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LETTERS: Matthew Walmsley Mapping choice in the NHS: Analysis is only as good as data BMJ 2005; 330: 906-c-907-c [Full text]

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Need, Demand and Priorities

Kurt Schwarz   (25 April 2005)

Need, Demand and Priorities 25 April 2005
Kurt Schwarz, Retired Prof of Preventive and Commercial Medicine 49, Grange Crescent, Chigwell, Essex, IG7 5JD Send response to journal: Re: Need, Demand and Priorities	The Health Care Commission and Atkinson Review emphasise the problems of smoking, alcohol, drugs and sexually transmitted diseases. What is surprising is that no attempt is made to concentrate on the NEED (*), DEMAND (*) and real PRIORITIES in medical care. Services would be more effective and efficient if instead of generalisations, attempts were made to really plan medical services based on Need, Demand and Priorities. *The personal and community requirements necessary to achieve a state of optimal health - Need comprises:- Care of the healthy, at risk groups, presymptomatic disease, minor disease, major disease, rehabilitation and mortality. The best examples are Heart disease, Cancers, Diabetes, Mental disoorders. Demand comes in two forms. 1. vocal demands from the community. 2. the necessity for the care of patients such as those in a coma or those involved in accidents - figures reflecting demand are standard morbidity and mortality statistics. Competing interests: None declared