Letters to the Editor
NHS crisis
Sir: In his letter (November 8) on the crisis in the NHS, Mr J. G. V. Howard advocates the investigation of real issues and objective criticism. He deprecates half-truths. I submit that his letter is full of half-truths and that he seems unable to identify a real issue, let alone investigate it.
His main statement appears in the third paragraph where he says: "If money and research were diverted to the improvement of facilities for treating patients at home rather than in hospital then it would lead to an overall saving of money and a very much happier patient."
What illnesses currently treated in hospital does Mr Howard have in mind for domiciliary treatment? It would be useful to have a list. What are the grounds for his surprising assertion that domiciliary treatment is cheaper? What evidence is there that patients would be happier to be treated at home for illnesses that at present require admission to hospital?
In the fourth paragraph he deals with the chronic sick and mentally handicapped, saying, "Indeed the whole field of research into the effectiveness of different approaches to care has not had the attention it deserves and one that in the long run may benefit us all more than will the discovery of new and more expensive ways of operating on people's aortas." Mr Howard appears to be thinking of treatment of the chronic sick and mentally subnormal in terms of cost-effectiveness since he mentions expense and says that it may benefit all of us. This would certainly be the investigation of a real issue, but is such objectivity intended by Mr Howard?
Whatever else may be obscure in his letter, the theme of "more research" comes clearly through, and presumably he means a diversion of funds into something like Planning and Development. Surprisingly at the end of his letter it turns out that Mr Howard is a member of the Health Service Development and Planning Dept.
If Mr Howard's letter is a fair sample of its standard of work, then St Thomas's Health District financial problems can be partly solved by economising on this department.
Richard Williams The New Hall, Hedon, E. Yorks.
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