Reform plan? No scan do

Copperfield considers the ‘scan-tastic’ future put forward by the Government’s elective reform plan

So Sarah has gone. You know, Case Study Sarah of Streeting’s ‘elective reform plan’ who rapidly achieved iconic status for needing multiple contacts, a scan and an MDT to get a diagnosis of rhinitis? She’s been edited out – offlisted, probably for abuse of NHS resources.

Which is unfair, because it wasn’t her fault. It was the system wot dunnit. As in the dystopian system the Government seems to think should be ‘modern healthcare’. And the one thing I learned from their vision – apart from the obvious fact that they don’t have a freaking clue about the role and value of general practice, which I don’t count because it’s hardly news – is that what the general public needs is more scans.

As in, more scanners. Extended scan opening hours. And more straight-to-scan pathways. Oh, and for scanning to become so routine as to fit in with, and become part of, your shopping schedule (I’d cite ‘Sarah case study’ here but I can’t, for obvious reasons).

Which chimes exactly with the public’s perception. Patients simply can’t be arsed to answer lots of tedious questions from their stupid GP. They know what they need, and that’s a thorough whole body scan, and they need it now. The tone of the reform plan suggests the authors have exactly the same attitude.

So everyone will be happy, except for those who know absolutely anything about medicine – for whom this is a vision of hell. If I’ve learned one thing in decades of practice it is that the key to safe and effective care is a careful history, with everything else playing second and third fiddle. Every move towards this dehumanised and scan-tastic future erodes that truth.

Worse still, there’s no acknowledgement of the dangers. A scan is a loaded weapon which can backfire horribly into multiple spin-off iatrogenic blind alleys. If patients weren’t ill to begin with, they certainly are by the end of the process. If you don’t believe me, I can only assume lung cancer CT screening hasn’t hit your patch yet.

All of which suggests that perhaps Sarah’s disappearance has a darker explanation. Which makes me wonder: will medical examiners accept ‘Incidentaloma’ as cause of death?

Dr Tony Copperfield is a GP in Essex