Some people are describing the new changes to the NHS as the biggest ever. It depends on your perspective. I can guarantee that from a patient’s (i.e. ‘user’) perspective, you won’t notice much if anything. If you have a health problem, you’ll still probably contact your GP, have a frustrating conversation with the receptionist, who may eventually ‘allow’ you an audience with a GP. S/he may or may not know much about your condition, and so, by lottery, you may get referred on. In time, you may get seen by a doctor who knows what’s wrong with you, and hopefully they’ll prescribe the right treatment. The whole process usually takes a long time, is unpredictable and liable to fail at many points. ‘Gatekeepers’ hinder your progress at every turn.
The central, simplistic issue is how to join together the person with the problem and the person with the answer. All the rest is intermediary. It seems to me that IT systems are very good at ‘disintermediation’, i.e. routing the message to the right destination quickly, even if it is highly circuitous.
Wouldn’t it be good to easily get past the ‘gatekeeper’, and rapidly find the right answer? Referrals could be ‘shaped’ upstream, that is, directed appropriately, and a few, suitable alternatives presented, which could then be accessed straightaway. Isn’t it about time that the NHS broke down the dividing walls between health issues and solutions?
There are many instances in the past of where barriers have been constructed to ‘protect’ something we’re told is highly valuable. In the end, they look like Berlin walls of oppression. Eventually, they get kicked down!