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编号:11341997
Professor Ian Philp
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     Health tsars: spin or substance?: Eight health directors ("tsars") were appointed from 1999 to 2002. Katherine Burke asked them to summarise their achievements and other people to assess their work. A ninth "tsar", Dr Sue Roberts, was appointed in March 2003 to cover diabetes. The full text is accessible at www.bmj.com

    Professor Ian Philp

    National director for older people's services

    Appointed: November 2000

    My achievements: The national service framework for older people has changed NHS culture, particularly in relation to age discrimination. It used to be routine to refuse patients heart bypass surgery if they were old. But since the framework was published the number of people aged over 65 years getting heart bypass surgery has risen by 16% and the number aged over 80 has increased by 65%.

    Another achievement has been the development of intermediate care services to bridge the gap between patients' acute care in hospital and their returning home. More than 200 000 elderly people have benefited.

    I have also maintained change while taking people with me. I have set up a coalition of over 50 organisations—professional groups and advocacy groups—which are working with me nationally.

    What others say

    Dr David Black, consultant geriatrician and chairman of the England council of the British Geriatrics Society: To be treated as a priority area in the current NHS you need a tsar. There can be no doubt that having a geriatrician as a national director has helped geriatric medicine. However, the appointee is still a government employee. Professor Philp and other tsars find that it is not always easy being in a leadership and management role rather than in a role as a representative for a specialist society.(Katherine Burke)