The proposed NHS reforms still pose too many questions for many people. Dominic Howard analyses pressures within the health service that need to be taken seriously
Commission Decision
Take for example GPs, at the frontline of the nation’s health. One of the original proposed reforms, which has now been watered down, is GP commissioning, whereby “key decisions affecting patient care should be made by healthcare professionals in partnership with patients and the wider public, rather than by managerial organisations.”
Many GPs consider the additional form filling and bureaucracy that comes with having to manage the finances of their community as a burden they could do without, as well as one that just adds more to a considerable workload.
This creates pressure, increased by restricted time they can spend with each patient.
Aneez Esmail, professor of general practice at the University of Manchester, has recently questioned the seemingly low level of errors, many of them misdiagnoses, reported by GP practices.
He says although 90% of patient contacts take place at GP practices, fewer than 5,000 incidents or less than 0.5% of the total number were reported by family doctors compared with 700,000 reported by hospitals.
Looking at medical claims, he found 40% of them were related to GP misdiagnosis.
At any position in the medical profession, there is the risk of human error and the possibility that another doctor may see something or know more about the original diagnosis than the first doctor.
In 2010, 14% of the cases we handled resulted in a modification of the original diagnosis and in 31% of cases, a change in the recommended treatment.
GPs indeed, all NHS staff are part of the political football being kicked around by successive governments. Consider the following:
GP commissioning was originally proposed by the coalition government to replace NHS Primary Care Trusts.
They were created in 2002 under Labour to commission health services for their local populations.
These replaced (GP) fundholding introduced in 1991 by the Conservatives. And so on and so forth.
No wonder both patients and medical professionals are so exasperated.
The impact of these initiatives does not present itself readily. The NHS is an organisation that moves at the speed of a tectonic plate.
The Rarer Cancers Foundation reported earlier in the year that a quarter of cancer cases are being missed by doctors until the disease is too far advanced.
A recent study conducted by the London School of Hygiene and Tropical Medicine suggests that five-year survival rates for British women with breast cancer are among the lowest in Europe.
A step in the right direction is the Department of Health’s Cancer Strategy, which includes investing more than £450m to increase earlier diagnosis and funding to increase GP access to diagnostic tests, plus more testing and treatment in secondary care.
It is believed that through this initiative, an extra 5,000 lives will be saved every year by 2014-15.
