"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Friday, 4 March 2011


Can you imagine that, as a patient, the tick of a pen in Whitehall can give you more personalised care, and do this instantly? No? The lack of understanding of this fact shows how out of touch Lansley's Department of Health team are. The latest round of GP Commissioning "pathfinder" consortia was announced with a press release that had the following title:

Two thirds of the country now benefit from more personalised care

This refers to  the fact that commissioning consortia now cover 2/3 of the population. However, they are exactly the same GP practices as before (so no change there). This is just propagandist spin from one of the legions of spin doctors in the Department of Health. I thought civil servants weren't supposed to take a political line.


Perhaps things are changing. I have six-monthly diabetic check-ups at my local GP. The check-up is usually carried out by the practice nurse. The drill for the last decade and a half has been for me have a blood test and then two weeks later make an appointment with the practice nurse who weighs me, tests my urine sample, examines my feet and tests my reflexes. I also have an opportunity to discuss my diabetic control. Since I have had diabetes longer than the practice nurse has been alive, I rarely need advice on my care. But the regular monitoring is vital. How will I know if I have lost the feeling in my toes? I mean, I won't be able to feel it! The practice nurse tests for this.

This has now changed. I have just been asked to have a blood test for the diabetic clinic, and the letter informed me that I will only have an appointment with the practice nurse if there is a problem highlighted by the blood test results. Of course, this means that my urine (kidney function) now will only be tested once a year, rather than twice a year. Similarly with the monitoring of the nerves in my feet.Will this make a difference to my diabetic care? I don't know, but it is definitely a change in the amount of care my GP provides.

One less appointment a year is a saving for the GP, but I am not sure what contribution that will make towards the £5bn that the NHS has to "save" in the coming financial year.


  1. your GP changes have been in place here in Cambridgeshire since 2006,the last major Labour government reorganisation of PCT/SHA's. As you know our funding level is among the lowest in the UK and so is our care...

  2. That's a bit concerning Richard,

    Diabetic foot care is hugely important. I know how to chop legs off but don't like doing it. This kind of regular check-up is vital.

    In the meantime, you need to make sure you check your feet for ulcers regularly. Especially the pressure areas (ankles, balls of feet etc - where there's most pressure.)

    (Sorry, for unsolicited advice...)

    This is exactly the kind of short-termism which is going to become more and more prevalent me thinks.