Thursday, 23 June 2011
Do We Save It Or Cure It?
The Neo-Liberals on the other hand, want to reduce it to the Purchasing Department of NHS plc, because (surprisingly) the paradigm they've constructed to prevent illness, in advance of it occurring hasn't actually worked. In truth, most of the political input to Healthcare is a 'busted flush' such as mammography, which has done nothing to reduce breast cancer incidence, and has often done more harm than good, as eminent breast Surgeon Michael Baum opined back in 2008. The position has deteriorated in the intervening years with more being spent to produce worse outcomes. And QOF (The Quality and Outcomes Framework) has assumed the mantle of a policy to keep UK 'Pharma' afloat, and reward GP's for achieving dubious surrogacy of health, than making any significant inroads into heart disease or indeed any disease of civilisation, such as Cancer, Diabetes or Stroke. In April the Kings Fund condemned it (QOF) for not having "improved health outcomes or reduced health inequalities". (please forgive me quoting from them).
Even more sadly, the health care unions have not raised the game, but generally portrayed themselves as a bunch of greedy militants, undeserving of their pensions, thus playing right into the sights of the Daily Mail assassins. When in truth the average 'coalface' worker in the NHS is poorly paid, often badly treated and gets a quite low provision in pension compared of course with the management. The 'elite' seem to be little affected by the proposed changes, and seem to move seamlessly into new roles to help forge the brighter future that we are told will be the reward for NHS reform (yeah, and the cheques in the post etc, etc).
As I have previously said the debate has sunk to a level of a 'war' between opposing armies, with Steve Field's lacklustre crew attempting to treat for an armistice, but only achieving surrender, with a few crumbs for the Dem's in the Coalition of Toff's. Little to nothing has been done to assuage the inroads made by PFI into an already 'stretched' budget. Nothing said about savings that could be made by shifting the paradigm to actually care for the sick, injured or dying, rather than medicating the population with the flawed output from 'Pharma'.
Structured targeting with science based interventions into disease, needs to be based upon evidence, not dogma and flawed or even falsified trials that pervade medical journals. Always, we are presented with a polemic by both politicians and most in health care. They will have no truck with opposition to flawed and often dangerous policies or protocols. We are patronised and vilified, lectured and harangued, always to reduce this or increase that and the net result to date has been somewhat less (health) for somewhat more (money). Just take this pill and you'll live forever (but your life will be miserable). As the funders of ... well everything, we deserve better.