A health service lacking a long-term view?

The Northern Irish LMCs conference voted for the NHS to be run by an arms-length body separated from politicians, rather like the Bank of England.

While one might suspect this was in part prompted by fears of yet another change of direction in the region when the power-sharing devolved government takes power, there is much merit in the idea when recent events are considered.

In Wales, the various regional directed enhanced services (DESs) introduced last year are to be dropped after Welsh GP leaders refused to accept a deal featuring more work for less pay.

These DESs include those for mental health and disability, so the decision will see patients losing out.

Back in Northern Ireland, there is the good news that the new commissioning bodies are likely to benefit GP services but GP leaders are still battling for primary care in the region to receive equitable funding with the rest of the UK.

With less funding per capita, patients services are surely undermined.

Then there is the recent decision by Suffolk PCT to serve notice on 46 PMS practices inevitably throwing primary care in the region into disarray as GPs try to figure out what their practices will still be able to afford in terms of services offered under their as yet unclear future funding structures.

Add to this the unclear situation regarding the continuation of the regional DESs introduced last year in Scotland, Northern Ireland and England and you have a health service apparently lacking in any long-term view.

These recent decisions typify a health service driven by political targets and short-term accounting rather than a strategic view of delivering a healthy and therefore productive nation.

The thinking behind the independent Bank of England was that the economy was too important to see every adjustment in interest rates subject to changing political imperatives or whims.

A strong argument can be made for the same thinking to be applied to health with a clear central  vision underlining all decision-making.

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