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Fundación Salud, Innovación y Sociedad "Contribuimos a la formación de opinión independiente" |
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| Entrevista David Taylor (inglés) Director de Atención Primaria. London Regional Office NHS Executive. Médico Generalista ejerciendo parcialmente en Runcorn (Chesire) Fellow de la Unidad de Gestión de Servicios Sanitarios. Universidad Manchester. Fellow del Colegio Real de Médicos Generales. Pionero de las reformas otorgando mayor participación e información al paciente, de nuevas formas de difusión de prácticas de excelencia y del impulso de la garantía de la calidad asistencial en la Atención Primaria. |
How did you come to health management?
My family has always been in the business. I studied social economics and kept interested by medical sociology and that's what I do.
What did you learn from today's conferences?
The first thing is that British and Spanish systems are very similar. They have in common the peculiar existence of primary care general practitioners dealing directly with patient. But the main difference is the high status (and revenues) that enjoy the British ones. The doctors have the highest individual status in the National Health Service. Another point is that we will have now to build a system considering the sovereignty of consumers who seem until now to be outside like in a retrenchment.
Why the Spanish and British Primary Care as a gatekeeper to Secondary Care is preferred to the other European systems?
There is some evidence that GPs are better to tell people what they have to do, not to see disease where they are not. It restricts people access to secondary care. A good gatekeeper avoids people to expose themselves to unnecessary risks. Operations kill 1% of the people operated. If you do not have to go in a Hospital, you are a consumer better off.
The British system was reproached not to provide enough quality and equity in its services.
My definition of quality includes some economic aspects and the aspects you want the service to have. We have to make clear whether it is detecting cancer, curing infectious diseases or also providing persons dignity, sense of control of their life. I got the impression that the debate in the UK about quality is much more advance than here. It is the pressure to deliver the proper services in a global competition context that drove evolution in the UK. Now, we already know how to solve the economic effectiveness so this bet is half solved. The problem is yet about continuing the social change. I think it is important to keep things better between nursing and medicine policies. In the short term the incentive now is the group, the Primary care trust. We give a group a common reason for achieving common goals.
