People-centred health care: What empowering policies are needed
By Olivia Wigzell, Director General, National Board of Health and Welfare, Sweden
The word “patient” comes from Latin, and means “the one that suffers.” Health care has historically been about “taking care” and “protecting” the patient that suffers. Under this view the patient is more or less helpless. The healthcare professional on the other hand plays the dominant role, as an authority, to be heeded and obeyed. This attitude is all too prevalent today, in that the passive patient is not seen as having useful knowledge or capacity, and so must wait patiently for the doctors’ orders. With people-centred care comes a new, fresher attitude and perspective, which highlight the patients’ capabilities, knowledge and own value-setting.
This shift understands that the patient is a person with a unique life and wishes. It helps both carer and cared for alike. Seeing the patient as an active person encourages professionals working in the health care sector to create a partnership. Professionals will become more like consultants, and pedagogical skills will be needed. Professionals will seek a relationship with patients, which is based on respect as equals, with an equal access to and possession of knowledge of different kinds.
A patient, or rather a person, cannot be reduced to a disease. People-centred health care means that health and capabilities are in focus. How you manage your own life, how you maintain your health, how you function though having pain and, of course, how you might be treated, get better and improve your health. Only this way can the term “health care” really mean what it says. Health is in focus, but so are patients, who no longer just consume care but help to produce better health and wellness, too.
So what can policy makers do to help? Patient-centred care means changing relationships, which is not easy to do. After all, patients have traditionally tended to look to doctors to cure them, and in return, doctors and other healthcare professionals see patients as clients. To transform this, it is important to provide tools that make it easy and inviting to become an active, or indeed, proactive patient. Such tools include information, creating more opportunities to co-decide, and a respectful way of listening and learning from the patient, as well as clearly acknowledging that patients have active roles and responsibilities within health care. The 2015 Swedish Patient Act states the health care sector has a responsibility to invite the patient into such a partnership. The Act empowers the patient.
Another action is the use of patient-reported measures as a support for improving the outcomes of the health care sector. Patient-reported measures, such as being able to function in your daily life, level of independence, being able to cope with your pain often focus minds on other issues than medical outcomes. It gives us a broader perspective on health and well-being.
The digital world, which is largely driven by the public, and that also means by the patients, can open new ways for patients to research, promote, and improve access to new innovative ways of delivering health care support and services. One example is cognitive behavioural therapy that has been launched over the internet in Sweden. Another example is our youth-clinic online that has been successful in reaching out to boys in particular.
Finally, the Swedish rheuma-registry offers further evidence that for successful approaches to health care, an active patient, patient-reported measures and an equal partnership work.
Visit the National Board of Health and Welfare website at www.socialstyrelsen.se
Internet Psychiatry website at http://web.internetpsykiatri.se/en/
The Swedish rheuma-registry at http://srq.nu/en/
Youth clinic online at http://www.umo.se/
©OECD Observer No 309 Q1 January 2017