David Cameron and the NHS

So David Cameron's main priorities are n.h.s. I agree that he needs to take this line to reassure the public but I dont think he really understands what the nhs means. The entire system is struggling under a series of contradictory government edicts (eg no postcode prescribing vs Local commissioning and budget control).

The finances are in a complete mess with the relatively healthy south being penalised for being healthy (because they use their healthcare services) at the expense of the less healthy north (who dont). Therefore the PCTs in the south have less money per capita, the hospitals in the south have higher demand and the GPs in the south cost more because they achieve their targets better (though not necessarily improving the health of their patients). No wonder the entire healthcare system in south east england is bankrupt. Meanwhile hospitals and PCTs in poorer areas are happy because they have more money and need to spend less. In theory they should be spending it all on prevention and improving the health of the local population-but are they? Even if they are its much easier to cut a smoking cessation or obesity awareness programme than to halve your mental health budget. Theis is not a criticism of these organisations, it is just that the govenment has stacked the odds in their favour.

So what is the solution? I don't believe the government can or should retain control over the whole nhs. Myself I would favour local health boards made up of capable people with representation from primary and secondary care as well as lay members and members with sound financial expertise who would commission local health services. But this would inevitably lead to postcode prescribing and different quality and scope of services in different regions-I dont know that this is necessarily a bad thing provided patients are able to travel.

One thing is for sure if we continue as we are the whe system will collapse in 3-5 years