The NHS in England has seen significant improvements since 1997 but health inequalities have widened and out-of-hours GP care needs improvement, according to a major review of the health service published yesterday (12 April 2010) by the King's Fund.
Improved access to primary care and significant reductions in waiting times have been key successes since Labour came to power, says the think tank's independent assessment of progress made by the NHS between 1997 and 2010.
However, the review says the health service needs to change rapidly if it is to meet financial challenges of reduced funding and an increasingly ageing population.
Furthermore, improving access to out-of-hours GP care, embedding a stronger safety culture across the NHS and tackling obesity and alcohol-related illnesses, which have increased since 1997, were among areas highlighted as needing improvement.
Professor Chris Ham, the new Chief Executive of The King's Fund, said: "Back in 1997, the NHS was in intensive care. As a result of investment and reform, it is now in active rehabilitation and is delivering more care to more people, more quickly.
"The next government faces a huge challenge in nursing the NHS to full health at a time when funding will grow very slowly, if at all. Doing more of the same is no longer an option. The NHS will have to do things differently by embracing innovation and becoming much more efficient in how it uses the £100bn it spends each year.
"The NHS must now transform itself from a service that not only diagnoses and treats sickness but also predicts and prevents it. This will not be easy and it is vital that politicians engage in an honest dialogue with the public about the changes needed."
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What's your view? Has primary care improved since 1997? Your comments: (Terms and conditions apply):
"What Mr Langford [below] doesn't mention are the stipulations surrounding his appointment. Was there a specific GP at a specific time? If he was prepared to be flexible on both of those issues and was still only able to get in on a Thursday I would possibly have issue as well. However, to base the funding of a GP contract on access alone is staggeringly naive. He doesn't work for the PCT does he?" – K Power, Lancashire
"I am with David on this [below] – patients have absolutely no idea what drs do, all they see is that they have more rights than ever according to government what they do not see is the that all these new rights bring new work new paperwork but no extra cash in many cases. Why should highly educated Drs work for poor wage anyway, lawyers etc don't – I know I am a lawyer! Married to a GP and despair of him living to see retirement if he does not cut his workload" – Name and address withheld
"Mr Langford [see below] is obviously not involved in primary care. If he was, he would be aware of: a) The amount of money that has been clawed back by the government of the last five years; b) The amount of extra work that has been pressed upon primary healthcare teams without adequate renumeration (and all taking more appointment time); c) The increased demand from patients through media hype, government propoganda, new medicines and pathways, patients lack of self-care, etc. We are open longer, see more people, and deal with more issues. However, despite huge amounts of work and investment, we cannot cope with the huge demand and trying to meet artificial targets for access at certain times of the year. As to out-of-hours, the system, in our area at least, is actually very good. Triage is an essential part of every service these days and through its use patients are seen appropriately. Nobody can expect a better service at night than in the day time. If it is urgent they are seen quickly. Nice to see government propaganda is working its black magic on the minds of readers here too" – David Doig, Buxton
"Just because one does not get an appointment for a day his regular problem it does not mean there is no improvement. One should know the amount of work, amount of documentation work apart from his clinical work a GP does today and before 2003. He does not get money for nothing. Any fool can comment or question but even a noble man cannot answer or satisfy every patient" – J Ravindra, Maidstone
"Not that I've seen. I rang for a doctor's appointment on Monday morning and the first one offered was Thursday. Combined with shorter opening hours and poor access to out-of-hours services I fail to see any reasons for GPs being paid substantially more than they were before the 'new GP contract' of 2003?" – Peter Langford, Wonersh