The radical new alternative to waiting lists involves patients themselves acting as a jury to prioritize cases, after hearing 'evidence' from fellow patient s and their GP advocates. He said that GPs should be up-front that they are selecting patients for treatment and then make the process transparent and easily understandable. Dr. Rouse deliberately based his idea on the legal system, both to give a level of comfort and reduce the openings for legal challenge. The jury considers written evidence, including reports from independent specialists.
Patients can veto evidence beforehand.
The outcome is decided by a vote. Rejects automatically get considered by two more panels. After three rejections, the application is dismissed. Although Dr. Rouse initially encountered hostility, tests among informal groups show that both physicians and lay people choose the same cases and come to agreement quickly. The idea grew out of a decade with the U.S. public health service.