Editorial
2008-09-01 00:00:00
National and local organization of health services affects us all, not only in our roles as health professionals but also when we or those we love are unwell or needing investigation of symptoms. Health care may be managed and delivered by the state, as the National Health Service (NHS) of the United Kingdom (UK), it may be part‐state and part‐private insurance or it may be all‐private insurance but at different levels and costs. In the last month the UK has been celebrating and remembering the development of the NHS since 60 years ago. In 1946 the politically controversial NHS Act described by the then Secretary of State for Health, Aneurin Bevan, was incredibly ambitious. The phrases, ‘imposes no limits on availability’, ‘the Bill places a general duty (my italics) upon the Minister of Health to promote a comprehensive health service for the improvement of the physical and mental health of the people . . .’, were revolutionary. Prior to this, health care was available to those who could pay doctors' fees or through the services of the various charities, which Bevan thought ‘repugnant to a civilised society’. One wonders what he would have said today of the tremendous and substantial contribution of the charitable sector to health care. While it was controversial it soon became a feature of the British way of life. Also in the last month, a review has been published by the Department of Health to look again at the delivery of health care for the 21st Century. Lord Darzi, also a professor working in the NHS as a colo‐rectal surgeon, led the review of every region of England. Clinicians of all health professions, patients, carers and the public were asked in one way or another for their views and experiences and how they saw health care in the future. In his introduction to the report of this review, the current Labour Prime Minister, Gordon Brown stated that health care ‘is not a privilege to be purchased but a moral right secured for all’. Again, the language is interesting and controversial. What has this to do with cancer? There has been much controversy in the UK recently about the so‐called postcode lottery for availability of newer cancer treatments. There is clearly some inequity depending upon where the cancer patient lives and what the local purchaser of drugs and other treatments decides to spend its money on. There are no easy answers and rationing has always been there despite the rhetoric to the contrary. However, considering the language used in this new review, ‘High Quality Care for All’, everyone should have what they need, no matter what age, creed, socio‐economic group, employment status or where in the country they live. I repeat Gordon Brown's words that health care (cancer care) is a moral right secured for all. If you see cancer as a long‐term condition (and many now do) what of the services available for those who survive our care? The recent Cancer Reform Strategy published last year in the UK addresses the needs of this group and the current lack of services to meet the demanding needs of those living with their disease and/or the effects of previous treatments that may have left many physical and psychological scars. The development of health policy and the resources to meet all needs is going to be more demanding than ever. Rigorous evaluation of the implementation of new policy is crucial.
http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.pngEuropean Journal of Cancer CareWileyhttp://www.deepdyve.com/lp/wiley/editorial-ZRdmYG1APS
National and local organization of health services affects us all, not only in our roles as health professionals but also when we or those we love are unwell or needing investigation of symptoms. Health care may be managed and delivered by the state, as the National Health Service (NHS) of the United Kingdom (UK), it may be part‐state and part‐private insurance or it may be all‐private insurance but at different levels and costs. In the last month the UK has been celebrating and remembering the development of the NHS since 60 years ago. In 1946 the politically controversial NHS Act described by the then Secretary of State for Health, Aneurin Bevan, was incredibly ambitious. The phrases, ‘imposes no limits on availability’, ‘the Bill places a general duty (my italics) upon the Minister of Health to promote a comprehensive health service for the improvement of the physical and mental health of the people . . .’, were revolutionary. Prior to this, health care was available to those who could pay doctors' fees or through the services of the various charities, which Bevan thought ‘repugnant to a civilised society’. One wonders what he would have said today of the tremendous and substantial contribution of the charitable sector to health care. While it was controversial it soon became a feature of the British way of life. Also in the last month, a review has been published by the Department of Health to look again at the delivery of health care for the 21st Century. Lord Darzi, also a professor working in the NHS as a colo‐rectal surgeon, led the review of every region of England. Clinicians of all health professions, patients, carers and the public were asked in one way or another for their views and experiences and how they saw health care in the future. In his introduction to the report of this review, the current Labour Prime Minister, Gordon Brown stated that health care ‘is not a privilege to be purchased but a moral right secured for all’. Again, the language is interesting and controversial. What has this to do with cancer? There has been much controversy in the UK recently about the so‐called postcode lottery for availability of newer cancer treatments. There is clearly some inequity depending upon where the cancer patient lives and what the local purchaser of drugs and other treatments decides to spend its money on. There are no easy answers and rationing has always been there despite the rhetoric to the contrary. However, considering the language used in this new review, ‘High Quality Care for All’, everyone should have what they need, no matter what age, creed, socio‐economic group, employment status or where in the country they live. I repeat Gordon Brown's words that health care (cancer care) is a moral right secured for all. If you see cancer as a long‐term condition (and many now do) what of the services available for those who survive our care? The recent Cancer Reform Strategy published last year in the UK addresses the needs of this group and the current lack of services to meet the demanding needs of those living with their disease and/or the effects of previous treatments that may have left many physical and psychological scars. The development of health policy and the resources to meet all needs is going to be more demanding than ever. Rigorous evaluation of the implementation of new policy is crucial.
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