THE paternalistic relationship between health professionals and their patients, "deferential lay members of the public", must change, a European hospitals' conference in Limerick was told on Saturday.
Mr Andrew Thompson, a lecturer in the Graduate School of Social Sciences at the University of Edinburgh, said if there had been one clearly identifiable development in the health care services it was the emergence of the patient as "someone with a view point that may merit attention".
Addressing the HOPE conference, which was attended by 300 delegates from all over Europe, Mr Thompson said that one of the most "counfounding" factors was that patients were often seen as "passive actors in a process that operates around them".
"The traditional view is that they are work objects to be processed in a way that at least does them no harm and hopefully leads to their recovery or amelioration of their symptoms," he said.
Various management approaches had been developed which highlighted the importance of the user, yet few hospitals had effectively integrated these, let alone adopted a more fundamental sharing of decision making.
"It is contended that notions of consumers or customers fail to understand the reality of health care and in fact help to disempower people through placing them in positions that are purely economic, rather than with civil, political and social rights," Mr Thompson said.
Generally, patient satisfaction was poorly conceptualised, which led to inadequate methods of measuring it. This, in turn, failed to assist doctors or managers to address the issues involved. "We need a reorientation of the way in which we think about patients," he added.
Prof Raymond Moss, chairman of Architects for Health, told the conference that more research was needed into hospital design. In an address dealing with research and development in hospital design in the UK over the past 50 years, he said that design should be focused to improve the quality of what were, all too frequently, the "underfunded and undervalued containers of healthcare activities".
"There is no doubt that, speaking generally, the architectural quality of hospitals, and particularly large hospitals in the UK, leaves much to be desired. Indeed, the bigger the buildings, the more crass they seem to become," Prof Moss said.