Healthcare Objectives

Healthcare  is a network of individuals and organisations.
Each has its own portfolio of objectives.
In these the improved care of patients today or tomorrow may not be uppermost.
Return on effort/investment might be a high priority and that in the shortest possible time.
Commercial companies must satisfy their shareholders first and foremost and while classical economics might suppose that they would best achieve this by satisfying their customers - in this case patients, healthcare professionals, or organisations, the reality is more complex.
Goldacre takes big pharma to task for its manifest failure to hold the welfare of patients as its highest good and attending instead to its perceived best, its duty to its shareholders. In the end by whatever route a commercial company must attend to the needs of the shareholders who are the best organised of the three contributors (shareholders, staff and customers) to the company and can most readily affect performance and effect change.
This is uncomfortable reading for those of us who would wish to see patient welfare as the highest good and accordingly must encourage us to reflect on current models of provision. The private sector may not be the best model
'via Blog this'

What's it Worth?

Today we learn of a small child with a debilitating lifelong disease - Atypical haemolytic uremic syndrome.

Her quality of life can, we are told, be markedly improved by a new vastly expensive medicine costing around £250000 per year, though there might be costs of her current treatment which might be avoided.

Can she have it in a communally funded system?
The details of course need scrutiny - is her quality of life that poor without and would it be much better with the medicine? Is the pharmaceutical company charging a reasonable price? And so on. But supposing they are all true?

And supposing we agree she should have the medicine?

Can we make savings elsewhere?  What about children not yet conceived? How much should we spend on assisted conception? If the parents to be, on investigation, show no tangible disorder apart from advancing age should we still fund treatment? How good are the results of assisted conception in parents of a certain age who have returned broadly normal findings on investigation? Is investment here worthwhile? Have such intending parents perhaps just waited too long to start a family and foregone their opportunity? Should a communally funded system just accept such a situation?

Perhaps we could fund that little girl after all.

Doing Without.

No not doing without healthcare - though many indeed do without.
No
Healthcare is doing without crucial help which would massively improve the help it can give to you and I. The illnesses we experience and the diseases which often are the cause of these illnesses are intimately affected by how we live together. They have a profound social dimension - part political, economic, psychological, chemical and physical. Our social situation is a major element in our well-being - or lack of it. Healthcare would be enormously improved if we had a reasonable understanding of what the social dimensions were and how they operated. For that we need social science. And there is none that is useful. There are of course social scientists aplenty, reading and writing all about healthcare. But nothing that is of the slightest value.
Social science is hard. It is much harder than physical science. It needs the sharpest minds and the most diligent workers. It has neither. Social science is seen in universities and the like as "soft science" and attracts students so motivated.  Social science (or sociology) grasps an issue, gathers a (very) few data, looks up its index of theories, makes the connection comes to the wrong conclusion and publishes. Mercifully few ever read the outpourings. So far so harmless.
Except
Social science is crucial for the improvement of healthcare. Healthcare needs to accept this and get together with universities to devise a programme of teaching, education and research which will address the real and compelling issues which continue to afflict patients and limit their chances of making a full recovery.
It will not happen soon, and the results when it does will be slow to appear (if it is done properly), but we must hope it will happen and our descendants at least will benefit.