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Rapid Responses: Rapid Responses published:
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Inconsistent policies
- Prasenjit raychaudhuri (12 March 2006)
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Comparable statistics required
- stephen black (17 March 2006)
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Re: Comparable statistics required
- W Angus Wallace (19 March 2006)
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Prasenjit raychaudhuri, clinical fellow ,surgery Kings Mill Hospital,mansfield,ng19 6qx
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The NHS,like Rome,was not built in a day.A lot of effort, talent and intelligence has brought it to a high level of perfection,inspite of perceived drawbacks which are perhaps not unexpected in such a huge organisation.Waiting lists and bad press notwithstanding, the NHS has shown excellent results in services, research and training and in the process produced stalwarts who have gained worldwide recognition and brought new ideas to the world of medicine. At present however,too many changes at too many levels are happening at a hectic pace. In the process services have been closed,wards shut down, lists shifted to ISTC's, undermining training and creating demoralisation and disillusionment in the workforce.Many of these changes have an uncertain future, as has been repeatedly pointed out by doctors at various levels,many of whom are of outstanding stature and reputation.Is anybody listening? The independent sector poses a major challenge to the future of the NHS.Prof.Wallace has shown an added dimension of poor quality of services prevalent at these centres which is a real cause for worry.This kind of "quickfix" service which bypasses the basic concepts of delivery of medical care bodes ill for the future.It is a strange inconsistency in policy that on one hand reforms in the NHS are directed at making it a "first class "service while centres outside are allowed to undermine it,providing services of questionable quality at the same prices. We stand at the crossroads where a paradigm shift in delivery of healthcare is in progress putting substantial parts of the NHS under threat of closure.One fervently hopes that the baby will not be thrown out with the bathwater. Competing interests: None declared |
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stephen black, management consultant london sw1w 9sr
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Am I the only person reading this who is concerned by the lack of statistics to back up the claims made? Surely, given that the treatment in the NHS is not perfect nor uniform in different hospitals, we would want to see error rates in NHS units compared to error rates in independent units (perhaps with some adjustment to ensure comparable casemix). This is an important debate and should not be primarily decided by anecdotes from a not exactly disinterested source. Does anyone know the comparable statistics? Competing interests: None declared |
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W Angus Wallace, Professor of Orthopaedic & Accident Surgery University of Nottingham, NG7 2UH
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Stephen Black is quite right. It is important to have comparable statistics. The British Orthopaedic Association approached Aiden Halligan the Deputy Chief Medical Officer at the Department of Health about 15 months ago and asked for an independent comparative audit of outcomes from joint replacement operations to be carried out. This was so the Treatment Centres and NHS Hospital outcomes could be compared in order to monitor the quality of treatment in both. This was initially agreed, the audit was planned but was subsequently suspended. We do not know why. We believe an independent audit is still required but this will have to be carried out carefully because, in general, the easy cases are going to the Treatment Centres and the difficult cases to the NHS Hospitals, so patients will have to be stratified according to their complexity before comparisons are made. Prof W Angus Wallace University of Nottingham Competing interests: I am an NHS Consultant. |
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