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A very political review indeed! Will it prompt appropriate responses from the new government? Starmer's 'no new funding without reform' stance looks suspicious but perhaps he could be persuaded of the merits of really significant reforms - though probably not the reforms he had in mind.
There are two ends to the austerity question - reduced funding and squandering of available resources. £37bn has been suggested as a starting point for reviving the NHS but unless the Chancellor raises tax revenue with enthusiasm in the forthcoming budget... Louis XIV’S finance minister, Jean-Baptiste Colbert, famously declared that “the art of taxation consists in so plucking the goose as to obtain the largest possible amount of feathers with the smallest possible amount of hissing.”, there is already considerable anticipatory hissing from the usual media suspects. I offer the suggestion that those factors which place the greatest burden on the NHS (tobacco, alcohol, sugar, salt, etc.) should, at the very least, be made cost neutral by taxing sufficiently to balance the ledger - presenting the tax rises thus would make sense to many.
Setting behind us the epoch defining waste, incompetence, negligence, corruption and cronyism that characterised the Tory pandemic calamity we should focus on the creeping privatisation of the NHS which is incontestably inimical to the rational and economic provision of care. Tax payer's money, voted by parliament for the tax payer's heath care, ought not to be haemorrhaging out of the system as private profit, shareholder gains and transaction costs. Moreover, there being a more or less fixed number of doctors and nurses in the UK, their being enticed away from the NHS and into the private sector is a real cause of concern. At the very least the private sector should be very tightly regulated to set health care on a level playing field.
The UK's poor record on cancer care has many causes. I offer the view that initial delay in diagnosis and immediate referral into the specialist stream is a major factor - as seen from a primary care perspective. It is time to make a trial of 'Red Flag Clinics' (RFC) in the most needy areas. Essentially, a GP detecting any 'red flag' symptoms or signs in a patient would dispatch the patient on the same day to the local RFC where all germane tests and examinations would be carried out and those investigations needing preparation being scheduled for the following 24-48 hours. Within 72 hours at most there should be sufficient data to triage the patient to immediate - same day - specialist clinic referral/admission or further investigation or return to primary care. This cuts out all the delay and duplication of tests, shortcuts referral delays, expedites definitive treatment and removes urgent cases from routine hospital clinics. I envisage RFCs being manned by nurse practitioners (or whatever they are called this week) and medical training grades - the exposure in training to the widest unfiltered spectrum of actual or potential pathology would be hugely educational.
Re: The Darzi review distributes blame effectively
Dear Editor
A very political review indeed! Will it prompt appropriate responses from the new government? Starmer's 'no new funding without reform' stance looks suspicious but perhaps he could be persuaded of the merits of really significant reforms - though probably not the reforms he had in mind.
There are two ends to the austerity question - reduced funding and squandering of available resources. £37bn has been suggested as a starting point for reviving the NHS but unless the Chancellor raises tax revenue with enthusiasm in the forthcoming budget... Louis XIV’S finance minister, Jean-Baptiste Colbert, famously declared that “the art of taxation consists in so plucking the goose as to obtain the largest possible amount of feathers with the smallest possible amount of hissing.”, there is already considerable anticipatory hissing from the usual media suspects. I offer the suggestion that those factors which place the greatest burden on the NHS (tobacco, alcohol, sugar, salt, etc.) should, at the very least, be made cost neutral by taxing sufficiently to balance the ledger - presenting the tax rises thus would make sense to many.
Setting behind us the epoch defining waste, incompetence, negligence, corruption and cronyism that characterised the Tory pandemic calamity we should focus on the creeping privatisation of the NHS which is incontestably inimical to the rational and economic provision of care. Tax payer's money, voted by parliament for the tax payer's heath care, ought not to be haemorrhaging out of the system as private profit, shareholder gains and transaction costs. Moreover, there being a more or less fixed number of doctors and nurses in the UK, their being enticed away from the NHS and into the private sector is a real cause of concern. At the very least the private sector should be very tightly regulated to set health care on a level playing field.
The UK's poor record on cancer care has many causes. I offer the view that initial delay in diagnosis and immediate referral into the specialist stream is a major factor - as seen from a primary care perspective. It is time to make a trial of 'Red Flag Clinics' (RFC) in the most needy areas. Essentially, a GP detecting any 'red flag' symptoms or signs in a patient would dispatch the patient on the same day to the local RFC where all germane tests and examinations would be carried out and those investigations needing preparation being scheduled for the following 24-48 hours. Within 72 hours at most there should be sufficient data to triage the patient to immediate - same day - specialist clinic referral/admission or further investigation or return to primary care. This cuts out all the delay and duplication of tests, shortcuts referral delays, expedites definitive treatment and removes urgent cases from routine hospital clinics. I envisage RFCs being manned by nurse practitioners (or whatever they are called this week) and medical training grades - the exposure in training to the widest unfiltered spectrum of actual or potential pathology would be hugely educational.
We need reform - but it must be the right kind.
Yours sincerely
Steve Ford
Competing interests: No competing interests