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Let’s not derail the healthcare changes before they’ve begun
Underlying the polyclinic concept are some pretty uncontroversial principles, says Karen Buck
ONE of the striking features of debates about public services is the variance in opinion between those who use them and those who do not.
Sadly some people do have dreadful experiences as patients, pupils or parents, and we must never stop trying to learn from them and improve. However, overall, those who use our schools and hospitals are much more positive than those who do not.
This was confirmed by last week’s national survey of hospital users, published by the Healthcare Commission, the health watchdog.
The commission found that 92 per cent of patients surveyed said that their care and treatment was “good”, “very good” or “excellent”.
With particular areas of improvement including reduced waiting times in accident and emergency – and a strengthening perception of “effective teamwork” between doctors and nurses.
As the share of national spending on health finally creeps up towards the European average, we are in a strong position. Waiting lists and times continue to fall and the effectiveness of new generations of treatment continues of rise. Yet behind the headlines of this generally positive story lie significant variations in experience and in the quality of care.
The next great challenge for healthcare is to raise the standards of the worst to the standards of the best.
This is the context for the review of London’s healthcare, which is being led by Professor Lord Darzi, a man who will be known to many local residents as a top surgeon at St Mary’s.
Lord Darzi’s review of London’s NHS is just reaching the end of its initial period of consultation. Perhaps predictably it – or rather one element, which is the polyclinic concept – has run into some controversy as far-reaching proposals often do.
Yet it would be a great shame if what are wholly sensible and much- needed changes were to be derailed before the debate has really begun. Underlying the concept of the polyclinic, which is really a form of health centre for the 21st century, are some pretty uncontroversial principles.
We want to enhance and develop the primary care services offered by GPs. We want to locate as wide a range of diagnostic and support services as possible closer to where patients are. We want to reduce the need for patients to travel to hospital. And we want to integrate services as much as we can, breaking down the traditional barriers between primary and secondary care and between health and social care.
Importantly though, and despite rumours to the contrary, there is not one single model of polyclinic. What is needed and what will work best in a dense inner-city environment like Westminster could be quite different from what will be needed in the outer suburbs.
Our issues are often different. The problem is less to do with having to travel long distances to hospital for tests, for example, and more to do with having a high proportion of people attending accident and emergency who could be better treated in another way.
GPs will not all be herded in massive new centres, breaking the link between the individual GP and the patient.
Many different ways of improving primary care are proposed, providing common support services to existing practices, for example. Certainly, where care is good and groups of GPs already work together well, which is the case for many practices locally, Westminster Primary Care Trust is not about to move in on them!
So before the petitions start being drummed up, let’s take a minute to debate what our needs are locally; and the strengths and weaknesses of the current means of delivering healthcare.
There is always scope for improvement, but no one, least of all our local primary care trust, is interested in threatening what works well.
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