NHS reform: a surgeon speaks

The Knife has no strong view, yet, on the NHS reforms planned for England and Wales. As far as I’m concerned the arbitrary nature of waiting list targets (and the ludicrous idea that they could be enforceable by law)  without asking for advice on what is manageable, is the single biggest problem with elective surgery in the NHS. it began under Labour, and Dave (and the SNP) have kept it going. Plenty of clinicians have offered their views to the relevant politicians and civil servants, in the spirit of facilitating, NOT opposing the targets.

The response? Either no reply, or the supremely arrogant we know best. This from politicians who view the ease of organising ten minute daycase operations as being the same as 4 hour complex procedures.  Pathetic, but dangerous.

However, it was amusing to see who didn’t get invited to Downing St. The Knife has often commented on “provocation tests”. Whatever Bono/Chris Huhne/Ed Balls says should be done, just do the opposite, and hey presto!

Well, excluded from the fun were (courtesy of the Mail) :

The Royal College of GPs – has called for the Bill to be scrapped.
The Royal College of Radiologists – has called for the Bill to be scrapped.
The Faculty of Public Health – has called for the Bill to be scrapped
The Faculty of Occupational Medicine.
The Royal College of Psychiatrists – has said it “cannot support the Bill as it currently stands” and called the reforms “fundamentally flawed”.
The College of Emergency Medicine.
The Royal College of Pathologists – has not come out in direct opposition to the Bill, but has concerns over the legislation.
The Royal College of Ophthalmologists.
The Chartered Society of Physiotherapy.
The Royal College of Midwives (RCM) – called for the Bill to be scrapped.
The Royal College of Nursing (RCN) – called for the Bill to be scrapped.
The British Medical Association (BMA) – – called for the Bill to be scrapped.
Unite – called for the Bill to be scrapped.
Unison – called for the Bill to be scrapped.

Far be it from me to give the government an opportunity to divide and conquer, but that is a list that I’m glad not to be part of.

In the hospital, the main frustrations from identifiable groups emanate from GP’s, Public Health (what do they actually do all day, in the absence of a Cholera outbreak?), nurses, psychiatrists (if you can find one), radiologists (famously unhelpful at least 50% of the time), anything to do with unions, and A&E.

That leaves pathologists, ophthalmologists (I’m amazed they have a dog in the fight), and possibly occupational health, who are a completely unknown entity to most of us. In other words, Dave has excluded many of the people who, shall we say, are classically obstructive  and less than essential to real, hardcore, acute care. I know A&E do acute care, but you get the drift. Of course Ben Goldacre has a slightly more Guardianista take on it.

All of which makes me think that the reforms might, just might, have something going for them.

Cholera!! Call public health, stat!!!
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