Politicians have made a strategic mistake in putting the patient before everything else in the quest to achieve effective health care. Their debates about the NHS have been based on a set of entirely false notions about what matters to patients, states the editorial. Meanwhile doctors have been left demoralised by targets that compromise patient care, shift work that compromises professionalism, and a massively over-managed health service.

The Lancet comments: "John Reid, the present Health Secretary, has spoken of a "personalised health service", one in which the patient takes control of decisions about the prescription of medicines and the selection of surgical procedures. Yet this attitude is manifest nonsense. If doctors have any role at all--and perhaps they do not in Dr Reid's world view--it is to establish a partnership with the patient. A partnership based not on power or untrammelled patient choice, but rather one based on mutual respect. Respect by the doctor for a patient's anxiety and care preferences. And respect by the patient for a doctor's skill and professional expertise.

"What UK medicine needs is a new and stronger political voice, one that is more concerned with augmenting professional standards than with protecting professional status. That voice does not exist at present. Doctors want to strengthen their professional morale because they know that a more robust and motivated profession will mean better outcomes for patients. Currently, no politician recognises this truth. May 5 will therefore not be about democracy at all. The public will be voting in a vacuum of fact. And our collective health will surely suffer the consequences."

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Contact: Joe Santangelo
j.santangelo@elsevier.com
1-212-633-3810
Lancet
28-Apr-2005