Sunday, 1 July 2007

Re-inventing the wheel

Sir Ara Darzi has been made Health Minister by Gordon Brown, it's all part of Gordon's new drive to recruit party-neutral experts in this revolutionary new style of Gordon centred, sorry public centred, government. I will believe it when I see it Gordon.

The report produced earlier in the year by Sir Darzi, the noble warrior for patients, throws a lot of doubt on his neutrality; it appears that he is another agent of HMG reconfiguration and reform disguised in friendly clothes. His words hardly fill me with confidence:

"I will be working closely with Alan Johnson to map out the next steps of the reform agenda that has achieved so much in the last 10 years. But we can do better."

His 'groundbreaking' report can be viewed here at the health care for London website. If you are able to endure the full portion of the nauseating propaganda then you will be able to follow the thread of my argument. The report can be viewed in full here.

The report uses DoH white papers for its evidence at times and falls back on the same selective use of public opinion to justify its program of reform. In fact some of the dubious evidence that backs up the expensive shifting of work from hospital to community has already been shown to be seriously flawed. Apparently Sir Darzi is also one of the leading forces behind the surgical nurse practitioner grade, a threat to surgical standards and training if ever there was one.

Darzi's report does not offer anything more ground breaking than the reinvention of the wheel. There are obviously some problems with attracting GPs to work in the poorest and most deprived areas, while the government has helped worsen community care by shutting a rather large number of community hospitals in the first place. Also the kind of community hospital used as an example in Darzi's report seems to resemble an inferior version of a District General Hospital.

London can probably get away with this type of sub-DGH as London is a freak, I say this because London's huge population in a small area is very much not the normal for the UK; this means that when things go belly up it is only a very short blue light trip to the specialist centre down the road. This doesn't mean that having certain types of elective surgery without the intensivist backup on site won't have some rather negative consequences, it will, however the proximity of the specialist centres will minimise the damage; this will not be the case if the same logic is applied elsewhere in the UK, in Sussex for example.

This centralised approach backed by Darzi's report is already being forced upon the rest of the UK, even though the evidence upon which it is based is less than wafer thin. The contempt that this arrogant mindset shows for the excellent specialist care provided by DGHs around the country is a disgrace. The most worrying potential aspect of this reform is that excellent DGHs that can adequately manage the vast majority of obstetric emergencies, paediatric emergencies and medical/surgical emergencies will be replaced by dumbed down units that will have to send these emergencies a significant distance for appropriate treatment. At the end of the day this cost cutting will cost some patients their lives, however I'm sure the noble Sir Darzi will be happy with his achievements, and he might have been promoted above Sir by then.

The UK is not London, and cutting costs costs lives, something Sir Darzi would do well to realise.

1 comment:

dreamingspire said...

And now at DoH there's Dawn as well. Previously she was Gordon's Rotweiler.