Today, I would like to remind you of a tale from Greek mythology. It concerns the city of Troy; a city that did in fact exist and whose ruins can still be seen today in northwest Turkey. Troy was the centre of the Trojan Wars, which occurred somewhere between 1200 to 1400 B.C. About that time, the ruling Royal family of Troy was King Priam and Queen Hecuba, and they had a beautiful daughter called Cassandra. Unfortunately for her, Cassandra had the power of foresight. I say ‘unfortunately’, as on many occasions nobody was prepared to believe her. One of her disregarded prophesies was the destruction of the city of Troy; something which indeed took place (remember the story of the Trojan Horse?). In modern times, the term ‘Cassandra Syndrome’ is used to describe the malady affecting those who disbelieve predictions of doom until the events actually occur.
Now, on no account am I suggesting that I can be compared with an attractive lady of royal parentage. However, I do feel that I am one of a growing band of doctors who have the power of prophesy (solely, it must be said, in relation to the future of the NHS) but have up to now been largely ignored. I can almost hear you yawn at this stage, and I appreciate that it may be a little tedious, but I make no apologies for returning again to the subject of the new Health & Social Care Act. Please read on, because I have a job for you all to undertake.
The fact is that, although the Act has been passed by Parliament, the detail has still to be implemented. In this respect, we can all be influential and potentially alter the destructive power of this Trojan Horse that now stands at the gates of the NHS.
There are two major issues for us. The first is to save the ‘National’ in the NHS. In an attempt to form a shared vision of the future of the NHS, the Royal College of General Practitioners (RCGP) is trying to encourage the adoption of a set of ten ‘core values’, against which the Act will be implemented. These values are: greater involvement of GPs in shaping NHS care, a UK-wide agreement on free NHS services, integration of health and social care, reduced bureaucracy and increased efficiency, patient empowerment, respect for patients’ beliefs and valuing diversity, patient involvement in shaping NHS services, encouraging innovation, promotion of public health, and cutting inequalities.
The second major issue stems from one of these values; that is the need for a national approach to public health. Under the new Act, public health services are moving from the umbrella of the NHS to the local councils. With no disrespect to my local authority colleagues, there is a widespread concern that councils are ill-prepared for this change, especially at times of epidemics. Already, we have seen a diminution of national advertising campaigns (last year’s influenza vaccine campaign suffered as a result, and we had a higher death rate from influenza than most other European countries). The fear is that, with more decisions of this nature being taken locally, will the public be as well informed of major health risks as in previous years? Sometimes, national leadership is the most effect way to get a message across.
So, your task, readers one and all, is to join me, along with my colleagues at the RCGP, and start to question how the Act is being implemented. Talk to your doctors, question your MPs, attend local council meetings, get involved with patient participation groups, write letters to the newspapers; in essence, take control of the future of your NHS. Please do not become victims of the Cassandra Syndrome. The Secretary of State for Health has delivered a modern day Trojan Horse to the doors of the NHS; don’t accept it as the gift he likes to pretend it is. Look to see what lies beneath and neutralise its threat now before it is too late and the NHS becomes your Troy.
(First published in the Scunthorpe Telegraph, Thursday 26th April 2012)