Dr Phil Hammond, broadcaster and GP returner in Bristol

Christmas is a time for consumerism; giving people what they want, or at least pretending (in a very British way) that what you receive is exactly what you wanted.

New Labour has been trying to infuse this consumer mentality into the NHS for eight years. We were given a ‘patient-centred’ health service last Christmas, but now it has been swapped for a new improved ‘patient-led’ NHS, just as old Xboxes and PlayStations are junked as soon as a newer version comes along.

Alas, the patient-led NHS appears to be suffering the same jamming and overheating problems as the latest games consoles.

The flu jab frenzy was a classic example.We were always in danger of running out of Xboxes, sorry - flu jabs, when we extended the remit to carers and those in the caring professions, as well as the usual suspects.

But when the Department of Health started warning about bird flu, coupled with the suggestion that avian and seasonal flu could mix with catastrophic results, everyone wanted a jab. And why not? Politicians and civil servants are offered flu jabs, so the government can hardly complain if everybody else asks for one.

Health Secretary Patricia Hewitt was quick to blame GPs for dishing out jabs to the ‘worried well’ but she clearly hadn’t seen the NHS Direct website which, until November 21, was advising patients that they may be able to pay for the jab, if their GP has stocks available.

Ironically, just as the flu jab shortage was becoming apparent, the Lancet published a systematic review claiming “the effectiveness of trivalent inactivated influenza vaccines in elderly individuals is modest, irrespective of setting, outcome, population, and study design.”1

So it seems we’ve had a mad rush for something that doesn’t work very well and then copped the blame for running short.

This is just one example of consumerism not working in the NHS, but there are plenty more. Just as we are having ‘choose and book’ forced on us all, patients are being denied the choices they really want.

Why are single-handed GPs being forced out of business when patient campaigns back them to the hilt?

Why are so many community hospitals closing or under threat of closure when the vast majority of patients in their locality wish them to remain open?

Why can patients no longer pop down to the GP for a chat and a bit of therapeutic gossip without having their lives medicalised by the GMS template?

And why have we lost the choice to refer to an individual consultant we know and trust?

Patients are being sent far and wide to treatment centres and hospitals we know nothing about, other than their brochure guarantees quality by putting a smiley face in the MRSA column.

I could go on, but you get the picture. Choice in the NHS is largely still an illusion, and where it exists there are strings attached – you can choose so long as it fits in with the government’s ideology. Otherwise, you’re stuffed. Happy New Year.

  1. Jefferson T, Rivetti D, Rivetti A et al. Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review. Lancet 2005; 366: 1165-74.

Guidelines in Practice, December 2005, Volume 8(12)
© 2005 MGP Ltd
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