The recent King's Fund Wanless report has concluded that the extra health spending has delivered poor value for money and that rising costs in the future threaten to undermine the service. It also concludes that the current policy framework is right and the financing system should remain unchanged.
Given the poor results, it is extraordinary to conclude that the current policy framework should remain. The government's central planning has skewed health resources towards secondary care when it would have been better spent on prevention and new primary care services, something the report agrees with.
How many more years are we going to have to listen to primary care organisations crowing on about shifting resources but it never actually happening?
Many clinicians are calling for a period of stability, but if anything we need more radical reform if the NHS is to survive at all. The current problems of the NHS stem from the decision to spend rather than reform.
The changes we have experienced over the past decade have concentrated on structural reform of trusts rather than changing what clinicians do.
This is because clinicians have not been given the power or opportunity to shape the changes. The result is a virtual disengagement of those that know what is going on and could provide viable solutions.
Dr Paul Charlson Brough, East Yorkshire.
