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Writer's pictureMichael Edwards

Add life to years and years to life

Originally posted @ 5:47 pm, Sun 15th Jun 2008

Spending on health was £35,000 million 10 years ago and is now £90,000 million. Waiting lists are down. The national 18 weeks waiting target looks set to be met. A lot to celebrate as we approach the 60th anniversary of the National Health Service. Our greatest expression of our commitment to equality and achieving more together than we do apart. But there’s still a lot to do. The population is getting older and we may need to provide more support for carers and better wages & recognition for carers (who often get trained to NVQ3 at their own cost). Information about patients is still held on a range of computer systems.

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My local branch of the Labour Party met on Wednesday to discuss health.

It’s striking to see how spending on health was £35,000 million 10 years ago, is now £90,000 million and will be £110,000 million by 2010/11.

We have moved on massively in those 10 years – a local GP told the meeting how it would take 18 months to get a case referred to a consultant and that 300,000 people were on the waiting list for 15 months or more.

Now the average wait is 8 weeks and the government are on track to meet the national target of no-one waiting more than 18 weeks (the target has been met in Nottingham), it is tempting to say the NHS should not go through more reform.

However, the demands on the health service will change again as the population gets larger and older. The services provided as a whole do need to be joined up more effectively through better information from patients; information which they and their carers should essentially have to give once rather than repeatedly. And there are concerns about the health service’s ways of working being focused on serving their own ways of working rather than the patients’ needs.

Part of the discussion featured the Nottingham City’s Primary Care Trust’s health investment strategy, for which the challenge is to “Add life to years and years to life.”

The public consultation document says the challenge will be met by “world class commissioning”; defined as “obtaining the best value and health outcomes for local citizens by understanding their needs, and then specifying and procuring services that deliver the best possible health and social care provision and outcomes within available resources”. The 11 core competencies are stated in even more challenging language but at a subsequent meeting, I found out that the document, although public, is actually geared to other organisations.

The overall strategic intent – or vision – is stated more simply “An end to health inequality”. A tough task since the gaps in life expectancy within Nottingham are dramatic. A man in for instance the wealthiest part might on average expect to live until he’s 80; a man in our most deprived community might expect to live until he’s 67. A 13 year gap less than 3 miles apart.


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