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Listening and Learning seems to be the order of the day. Before this issue hits your floor mat the government’s, “Listening Exercise”, on the NHS reforms will have been completed and the policy enunciated by Andrew Lansley, and at inception agreed and signed off with Lib/Dem approval, will be dead or marginally watered down for appeasement. If the former I suspect Mr Lansley will have to be politically sacrificed.

It has been difficult to square the circle on this one as my straw poll on attitudes to there forms, which is talking to clinicians and other healthcare professionals, indicates a strong feeling of frustration with the present structure of PCTs and SHAs etc. The government, from David Cameron to Andrew Lansley, coalition partners, the opposition and front line staff accepted that the status quo is unacceptable. Why then the fuss! It is the usual suspects of vested interests worried about their little empires, unable or unwilling to see the broader picture that requires addressing. The ageing population, the inexorable rise and rise of Long Term Conditions and clinical management, in many instances, now easily and less expensively delivered in the community.

The most important structure that will ensure that GP commissioning functions as envisaged is a robust monitoring organisation. This Monitor should be equipped with very clear and specific powers to sanction those who go beyond the statutory boundaries. The view that GPs will run amok with £60 billion of public money is a cartoon image peddled by detractors of the changes proposed. There are a plethora of checks and balances to prevent this which are already well embedded. Could it be any worse that SHAs and PCTs wasting billions on inappropriate IT systems, selling NHS estates and getting turned over by large suppliers?

Most of us at the, “Fron tline”, have to contend with this farrago and manage our patients. I am therefore pleased that we have an array of clinical articles to help us focus on the real job. The UK rag bag of newspapers has been very aggressive at purveying the notion that“Attention Deficit Hyperactivity Disorder” does not exist! Once you have read the article by Drs Katagampula and Banerjee you may appreciate the mythological world that many of our national medical and newspaper journalists inhabit. I have mentioned Long Term Conditions previously and Diabetes is one that will be a major player. Pharma companies seem to launch a new class of drugs for diabetes every week. Berit Inkster and colleagues have provided an overview that cuts through the hyperbole and focuses on exactly what you need to know to best manage your patients.

Most GPs will encounter patients with eating disorders with Anorexia Nervosa being not uncommon. Dr Kan and Professor Treasure have provided us with an excellent up to date summary of this condition. Any symptom that involves neurology, and the head/brain inparticular, usually initiates sweats and palpitations in clinicians. Headaches in Children must be such a symptom. Dr Sheikh Nigel Basheer has penned a contribution on this topic that allows the clinician to reduce their worries. Drs Sack and Wilkinson have visited the “Human Papilloma Virus”. It is an organism with protean related medical conditions. The authors have deftly addressed the clinical issues and for spice have also confronted the vexed question of HPV vaccination. Very interesting it is too, with political intrigue in the mix!

Finally, I would like to commence a “Correspondence” section in the publication and so comments would be gratefully received. Should anyone wish to contribute please contact me by email.

Happy reading.

Professor Ram Dhillon

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Read 30743 times Last modified on Tuesday, 03 May 2016 14:35

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