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EDITORIALS: Rudolf Klein The future role of the Department of Health BMJ 2007; 335: 2-3 [Full text]

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Local healthcare

Neville W Goodman   (6 July 2007)

Some Good Things

Christopher E Nancollas   (8 July 2007)

Local healthcare 6 July 2007
Neville W Goodman, Consultant Anaesthetist Southmead Hospital, Bristol, BS10 5NB Send response to journal: Re: Local healthcare	Rudolf Klein asks, "Will the new secretary of state accept the logic of "locally driven healthcare systems" and accept diversity in the pursuit of national policies?" He will be able to do this only if he can persuade the media that postcode prescribing, far from being an evil that provides the laziest of headline medical stories, is a necessity. Competing interests: None declared
Some Good Things 8 July 2007
Christopher E Nancollas, GP Newnham Surgery GL14 1BE Send response to journal: Re: Some Good Things	Dear Ms Godlee, Whilst I agree with Prof Klein that the DoH needs attention, I believe that we should give the department credit for some solid achievements. We may bemoan the target culture and obsession with waiting times, but the fact is that access to secondary care has improved dramatically over the past ten years. I can remember when GP's had to personally arrange every urgent consultation, with all the hassle that entails, so I believe the current situation is an infinite improvement. Similarly, he describes the new medical contracts as a 'fiasco', but are they? The new GP contract ensures that a patient can walk into any surgery in the land and be assured of relatively standardised treatment for the major medical conditions. It is probably the most advanced system of chronic disease management in the world, and we should be proud of it, not constantly moaning about the cost. As for the observation that the government are paying more money for less work, that is not strictly true. What they are paying for is work that had been previously done for free or for nominal cost, like out of hours. In the process they have given doctors the option of having a proper work-life balance. I call that civilised, not a fiasco. Yours sincerely, Chris Nancollas Competing interests: None declared