Back to stagnation and fragmentation

As a patient, I don't ask the political parties for much. All I want is the next government to give me: - Faster and more timely treatment by eliminating snail mail in the transfer between hospitals and GPs of pathology data, bookings, discharge summaries and outpatients reports. - All this should also be available to me, the patient, at the click of a mouse. - Because I don't want to catch MRSA or other people's snuffles, when I visit hospitals or GPs, I would like to see a future government take telecare seriously for a change. - And, above all, I would like to know that any doctor treating me has instant access to a record of any other treatment I have had from any other doctor, so that he/she doesn't give me 'inappropriate treatments' that will kill me. Actually, I have been expecting since 2002 that the National Programme for IT would give me all these good things. But it hasn't. I am in despair that, after eight years, the three parties' manifestos offer no real cures for any of my modest needs. Labour makes woolly statements about diverting resources to 'frontline services', but then goes and axes frontline Cerner implementations in London to save a paltry £112m, as well as those in the south of England. It gives no clue about how the NPfIT will proceed. Will they break it up? The Tories and Liberal Democrats claim to give patients control of their records, but give no details of who would be responsible for holding and updating those records. Is it the GP, the primary care trust or the spine? Or will the British Medical Association be allowed to strangle any nationwide care record system at birth? We, the patients, need to know. Both Labour and Conservatives say that they will turn all hospitals into foundation hospitals. In the wake of Stafford, Basildon and Colchester, I would have expected them to pause a moment over the whole foundation strategy. The local hospital, which treats my wife's cardiac condition, is a foundation hospital, but is graded only 'fair'. I would have thought that any hospital graded less than excellent or good should be immediately stripped of its foundation status. Another trouble with foundation hospitals is that they have the power to reject NHS standards. To me, data standards are what stops the NHS from fragmentation and chaos. The Liberal Democrat party wants to shoot the 'white elephant', NPfIT, but gives no clue about what should replace it. It quotes the American health provider Kaiser Permanente and the US Veterans Administration as models of innovation. Why is it that British politicians, devoid of original ideas, always tote American models? This seems particularly misplaced, when the bizarre American health system is so different from ours. Like the Conservatives, the Liberal Democrats call for decentralisation. I am old enough to remember what decentralisation means. In 1992, I had an operation in my local general hospital. There was no computer on the ward. In 2000, I had another operation in the same hospital. There was a computer there by then, but it did only patient administration – no clinical stuff – and each department of the hospital had to rekey the patients' data if the patient moved from one department to another. And yet this was the period when the world wide web encompassed the globe. But not in my hospital trust, or the NHS in general. It is this glacial rate of progress that you get, when you rely on hospitals doing their own thing, "bottom up". And then of course, a hospital trust, faced with financial difficulties, will always raid its IT budget to meet a crisis. So, beware any politician who wants to localise. The result in the 80 and 90s was stagnation and fragmentation. It will be even more so in the 10s because of the cuts. And none of the parties have anything to say in their manifestos about the canker that has done more to stop the spread of smart healthcare: the stand-off between Connecting for Health and the BMA. Both sides have totally failed to engage with each other for eight years. All they have done is hurl brickbats at each other. I will vote for the party which will knock their heads together.