Healthcare delivery
savvy, as a recent appointment made had to be confirmed by a letter despite this authors protestations that it was unnecessary. Those costs are ready to be saved. However, there are many elderly who do not
have access to up-to-date tech and will find access very difficult if all the other avenues are cut off in a bid to save money. This will disenfranchise them and needs to be dealt with sensitively and with great care. The plan announced by Wes Streeting is that the NHS app will be a central focus so that individuals can manage their own medical history by bring together a single patient record, test results and letters into one place. This signals a huge volume of work by a mountain of people accessing and digitising records and will not be complete for many years.
From sickness to prevention The government wants to shorten the amount of time people spend in ill health and prevent illnesses before they happen – an excellent ambition and, in my memory, it has been the focus of many different governments over the years. It is a great deal more difficult to achieve than may at first be seen. Screening for both breast and cervical cancers are often ignored by a significant percentage of the population. Children are not being immunised against many of the childhood diseases. A new emphasis will need to be placed on each citizen to ensure they take more responsibility for their own disease prevention. However, it is not all able to be managed; poor housing, poor diet, lack of exercise and many more determinants of poor health are at work and are very hard to fix, as people resist the ‘nanny state’ telling them what to do.
The promises There are many excellent intentions within the Secretary of State’s first words. For example, the move away from central diktats to more local control. The move towards a great many fewer targets – down to a few clear priorities so that the people who are tasked with delivering care can get on with it, reducing waiting lists and increasing quality. Integrated Care Boards will be, in the brave new world, strategic commissioners and will be responsible for developing neighbour health services. They will be expected to build primary and community services with the aim of keeping patients away from hospitals and being treated at home. Acute care will be focused on restoring the 18-week waiting standard, which will take years of intense work.
Conclusion One glaring gap in all of this is the lack of attention to social care, which has such a cumulative effect on health and health services in the last few years. It must be subject to a strategic plan and enacted very soon. The impact of the pandemic on health services in all areas is profound and must be taken into consideration, as the plans start to become more detailed. The view of this author is that there are many
great things about this health service that are fundamentally excellent and do not deserve to be scrapped. As Lord Darzi stated, the vital signs are good but the NHS is in a critical condition. There are areas which will benefit from more cash and a light being shone on them, such as mental health services. It is not time to throw the baby out with the bath water.
References 1.
Gov.uk. 2024 Ara Darzi Summary letter from Lord Darzi to the Secretary of State for Health and Social Care. Accessed at: https://
www.gov.uk/government/publications/ independent-investigation-of-the-nhs-in- england/summary-letter-from-lord-darzi-to- the-secretary-of-state-for-health-and-social- care
2. UK Government. 2024 Rt Hon Wes Streeting MP Our ambition to reform the NHS. Accessed at:
https://www.gov.uk/government/speeches/ our-ambition-to-reform-the-nhs
CSJ
3.
Gov.uk. Press Release Prime Minister Speech. Major Surgery not sticking plaster solutions need to rebuild the NHS. Accessed at: https://
www.gov.uk/government/news/pm-major- surgery-not-sticking-plaster-solutions- needed-to-rebuild-nhs
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