Re: Labour sets out stall with ambitious primary care reform agenda

Dear Editor

Before road testing bold ideas it would be a good idea to discuss first with experts and save later embarrassment. The rowing back from Labour’s assertion that patients should be able to bypass their GP and self-refer to specialists is welcome (1). However, recent proposals by Wes Streeting (2) suggest he is unaware that opticians can already refer directly to hospital specialists (3) or that the walk-in chest X-ray service in Manchester (4) is not an NHS service as such, but the first stage of a pilot research study – a partnership between the Greater Manchester Cancer Alliance and AstraZeneca UK.

The UK National Screening Committee has recently recommended targeted screening (5) for lung cancer and that this should be integrated with smoking cessation services. Unfortunately, local authority funding for the latter together with tobacco control measures has been cut by 46% (6). A commitment by Labour to make the NHS work better for patients is welcome, but this will require a very significant increase in funding as well as the promised enlarged workforce. Wes Streeting would do well to heed the words of the Health Foundation’s Anita Charlesworth: “There is no route to a better NHS that is not an appropriately funded NHS” (7).

At a recent emergency care summit (7), Anita also emphasised that the key was building sufficient capacity in the NHS, which was hampered by a long-standing lack of capital funding: “If we had matched the levels of capital funding of the EU14 countries the NHS would have invested an extra £33 billion by now.” That’s why the backlog maintenance bill has soared to almost £11bn, and why there is not a better digital infrastructure and why the NHS lacks the numbers of scanners and additional pieces of equipment other countries have. It is no good Labour imagining that, should it gain power, simply shifting resources from secondary to primary care will solve the pressing problems now faced by the NHS.

References
1. https://northeastbylines.co.uk/self-referral-no-thank-you/
2. https://www.theguardian.com/society/2023/feb/22/labour-reforms-will-save…
3. https://www.abdo.org.uk/regulation-and-policy/advice-and-guidelines/clin…
4. https://www.manchestereveningnews.co.uk/special-features/drop-in-chest-x…
5. https://view-health-screening-recommendations.service.gov.uk/lung-cancer/
6. https://www.health.org.uk/news-and-comment/charts-and-infographics/publi…
7. https://lowdownnhs.info/emergency-care/emergency-care-summit-the-lowdown…