A friend once told me that he had split up with his partner. This was a surprise to many of us as we thought that they were a great match. "What went wrong?" I asked. "Yeah, we got on fine", he replied. "The problem was the we couldn't agree who was in charge"
That made me think about healthcare. Who's in charge, or rather, who thinks they are in charge? Patients? Probably not, but at least they are getting better informed. Governments? Well, sometimes, maybe, perhaps. Clinicians? Hurrah, GP commissioning is back in Britain! Companies? Researchers? Insurance companies? On top of that we have charities, lobbying organisations and a myriad of special interest groups. Not easy, is it? No wonder we're not getting on.
What you have, within the healthcare ecosystem, is a network of influencers. It's always changing, it differs widely among countries and even regions, and the levels of influence are always fluctuating. Currently the whole network is under some strain, as resources are so stretched. This increases the pressure on everyone, and stresses within a relationship get much worse when money is tight.
The new NHS White Paper, published by the UK Department of Health, "represents one of the biggest shake ups of the health system since the NHS was established" (King's Fund), as an attempt to streamline processes, empower decision making and encourage THE BIG SOCIETY to make a contribution . The King's Fund examines the issues that it raises, analysing the reforms it suggests and commenting on the topics it discusses in both a health care and wider context. Take a look and see if you can figure out who's in charge!
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