Health Reforms
The centrepiece of the government’s White Paper on Health is that GPs (I prefer the title Personal Doctor) will be in control together with the patient, of their diagnosis and treatment path, for the first time since the NHS was formed. This is the critical point. It is not about funding or who controls funds. Huge delays now occur to both diagnosis and treatment (especially for less well known or test sensitive conditions) because patients are shuffled from hither to thither without anybody being responsible for the overall progress or outcome.
In conditions such as cancer, diabetes or heart disease, which are common and for which there are well rehearsed and resourced procedures, the inefficiency of the current system is masked, as is also the case in an accident or health emergency. Outside these and similar boxes there is a muddle; sometimes sufferers make do for years without a correct diagnosis or, therefore, effective treatment. Putting GPs in charge, as opposed to keeping them informed, will not only change process and outcomes, but will, if done properly, be much more patient focused. It will be better for the doctor and better for the patient.
The idea that timely and efficient healthcare could be organised by ‘commisioning trusts’ responsible for determining the scope of care, in which patients and doctors were no more than customers or providers, has always seemed to me to be based on a misunderstanding of the nature of medicine itself.
The path ahead will not be smooth or without mishaps, but it does go in the right direction.