Good health has little to do with doctors, Mr Lansley

Abstract

Much of the political rhetoric surrounding the NHS reforms has centred on results. Regarding the NHS Outcomes Framework: > ‘The framework sets direction of travel in the journey towards improving outcomes, and offers an opportunity for the NHS to begin to understand what an NHS focused on outcomes means for individuals, organisations and health economies.’1 Suggesting that doctors have the power to really influence outcomes on a population basis is however a sleight of hand; while we are distracted by the shiny coins given to GPs, we fail to see who is really holding the cards. Even a novice student of medical sociology will be familiar with the graph showing mortality from tuberculosis in the UK. From the middle of the 19th century, deaths attributable to the disease went into a steady decline. By the time that the BCG vaccine was introduced in 1953 and antibiotics became available in the 1940s, death rates had already fallen to about one-sixth of those seen 80 years earlier. The vast majority of the improvement in outcomes was not related to medicine at …