I’ve said it so many times I am boring myself, but if you want to save money
in the NHS it’s not so hard to do it. Choose and Book, all NHS logos and
branding, all NHS advertising health promotion campaigns, NHS Direct for all
except acute care, the electronic records system, etc, etc, etc. They don’t
work, and they create layers of bureaucracy wasting time and effort.

What we never get to hear about are the small, local schemes which keep
vulnerable people well and which provide constant support and knowledgeable
and personal care for people. Such as Valerie Lodge, a drop-in centre for
people with mental health problems. Mental illnesses, as anyone who has been
affected by one will know, are often chronic and people are often very
frightened of relapse. Support by trained professionals can help people keep
well and often help quickly if relapse is suspected.

There might be scant randomised controlled trials on how well these kinds of
low-key interventions work, but that’s the fault of research priorities in
this country, not the people who work in them. But if you are going to try
and analyse the benefits – or not – that such services offer, please don’t
try and do it the way they did when Bob Farmer asked questions of why the
service was cut. The PCT decided that ‘service users’ (sorry, I will
have to call us ‘patients’, since I hate the phrase so) didn’t want the
services that Valerie Lodge had to offer. They claimed they had the data to
prove it. But the data didn’t compare equal groups of patients before and
after the service was reduced – instead it was a mixed group where what
they had was a group of people who had been offered a different service and
compared them to people who had had a large cut in hours at Valerie Lodge.

This is the best bit. When Farmer appealed his complaint, the reply he got
said that:

“As far as clinical advice is concerned, we considered it would be helpful
to have an adviser’s view as to whether the PCT’s reply to your complaint to
them had been reasonable. Our Adviser considered that the PCT had acted
reasonably and responsibly. The Adviser did not have experience of, or
advise on, data analysis, but I do not consider that fact to call into
question the advice that was provided.”

So if you can’t analyse data, you can still advise on decisions made on the
basis of it: that makes no sense to me.