Health crunch
Article Type: Editorial From: Clinical Governance: An International Journal, Volume 14, Issue 1
Some new words are creeping into the everyday vocabulary of politicians and journalists; sub-prime, toxic and crunch now feature large. I wonder how long it will be before the health commentators start to use such words. Public health messages are beginning to get close as we sift through the ashes of the smoking cessation campaign, count the cost of alcohol misuse and note that up to one in ten deaths are now attributed to diabetes. It sounds like sub-prime lifestyles dominated by toxic addictions are leading to a health crunch which will require a significant investment in behaviour change to help the nation, hopefully, get better at staying well.
One in three deaths are now attributed to these potentially self-manageable conditions and primary care in particular, through their public health programmes, are having to dedicate significant additional resource to these initiatives. If the Government were to intervene in a similar style to that adopted in the credit crunch, what would we see? I suspect a massive investment in educating children about lifestyles, banning alcohol and smoking in public places, making healthy eating affordable and pricing all those things that pose a health risk at a premium that covers the cost of their consequential treatment. If we are to be forcibly directed towards a sensible approach to credit, then why not to lifestyles.
The latest generation of guidelines and support programmes suggest that this is beginning to happen and a considerable amount of health spend has now been directed towards staying well. However Directors of Public Health still feel more needs to be done. Ten week waiting lists for smoking cessation treatment,half a million undiagnosed diabetics, and the latest Health Care Commission Report identifying timely access to GP Services is worsening, suggest we could do better. All this suggests that to head off the health crunch we may need even more resource and definitely better guidance.
In this issue we continue to see some excellent clinical governance outcomes;good progress in incident reporting (Basu) and some positives in the pursuit of clinical excellence (Kapur).
Jadoon et al. report on a prospective audit in secondary care regarding the role of the chaperone and Mahadevan reports on patient trauma and orthopaedic surgery referral rates among orthopaedic physiotherapy practitioners.
Five positive contributions to clinical governance support in the name of making better, but will it see off the health crunch? I suspect not.
Jeff Lucas
