NHS; From Top To Bottom

Main Category: Public Health
Article Date: 01 Jul 2008 - 1:00 PDT

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Health minister Lord Darzi's NHS Next Stage Review, due for publication today, is bound to increase public expectations of the NHS.

But it is the how rather than the what of Lord Darzi's aspirations that will determine the future success or failure of the health service. And top-down control will no longer work.

The focus of attention will be on hospitals and acute care. Not surprising, perhaps. Hospitals save lives - sometimes in the most dramatic way. Hospitals take the largest slice of NHS money too.

Yet it is the relatively low profile primary and community services that really make a difference to the health and wellbeing of NHS patients.

Whether it is the teminally ill cancer patient, a sick child or an elderly person with complex needs, it is the quality of primary and community health services that will largely determine their care.

And its cost too. Because it is GP practices and primary care trusts that commission hospital care. And because hospitals are not the only places where NHS care is delivered.

NHS Alliance chairman Dr Michael Dixon said:

"The NHS can no longer afford to treat GPs, community nurses, PCT managers and others working in primary care as second class citizens.

"There is a top-down stranglehold that prevents the innovation Lord Darzi says is vital. That must be loosened in favour of genuinely local decision making, with patients and professionals working together to provide the efficient and compassionate health service we all want."

Notes

1. The NHS Alliance is a collaboration of clinicians, managers and board members who put patients first. It is the independent body that represents NHS primary care. Values based, it is the only organisation that brings together PCTs with GP practices, clinicians with managers and Board members, and NHS primary care with its patients. The Alliance membership and its hard working national executive is fully multi-professional.

2. Dr Michael Dixon, NHS Alliance chairman, is a member of the Darzi Review's Primary and Community Care Advisory Board.

http://www.nhsalliance.org