The bigger picture

The future of healthcare is constantly debated by politicians, policy makers, academics and clinicians. No one has the answer as to how to organise healthcare, pay for it and ensure that the citizens receive what they require to lead full and healthy lives, writes Dr. Peter Lachman.

Dr. Peter Lachman
Dr. Peter Lachman

We need to have a vision with an ambition goal, while we try to solve the day to day minutia of care delivery.

This will mean that the role of healthcare organisations needs to change fundamentally to promote health promotion above the treatment of disease.

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The WHO has started to focus on several key programmes that may make a difference. Perhaps if we keep these in mid it could help focus our efforts to improve care.

When one is mired in the challenges of meeting waiting list targets, moving patients off trolleys in the ED and trying to balance the books, one needs to have the wider vision of healthcare in mind.

The first is a return to a basic human right of universal healthcare. The aim is that countries all move toward providing this basic right. The issue will be around who pays for it and what should be included. I think that focussing on maternal and child health, with promotion of healthy lifestyles in the early years, will be a good long term strategy for this, but the first step is acceptance of the State’s responsibility to provide UHC. http://www.who.int/universal_health_coverage/en/

A second programme is the provision of integrated care with an emphasis on enhanced primary care that is truly person centred – proving care where it is needed when it is needed. The framework for integrated care implies a restructuring of healthcare delivery with a new way of looking at how healthcare is organised. http://www.who.int/servicedeliverysafety/areas/people-centred-care/en/

A third programme involves the increasing need to provide safe care and there is a focus on medication harm with a new challenge to decrease medication harm worldwide. This is the third global challenge and one which focusses on the greatest area of harm. http://www.who.int/patientsafety/medication-safety/en/

Now why am I raising the issues here. It because when one is mired in the challenges of meeting waiting list targets, moving patients off trolleys in the ED and trying to balance the books, one need to have the wider vision of healthcare in mind. If we looked at the bigger picture and then paid attention to the detail perhaps some progress would be made in our continual improvement of the care we deliver.