Sustaining the NHS

Sajid Javid in the introduction to his keynote speech to Policy Exchange on 'Digital transformation in health and social care' said "The truth is that our health and social care system is following an unsustainable path that is too often not delivering for patients". He went on, "At the start of this century health service spending represented some 27% of day-to-day public service spending. By 2024 it is set to account for 44%. ... But can we really say we've seen an equivalent improvement in outcomes?"

Obviously this rhetorical question was meant to be answered in the negative and I would agree. I've said before (eg. see previous post) that overmedicalisation of society has created too much medicine. This situation is ironic as the currently fragmented and dysfunctional NHS has also inflated demand so that it cannot cope. The NHS needs to relearn to concentrate on priorities. There needs to be a shift back towards meeting need rather than demand.

The BMJ has recently called for a reset in its campaign against too much medicine (see editorial). A rushed article of mine 'The limits of psychiatry' was published (with several fairly minor errors eg. picture of Alfred rather than Adolf Meyer) in a BMJ theme issue in 2002 highlighting the dangers of too much medicine. As the recent editorial says. "Evidence for the damaging effect of overdiagnosis and overtreatment continues to grow". And as it concludes, there needs to be a move from "rhetoric and scattered evidence to actionable evidence and measurable impact".