From Patient Voice to Institutional Accountability: A Rights-Based Framework for Dignity-Centred Governance in Public Healthcare

Public healthcare institutions routinely invite patients to report their experiences, raise concerns and participate in decisions. Yet the presence of feedback channels does not establish that an institution has listened, recognised the rights at stake or accepted responsibility for an adequate response. Recent research has examined patient and public involvement, the organisational conditions that support patient voice, complaint-based learning and the use of patient-experience data. These developments make the question of institutional accountability more—not less—pressing. This article develops a rights-based conceptual framework for understanding how patient voice can become an institutional claim to explanation, review and appropriate remedy. Drawing on a critical integrative synthesis of scholarship in health services research, public administration and human rights, it proposes the Patient Voice-to-Accountability Framework (PVAF). The framework distinguishes five connected institutional functions: accessible voice, rights-based interpretation, reasoned response, review and remedy, and governance-level learning and answerability. Inclusion, procedural fairness and protection against retaliation operate across the framework. The article’s contribution is not the invention of patient participation or complaint-learning concepts; it is the specification of the normative and administrative links that should connect a patient’s account to an institution’s duty to explain, correct and learn. The PVAF is a conceptual proposition, not an empirically validated model. Its value and limits require testing across different legal systems, healthcare settings and patient groups.