Since this kind of headline hit the papers a few weeks ago, there has been much panic that it means patient care is about to go rapidly downhill. I don't believe that is the case.
What the headlines don't tell you, but which you will easily discern if you read on, is that the medical profession are keen to scrap interventions which aren't helpful. Interventions include investigations (MRIs, X-Rays, CT scans, blood tests etc) as well as treatments (drugs or otherwise). Not only do they want to scrap those which aren't helpful, they also want to scrap those which might be harmful. And yes, such interventions are going to also be a complete waste of public resources and it will, inevitably, save money.
The Academy of Royal Colleges would like 'doctors to start talking honestly to patients about the benefit or potential lack of benefit from a certain procedure and the possibility that some treatments involve risk, and about alternative ways of handling their illness.' They are concerned that treatment is being driven by patients' expectations rather than by what might be a healthy medical approach. Treatments are being given, often at great expense, but based on very little evidence that they will be beneficial.
Of course, this is partly money-driven. But rightly so. We value our national health service but we also make (often unreasonable) demands on it. A free health service is an incredible privilege. But we have to take care of it and use it wisely.
As you may know, I do some work within the NHS environment, providing my skills to the NHS as a qualified practitioner. It gives me an interesting insight into the use of and the attitudes towards NHS-provided care. I notice that many patients who use the NHS for one service, also use it for many others. In my opinion they become a little reliant on it.
The medical profession tend to encourage this. Instead of insisting on seeing signs of a healthy diet and more exercise, they prescribe statins and beta blockers to reduce cholesterol and blood pressure. But the frameworks used to measure hospital and GP performance give them targets that encourage this approach. GPs are not always able to treat entirely according to the patient's best interests, rather they work to meet a variety of criteria used to measure their performance.
Naturally the Patients Association has voiced its concern that this approach may lead to rationing of investigations and treatments. However, the Royal College of GPs is clear that it's partly about using resources wisely and resonsibly and partly about ensuring the best patient care.
Best patient care isn't always what you think it might be. Most of us now understand that taking antibiotics to combat the flu is pointless. Most of us would not consider continuing on a course of antidepressants if we felt no benefit. Most of us understand that taking painkillers to deal with back pain is no long-term solution. And that's really all the College are saying. Rest and vitamins for colds and flu. Mindfulness and gentle exercise and talking therapies for depression. Osteopathy or other manual therapies as well as exercises for musculoskeletal problems.
In conclusion, there's been a fairly negative reaction to this announcement but if you have a think about it, don't you want the most appropriate course of action for your own health?