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International Primary Care Association

from the editor...

A very Merry Xmas and A Happy and Prosperous 2016 to all our readers.

 

We leave 2015 with the Chancellor agreeing to pump in an extra £6 billion into the NHS and the government retreating from the unnecessary confrontation with junior doctors. The cash is welcome to ease general and the upcoming winter pressures but unless there is a concomitant restructure to minimize the bureaucracy much of the money will not be directed at frontline services but on bean counters. Bean counters incentivized to attain, and generally failing, the meaningless central government health targets, and being paid very well to do so. This smacks of and mirrors in many respects what we all loath about the financial industry which almost single-handedly ruined the UK economy, but purportedly was working in the public’s best interests!

 

Responsibility and accountability for non-clinical managers appears not to exist in the NHS. Individuals failing in one healthcare sector end up taking large wads of cash to move on and shortly re-emerge in positions elsewhere in the service. Compare this to doctors, nurses and our fellow healthcare professionals who are heavily regulated and likely to have their professional registrations terminated if found guilty of misconduct. We cannot hide under the umbrella of corporate responsibility. Ours is an individual responsibility to be advocates of our patients, whatever the circumstances. The NHS is a prime example of senior managers having power but without the responsibility that should accompany it. There was some years ago a voluntary “code of conduct” devised for managers. “Voluntary” being the key word, and without any formal structure for enforcement. The epitome of lip service.

 

There is nothing festive in the contents of this issue, unless the intake of alcohol is considered. Hull and Day (p.135) discuss alcohol disorders and the key role of primary care health professionals in its identification and management. Cerebral palsy, which manifest early in life is now a condition where suffers, thanks to modern medicine, are living into adulthood. This has resulted in new and otherwise uncommon problems that need addressing in this group. Their care is mainly delivered in the community and Kurup and Nair (p.116) provide a useful overview of the key issues.

 

Kidney injury may not seem a commonly encountered pathology for GPs but be prepared to be disabused of such a notion. Sawhney and colleagues (p.124) contend that Acute Kidney Injury frequently commences in primary care and even when patients are subsequently discharged a proportion will go onto to develop Chronic Kidney Disease, unless monitored adequately in the community.

 

UK has one of the highest incidences of Teenage pregnancy in the OECD countries. Murphy & McCarthy (p.147) take the reader on a journey from counselling adolescents requesting contraception to addressing the needs of those individuals who become pregnant. They highlight the continued work of the government, working with frontline community services to prevent such pregnancies, support those who become confined and provide continued care into the postnatal phase and beyond.

 

In solidarity with the French, after the awful terrorist attack, I additionally wish a Merry Xmas to all communities across the globe: joyeux Noël, ديجم داليم (miilaad majiid), חמש דלומ גח (hag molad saméa’h), с Рождеством Христовым (S rozhdestvom Khristovym), buon Natale, feliz Navidad, Krismas ki subhkamna...

 

Professor Ram Dhillon

 

Editor

 

Additional Info

  • Authors: Professor Ram Dhillon
  • Keywords: Clinical Focus Primary Care
Read 570 times Last modified on Friday, 15 April 2016 09:54

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