Thanks to Ted Harding for raising the news story on NHS Direct,
very pertinent when it gets a big plug in "the NHS Plan" as key to
the new NHS. Particularly from Ted's message:
> Tailpiece: A spokesman for the NHS Direct setup said that "There were
> serious design flaws in the study. There was no control, for instance."
> [Control??? Do the Automobile Association, for instance, need a
> Control Group when they investigate whether repair garages fail to
> detect or properly or economically repair deliberately created faults
> in test cars submitted for overhaul and repair? Forsooth.]
Sounds like the "spokesman" had latched onto a bit of pseudo-
scientific terminology to try and rebuff a embaraasing report.
Maybe the ball is in their court to set up a proper study:
*Research question: do patients using NHS direct have better
outcomes that those using conventional methods.
*Outcomes: ??patient satisfaction; resolution of symtpoms
*Method: random allocation of patients with defined symptoms to
a control group (?self medicate; ?call GP: ?do whatever you
would do if NHS Direct didn't exist); intervention group (put through
to NHS Direct)
I have the uncomfortable feeling that because NHS Direct is such a
flagship, the powers that be will not allow it to fail: they will
produce an extreme version of the Whig View of history "everyday
in every way it gets better and better: anything that suggests it
isn't must be investigated and rebutted."
When I went to a presentation on it in Jan, I recall bits like
*Increased number of ambulance calls being cited as
demonstrating its effectiveness (little attempt to decide if the
ambulance calls were appropriate)
*NHS Direct will go national: the evaluation is not to decide this,
but merely to inform the final form (i.e we have already decided in
advance it works: we are just tinkering with the details).
Regards Alan O'Rourke
Alan O'Rourke
Information Officer
Wisdom Centre for Network Learning
http://www.wisdom.org.uk/
Institute of General Practice
Community Sciences Centre
Northern General Hospital Sheffield S5 7AU
Tel: 0114 271 5095 Fax: 0114 243 3762
E-mail: [log in to unmask]
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