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Political issues

Open Door - November 2007 page 2

The autumn is often an uncertain time for the NHS. In 2007 there is an added feel of uncertainty due to the fact that there is a new Department of Health team in office.

All the political parties have stated that the NHS is a priority and yet there seems to be no certainty as to the best way forward. Local delivery is the mantra, but central direction seems to be lacking.

'Our NHS, our future', Lord Darzi's review of the NHS 2007-2008, is the latest initiative. Using the Department of Health words, Lord Darzi, an eminent surgeon, is carrying out a wide-ranging review to ensure that a properly resourced NHS is clinically led, patient-centred and locally accountable.

The review plans to directly engage patients, NHS staff and the public on four critical challenges:

  1. to ensure that clinical decision making is at the heart of the future of the NHS and of the pattern of service delivery
  2. to improve patient care, including providing high-quality, joined-up services for those with long-term or life-threatening conditions, so that patients are treated with dignity in safe, clean environments
  3. to ensure that more accessible and convenient care is integrated across primary and secondary providers
  4. to establish a vision for the next decade of the health service that is based less on central direction and more on patient control, choice and local accountability, and which ensures that services are responsive to patients and local communities.

The review comes as the NHS is about to celebrate its 60th birthday and Lord Darzi has been asked to present his preliminary views with regard to primary care. To date he has put forward a radical plan for the health service in London involving the creation of polyclinics and re-allocation of roles between hospitals and general practice.

It is very unclear how, or if, any new structure would benefit people with MS, and it is also unclear whether London-style recommendations will be made for the rest of England. There are however some encouraging words in the overall announcements: clinical decisions rather than financial constraints at the heart of the service would be good, and joined up services would certainly help many people with MS.

We are all being encouraged to take part in this review and it is frustrating to be given so little time. However, in MS we have two documents - the NICE MS Clinical Management Guidelines and the National Service Framework for Long-term Conditions - that define what a good service would look like and we will be submitting this evidence and some other comments to the review.

Maybe by the time the next edition of Open Door drops on your mat we will have a clearer idea of the next set of changes. We certainly hope so!

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