Letter from the Adviser: Lynn Young
No doubt, TB nurse specialists in England are wondering what Lord Ara Darzi is up to with his NHS review – and nurses working in Wales, Northern Ireland and Scotland might be thinking that they wish to remain apart from England with its addiction to continuous change ...
More change does lie at the heart of English health services and with it a recent announcement made by Prime Minister Brown to the effect that there will shortly be a major consultation on the future funding arrangements for social care. We, who work in health care and who therefore focus on health care, also need to keep an eye on what is happening to our local social services department. If you think that the NHS has problems with funding, it looks as if social services departments are about to implode with excessive demands and lack of funds. The following may have little to do with the incidence and management of TB, but it is important for nurses to have a sense of the bigger picture.
And the NHS is certainly moving at a pace in England. Nurses working in TB may be interested to learn that policy is designed to, once again, take all the attention away from hospitals and focus it well and truly in the community, the place where – if we get it right – we could do so much more to prevent disease.
London is rapidly becoming the European capital of TB – not something to be proud of – but plans are in place to prevent and manage TB better. As you probably well know, tracing those who have been in contact with TB and who, because of health and social factors are at considerable risk, is extremely difficult.
However, wearing my pathologically optimistic hat, there are reasons to be hopeful. With huge effort and political will we have the opportunity to significantly improve community health services. The Darzi Review is already recommending that the NHS has to focus as much on the prevention of disease as on the best possible care and treatment of it. Change is about to happen and may be quicker than is comfortable for most of us. Better health for all lies in the hands of primary care and it is in this setting where we need to get the right resources in place, with the right people and the right skills. If this happens, we have a good chance of becoming much more successful at preventing the spread of TB.
Enjoy the summer.