedback from their health services. Since starting, I have found myself straying from the entertainment section, to now searching the society and health section of the Guardian website, hoping to find out more about how a health service I always took for granted actually works.

Patient Opinion has told me that patient interaction and feedback is essential to improve services. But I’m interested in why this works. Right now, the NHS is owned by all of us – we feel pride in it (as the #welovethenhs campaign last year showed) and we want it to be great. I can’t imagine wanting to share my story, hoping to make shopping at Tesco better – but somehow it works for the NHS. We feel ownership, and that ownership makes us want to help the NHS. If the health service becomes more commercial – would we still feel that way?

The NHS Reforms have quickly become a real interest for me.The Health and Social Care Bill has fast become one of the most contentious pieces of legislation in British history. Their main proposals seem sensible; to create an independent central NHS Board which keeps an eye on spending across the country, to promote patient choice, and to reduce NHS administration costs. According to proposals, funding and commissioning local health services for patients will no longer be handled by Primary Care Trusts; instead they will be overseen by groups of GPs. However, as this is a new skill for them, GPs will need help – and this help often comes in the form of private consultancy and management companies. The concern is that this will encourage more privatisation and commercial competition.

Criticism of these changes stems from the fear that new reforms would enhance private investment, at the cost of patient welfare. Competition has become the most controversial NHS proposal by the coalition. It is fantastic for business, where it drives quality, but can the NHS be regarded as a business in which competition will flourish? As Doctor Sohom Das remarks, ‘One only has to look at the outcome of the privatization of rail services - dire quality and ever inflating fares’.

I personally feel that it is us, you and me, who make our health services great. Our engagement with the services, sharing our experiences and working collectively to make a difference is key. The question is: would we still feel like this about an NHS that expects us to act as customers, not citizens?