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A new direction for community healthcare?

Lynn Young
Primary Healthcare Adviser for the RCN

Regardless of the whims and ethos of the new Cabinet, our dearest friend, the NHS, is facing choppy waters. Lynn Young advises nurses to connect with their local RCN officers and be prepared to get involved and get active ...!

Just as I was completing this article, the news broke that Mr David Cameron has been made our new Prime Minister and that Mr Andrew Lansley is to be England's Secretary of State for Health. Working at the Royal College of Nursing (RCN) gives you a fascination for politics, even when you may disagree  wholeheartedly with the daily activities and views of the various politicians who have been duly elected by their constituents. So, here at RCN headquarters we will be busy for the rest of 2010 building new political relationships and getting to grips with the decisions being made on the future funding and direction of healthcare.

New political health advisers may soon be appointed, and while civil servants stay put rumours of redundancies within the Department of Health are being heard.

Whoever is in political power, and regardless of the whims and ethos of our new Prime Minister, Chancellor of the Exchequer and health ministers, our dearest  friend, the NHS is facing choppy waters. Nurses are advised to connect with their local RCN officers and be prepared to get involved and get active. Doing this through the RCN is much more effective and manageable then attempting to "go it alone".

Questions are being asked: can we sustain the NHS during economically challenged times? Which healthcare services should the state fund? Where can service  cuts be made which cause the least distress to local people? And how are we to successfully prevent the diseases of appalling lifestyle?
And, of course I, with my colleagues, have strong views on how future health services should be funded, managed and provided in the next decade. Much respectful disagreement flows between us, but discussions are generally good-natured and we all own up to how important it is for us to hear the perspectives of others.

My personal bias lies heavily in favour of the community side of healthcare in the belief that hospitals consume vast amounts of cash, of which a proportion could be so much better spent on preventing disease and improving public health. The ethos of the "greater good" is alive and kicking in the community. But at the same time it is important to admit that should one of my children become seriously injured in a car accident I would shout loudly for world-class intensive care
services.

So, human beings are a complex mix of emotions and experiences. When we are personally affected, rationale and logic fly rapidly out of the window, and we demand that our personal needs are instantly catered for.

Yes, healthcare is tricky, and the UK public - encouraged by our politicians - now has high expectations in terms of demanding speedy access to quality services.

Personalisation is the modern name of the game. UK citizens are no longer mere bed numbers within a traditional Florence Nightingale-style hospital ward. Politicians of all persuasions believe that people desire choice in who treats them and where they are treated. Many of us still need to be convinced on this one, as people are often heard to be saying that all they want is excellent local healthcare from professionals who are both kind and competent.  

Sounds simple, doesn't it? Yet achieving this reasonable state of affairs seems to elude even the most determined and tenacious of us. But spare a thought for the introduction of personalised health and social care budgets - Labour started them and the Tories have declared that they will continue them.

A number of people have been successfully using their personal social care budgets for some time. They  buy their own care services and exercise preference over what the traditional service has been prepared to provide in the past. The next step is the personal health budget, which is a brave move, but one we must give people the opportunity to test.
After all, the rich have always had the benefit of purchasing their own health and social care services. Maybe it is time to become more egalitarian and enable  the less rich to enjoy the benefits that personal budgets  have, for many years, brought to the chosen few.

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"In the current climate I often wonder how anyone knows what people desire from our health service when so much time is spent nurturing the needs of the organisation - form filling, with little time left to communicate with the people that matter, and showing them that we care" - Christina Milligan, Scotland