Yesterday the Conservative party announced their policies for the NHS. I had been invited to the Royal College of Physicians. What do the doctors have to say?
At dinner I sat amongst consultants, all in their 40s – the new generation of senior doctors. An oncologist (cancer), cardiologist (hearts), gastroenterologist (tums ‘n bums), and a leading businessman who, as a volunteer, has spent the last 6 years on the board of his hospital trust.
“What’s wrong with targets?” I asked.
“They’re not all bad” said the Guardian reader. “Waiting lists are shorter – patients have to be treated within 18 weeks – soon it going to be 11 weeks. That’s much better than it used to be.”
“But they are easy to manipulate” said the heartman “If I see a patient in my clinic 6 weeks after the GP wrote to me I can give them a simple drug and tick, the “treatment” has started. I haven’t cured him but I’ve met my 18 week target. The patient still waits 6 months for the proper treatment that they really need but that doesn’t appear on the target”.
“Those long hours in casualty waiting rooms have gone. Now everyone is seen in 4 hours” said another.
“Yes but…” said the businessman “my hospital used to see everyone in 4 ½ hours anyway. The doctors said there was no medical benefit from cutting the 30 minutes off the end, but the government said we had to. It cost us £16 million to meet that target. We could have spent that money on making real differences elsewhere.”
“So what do you want?” I asked
Here was the list… at least part of it.
Managers and Politicians who listen to the doctors, Fewer central government directives, More local and regional decision making, More front line professionals involved in those decisions, Doctors to be involved in the design of their buildings and resources, Less rigid targets instead more flexible “thresholds” that really make a difference to whether patients get better.
At the weekend I met a group of leading Surgeons. “I had dinner with Andrew Lansley this week” said one “He knows his stuff. He really listened.” It’s a long time since anyone said that about a Health Secretary.
As for what they said about MTAS – that’s another story.