I work in the NHS – the National Health Service. I was just wondering the other day……..why isn’t the NHS primarily about delivering services which are intended to improve health?
Pardon?
Well, think about it for a moment. Almost all of the services in the NHS are organised around diseases or body systems. Next door to where I work is the “Cancer Centre”. Around the rest of Gartnavel site there are departments of Infectious Disease, Dermatology, Rheumatology, Gastroenterology etc – all with a clear focus on delivering care to people with specific diseases and administering treatments designed to modify or manage disease processes.
That’s what health care does. It conceptualises illness as disease, usually by identifying objectively measurable changes in the body, then uses either surgery to cut out diseased tissue, or administer drugs “proven” to modify defined physical parameters (blood pressure, blood sugar levels, inflammatory markers etc). The hope, I’m sure, is that in doing this, health will emerge or improve.
My point is, that very little of organised health care seems to be structured explicitly, or directly, to stimulate or create a condition called health.
In fact, when I ask groups of doctors or nurses to give me their definition of health without referring to either illness or disease, they frequently struggle. Health doesn’t even get an entry in standard textbooks of Medicine, and the stated goal of Undergraduate Medicine is to teach doctors how to make a diagnosis (of disease). Despite that, I’m pretty sure most doctors and nurses would say they go to work each day to try to improve the health of their patients. The odd thing is that by focusing on disease and it’s management, health improvement is left to Nature, or chance, or hope. It’s kind of a side effect of the interventions delivered. A hoped for side effect.
Wouldn’t it be a good idea to have some of the Health Service focused directly on health? Might not a focus on health produce some useful impacts on the presence or progress of disease? Wouldn’t it be a good idea, in other words, to have another approach which directly intends to stimulate and increase health, and which hopes for a side effect of reducing disease?
But here’s the main idea – what about an integrated health service – where, with the focus centred on the patient, care is delivered which impacts on disease AND care is delivered which impacts on health – in each case, directly.
We’re well placed on the Gartnavel site in Glasgow. We’ve got the services focused on disease, but we’ve also got the Centre for Integrative Care, Glasgow Homeopathic Hospital, (where I work) which is focused on health. Here’s a photo of the site
The red circle is around Gartnavel General, the physical disease hospital, the yellow is around Gartnavel Royal, the psychiatric disease hospital, and the blue is around the Centre for Integrative Care, the health-focused hospital.
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