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In his review Professor Collier perpetrates the old mistake that
prescribed medicines are the most expensive commodity in healthcare. This
is a false view and should be challanged.
Over time drug costs have been about 10-15% of the total NHS budget
and this fraction is surprisingly stable.
The most expensive commodity in the NHS is staff time, and the demand
for this is rising. The popular mood is away from drugs and towards more
time spent in consultation with patients. The rising demands are seen in
clinics and GP surgeries and in the large overflow of people into the
realms of complementary practitioners.
Sadly for patients,and practitioners, it is relatively cheap to
provide drugs and relatively expensive to provide time with trained staff.
So, for example, patients with depression are more likely to be offered
anti-depressants than counselling. Also more evidence is gathered about
the use of drugs than about the use of counselling.
The ready availibility and affordability of mostly effective drugs
has diverted medical attention away from other aspects of health delivery.
It is time to focus our attention not just on the correct use of drugs but
also to enlarge our view of therapeutics to include the therapeutic
potential of the human interaction involved in each consultation. The
doctor is the most expensive drug of all in healthcare. We do not yet
acknowledge our own power.
Most expensive commodity in healthcare?
Sir,
In his review Professor Collier perpetrates the old mistake that
prescribed medicines are the most expensive commodity in healthcare. This
is a false view and should be challanged.
Over time drug costs have been about 10-15% of the total NHS budget
and this fraction is surprisingly stable.
The most expensive commodity in the NHS is staff time, and the demand
for this is rising. The popular mood is away from drugs and towards more
time spent in consultation with patients. The rising demands are seen in
clinics and GP surgeries and in the large overflow of people into the
realms of complementary practitioners.
Sadly for patients,and practitioners, it is relatively cheap to
provide drugs and relatively expensive to provide time with trained staff.
So, for example, patients with depression are more likely to be offered
anti-depressants than counselling. Also more evidence is gathered about
the use of drugs than about the use of counselling.
The ready availibility and affordability of mostly effective drugs
has diverted medical attention away from other aspects of health delivery.
It is time to focus our attention not just on the correct use of drugs but
also to enlarge our view of therapeutics to include the therapeutic
potential of the human interaction involved in each consultation. The
doctor is the most expensive drug of all in healthcare. We do not yet
acknowledge our own power.
Competing interests: No competing interests