Foundation Trusts and Children's Participation: Some new opportunities?

The call for children to be allowed to make decisions for themselves in recognition of their autonomous interests is not new in the healthcare setting. 1 The suggestion that they should be offered opportunities to make other-affecting decisions through involvement in health policy formulation is a relatively recent phenomenon, but one that can be supported by human rights arguments. It is accepted in other contexts that policies that affect children will be improved by involving a wide range of participants in general decision-making and there are many examples elsewhere of children being meaningfully engaged in decision-making, but there are few examples in the healthcare context. Where there is participation, it tends to be at a consultative rather than at a decision-making level in any real sense. Although NHS institutions may be willing to adopt child-participation initiatives, many lack confidence in their ability to do it properly. The establishment of the new NHS Foundation Trusts, requiring the adoption of governing bodies representing broad constituencies of patients, the public and other stakeholders, means that this involvement can be expedited. The learning curve is likely to be steep, but there is considerable excitement that efforts to grant young people a greater role in determining policy will reap considerable rewards for everyone. This paper argues that the current age restriction on Foundation Trust governors unnecessarily undermines children's human rights, is indefensible in law and weakens healthcare policies. There is a theoretical case for involvement and the governance arrangements for Foundation Trusts offer a model for such engagement.