Patient choice – whose choice is it?
One of the big tensions in the NHS arises from the need to provide high-quality care that is free at the point of delivery and easily accessible, but that also makes patient choice a priority. At the same time, it is critical for the public purse to keep costs affordable. Everyone wants to deliver sophisticated healthcare with no waiting lists and instant access to high-tech investigations as well as the latest treatments. Patients, doctors and of course politicians all set this goal, but is it affordable and possible?
Healthcare can be seen as a black hole into which huge sums of money disappear in a flash, as politicians are keen to be seen building new hospitals and clinics and providing the latest innovations. Equally important is training and retaining enough staff to meet the ever increasing demand. If on top of this, the whole service centred on patient choice everyone would be happy - but as we all know, this is not a perfect world.
The subject of putting patient choice at the heart of healthcare was highlighted again in the political arena last week, as reported in the univadis GP News service (click here). The Health Secretary, Andrew Lansley, stated that he "plans to place a duty on clinicians involved in commissioning to 'protect and promote patient choice as far as possible'". This was in the context of a clampdown to stop "NHS managers from setting minimum waiting times for referrals and caps on operations".
Of course, politicians need to be seen to be strong and advocating patient rights and that is quite correct. But actions like this often need to be followed up with hard cash and in the context of the current economic climate, this is going to be a tricky problem to solve. We do need to put patients at the centre of healthcare activity and their choice is paramount. But there is also a duty to be sensible with the limited amount of money we have available to spend on healthcare and these ideals are sometimes conflicting.
The easy part is to state the goals and make bold statements, the hard part is make the NHS run in such a way that everyone gets a fair and deserved share of limited healthcare resources. That requires all the stakeholders to work together and appreciate eachothers' problems, something that is far from easy. It will take more than just fine words to produce the correct and desired outcome.
Dr Harry Brown, editor-in-chief univadis
By Dr Harry Brown