London Bridge Falling

Guess
what? Recent headlines in UK would have you believe that the government is
showing a new interest in preventive medicine. From now on,
GPs are to be allowed to
prescribe free air-conditioning at the expense of the NHS for patients with
breathing difficulties. It makes perfect sense, but this represents a really
radical departure for the NHS.

The mobile systems are one of a range of preventative health
measures detailed in a scheme entitled the “Framework for Health and Well-Being”/
The measures (addressing a multitude of health issues) all are designed to
address health problems before they become serious enough to require hospital
treatment or expensive drugs, and are hoped to save the NHS millions of pounds,
said a Department of Health spokeswoman.

The framework will advise GPs to encourage patients to adopt
healthier diets and lifestyles, exercising regularly to prevent health problems
developing. Practioners even are expected to be allowed to prescribe swimming
lessons for the obese and anger management lessons for violent teenagers.

The
Health Department spokeswoman explained that air-conditioning units could be
offered to patients with chronic respiratory disease which is aggravated by hot
weather, potentially forcing them into hospital. “As a preventative
measure, the GP could give them an air-conditioning unit ahead of a hot spell,
and save a lot of money in the long term,” according to health minister

“This is all part of public health strategy according
to the present health minister who wants the NHS to become a national health
service, not a national sickness service. “It is all about saving money by
stopping people coming back to the doctors offices again and again and stopping
them ending up in hospital.”

Speaking
as one physician to another, it is not a bad idea, even though the underlying reasons
may have been purely financial. I have heard that similar schemes have been
successful in the United States, in particular the one which took the care of
childhood asthma out of general pediatric offices and placed the patients in
selected specialist offices. The results were dramatic on two terms: far fewer
visits to the emergency rooms and far fewer prolonged hospitalizations.

Let us hope that it works. Till next month.

Karoshi

* London Bridge is Falling is a monthly column in the form of a letter to Dr. Keith from his colleague, Dr. Mahantesh Karoshi in London.