August - the media's traditional 'silly season' - has been short on stories about GPs and polyclinics. Most of the month has been dominated by discussion of NICE and access to drugs, with the politics of food making an interesting appearance at the end of the month.

In September, these themes will continue and be joined by primary care finance and reform.

ANDREW LANSLEY CALLS FOR GP-LED REFORM

Alan Maynard is professor of health economics, University of York

Monday 1 September 2008

Time to "screw" the NHS?

The Blair-Brown axis has increased the funding of the NHS in an unprecedented manner, with an additional £50 billion and total expenditure now of £105 billion. Soon we will be spending ten per cent of gross domestic product (GDP) on the NHS. What are we getting for our money?

Amid reports of a surprise surplus for the NHS, many patients will be asking whether the money can be put toward new treatments, particular those patient protestors who locked themselves in to the NICE offices yesterday to complain about the rejection of drugs for advanced stage kidney cancer.

NHS FORECASTS A SURPLUS AND BEGS THE QUESTION – ‘AND WHY CAN’T YOU FUND MY TREATMENT?’

Today’s headlines in advance of Andrew Lansley’s speech on obesity were along the lines of ‘Conservatives say there is no excuse for being fat’, but this masks a deeper political point.

In a wide-ranging speech, Lansley sought to put clear blue water between Conservative and Labour approaches. The problem is that the speech is being interpreted as a little too close to business interests.

QUESTIONING SPENDING ON INEQUALITIES

The debate about the availability of expensive drugs is changing in nature. It is being linked to a need for more insurance, to provide for expensive drugs, amid reports that the European Commission proposes to allow pharmaceutical firms to provide information directly to patients about their products, on the radio, the internet and in newspapers.

NOT NICE AGAIN

GPs you see today might have a spring in their step. The BMA aims to enlist local authority Overview & Scrutiny Committees in their war on polyclinics. Reports of a Lancet paper suggest the new GP contract has rapidly eroded inequalities of care in just three years. We are even told that the news prescriptions rose in Wales by 5% (in the first year since charges were scrapped) is a good thing and testament to the success of GPs better managing chronic conditions, giving more medicines so less is spent on hospital admissions.

In today's press there are 17 pieces relevant to the ongoing debate about access to drugs; their cost; and how we judge their effectiveness. There are also reports of safety concerns, but by far the biggest volume of stories (7 from 15) relate to potential new discoveries. This tablet of stories reveals an unhealthy social obsession with drugs.

Listing all these stories in a table allows them to be moved around, better revealing the contours of our drugs debate (pasted at the foot of this piece).

Oh. For. Fuck’s. Sake.

I have just wasted half an hour of my life that I’m never going to get back again, watching the BBC Panorama programme on drug access and NICE.

Now 30 minutes is far too short a time to even attempt a serious programme about healthcare rationing if you’re clever and thoughtful (even though the BBC evidently believe that the attention deficit disorder generation, weaned on Ritalin and fast edits, can bear no more), so a serious programme is what we didn’t get.

It is sometimes said that what happens in the US comes to Britain a few years later. It is not so often commented, however, that the US is beginning to pick up some things from the British system.

While blogging last night, I didn't yet know that NICE chair Professor Sir Michael Rawlins would be writing a piece for the Health Service Journal website today, and merely went from what was in The Observer's interview / feature.