20 March 2006
Home care

The government is planning to save money on casualty by giving better health advice to patients with chronic diseases - the idea being that, armed with this advice, said sufferers are less likely to clog up casualty in future.


  • I sighed when I first heard this.  While, for all I know the aims of the scheme might be entirely laudable they will almost certainly fall victim to the law of unintended consequences.
  • Then it occurred to me that this really might be quite devious

So, the unintended consequences?
Well, who knows.  This is always the fun aspect of government policy - predicting where it’s going to hurt.  There’s bound to be more bureaucracy.  There may be inappropriate pressure put on doctors to dissuade their patients from going to casualty when they really need it.  There may be cases of patients being poorly advised and ending up dead.

The story right now is that there is a cash crisis in the health service.  At the same time there is a policy of trying to turn nurses into doctors.  It strikes me that the former may be being used as an excuse to introduce the latter

What makes you think that?
For starters the time lag.  The cash crisis is here and now.  An advisory service what with all the recruitment and training involved is going to take months if not years to make an impact.  Then there is the track record.  Rail privatisation being used as cover to introduce vertical fragmentation.  The War on Terror being used as cover to introduce ID cards.

Update 22/03/06
Dr Crippen also has some thoughts

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