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Rapid Responses: Rapid Responses published:
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Secondary care is not evil
- John H Coakley (3 March 2006)
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Re: Secondary care is not evil
- Roberta Smith (4 March 2006)
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John H Coakley, Medical Director Homerton University Hospital NHS Foundation Trust, N6 4AA
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Well said. I too am getting fed up with the suggestion that the acute sector is responsible for sucking all these patients in to make money. I have pointed out at a couple of meetings in the last few weeks that the major drivers in getting patients out have been hospital consultants and their management colleagues (day stay expansion in medicine and surgery, one stop clinics, reductions in length of stay etc). I am also fed up with the recurrent suggestion that primary care is better and cheaper – when in fact all that is really being observed (put simplistically) is that a course of oral amoxicillin is cheaper than a cholecystectomy. Care in the community is cheaper if cheaper care is delivered in the community. Equivalent services to the same standard are in fact cheaper in hospital because of economies of scale amongst other things. Yesterday's Health Service Journal has a good piece on this, pointing out (as I have done to our Trust Board) that the financial analysis seems to have been missed out from the White Paper. Competing interests: Medical Director of an acute trust |
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Roberta Smith, Writer/Secondary care patient Home
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Well said. Primary care is great, if all you need is penicillin and flu advice. I spent three years trying to get a referral back into secondary care. I received about 14 prescriptions of penicillin. When I did get back into secondary care, I was asked for the first time if I was allergic to anything. Yes, I said - Penicillin. Competing interests: Laughter is a good medicine if all else fails. |
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