Late last evening I received a text. The message from a friend of mine simply asked: “What did I think of David Cameron’s speech?”
I have not yet replied because the real answer is that I simply do not know what to make of it. Certainly the promise to end the target culture was encouraging - and indeed not surprising. Targets have done much to destroy the doctor/patient relationship.
We have consistently argued to government and the opposition that the competing priorities between clinical need and political targets have led to a dilemma for doctors almost impossible to reconcile. So, well done David Cameron.
But the flip side is that doctors will be asked to trade-off the target culture against a new measure of patient satisfaction, and greater patient choice. The concept of patient satisfaction is in itself no bad thing. If you don’t like the service from the bank, then change bank.
As the Royal Mail is finding to its cost, if you don’t like the service then change to a different courier or use the electronic technology now available.
But how does a patient assess the quality of medical care and treatment? No matter how good the doctor, prognosis and treatment are not necessarily indices of success. And the environment is not one necessarily controlled by the doctor alone; the doctor may lead the team but health outcome is governed by a complex combination of factors often outside the doctor’s influence.
If we have to work through these issues as a price for losing the dreaded target culture it seems to me that is a price worth paying. I think I will reply to my friend’s text as follows: “Speech encouraging - the devil will be in the detail!”
Tags: Cameron, Patient satisfaction, Targets
