NHS leaders are failing to “speak truth unto power”BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j256 (Published 19 January 2017) Cite this as: BMJ 2017;356:j256
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Lock succinctly exposes the blinkered policy making that is blighting the NHS. Even so it worries me that along with most commentators there is only passing allusion to (heaven forbid) the possibility of “reducing standards” to keep us within budget. Have we all become complicit in raising impossible expectations? It’s not just about accessing a health professional 24/7 irrespective of severity, it’s also about fostering the illusion that there is a pill/surgery/treatment “for every ill”, and the sooner one is seen the quicker those “clever doctors” can restore perfect health or if not radically extend longevity. This may not be a popular (populist?) attitude, but having just retired as a Palliative Care doctor, I am very aware that when the chips are down what most patients want is sensitive, time-rich care rather than increasingly redundant and expensive attempts at active therapy. The evidence suggests we routinely exaggerate the benefits over the harms to our patients, but as patients doctors are much more choosy in the treatments we’ll accept.
A further consideration is that we live in a world where for the majority the health benefits we already enjoy are beyond the realm of fantasy. Is it morally right that we invest mega sums on therapies that merely tinker with public health statistics, when we know that by far the biggest drivers of health improvement are lifestyle, nutrition and environment? Isn’t it about time we were honest both with ourselves and the public that much of what we do is of marginal benefit, and that the NHS is living both beyond its means and wasting limited resources?
Competing interests: No competing interests