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What could make health care better?

According to a new review of Britain's health care system, the answer is a pen and paper.

The report, by Labour MP Ann Clwyd and National Health Service manager and former nurse Tricia Hart, is highly critical of how hospitals handled complaints from patients, saying they have a culture of "delay, deny and defend." The report made dozens of recommendations – such as empowering patients to speak up about care, making sure they know who to tell, and creating a "duty of candour" obligation for doctor and nurses to tell patients when a mistake has been made.

But it's the "simple step" of giving patients a pen and paper to write down concerns that's getting traction in headlines, along with a certain amount of ridicule from readers. Such as this on the Telegraph site from Simon Coulter: "Sorry your mother didn't leave a note of complaint about dying of dehydration in an NHS hospital – we left pen and paper right by the glass of water out of her reach."

On the other hand, an argument could be made that a pen and paper is a not-so-subtle reminder to everyone in the patient's room that they have a right to file a complaint (including nurses and doctors who see mistreatment) – but really wouldn't an e-mail address that sends messages directly to someone of authority also be a useful method?

The report was commissioned by the British Department of Health to look into whether patients felt free to highlight problems in their care, and when they did, if it had any effect. It details incidents in which nurses dismissed requests from patients, the Telegraph reports, including one nurse who said she "doesn't do sick," and a visitor who couldn't get a nurse's attention because the staff on the floor were bidding on an eBay item.

Canada has had its own cases, of course: Most recently, a dying 77-year-old man, a war veteran with late-stage lung cancer, was ordered to speak French at a Gatineau hospital by an orderly who refused to speak English. In that case, his family filed a complaint, and the orderly was disciplined.

The British report is meant to address similar cases, calling for a revolution in how complaints were handled after receiving more than 2,500 letters and e-mails from people describing incidents of mistreatment or neglect.

"If you ignore somebody asking for an extra blanket, an extra pillow, wanting a drink of water, or wanting to go to the toilet, then you should not be caring for patients … and there are too many cases where these kind of things are happening," Clwyd was quoted in the Telegraph.

If the recommendations are followed, at least patients will have the chance to record incidents on paper. Whether they will feel confident enough to actually do so, and pass it on, is another question.

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