Committee calls for substantial investment in allergy services
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《英国医生杂志》
The government needs to make a substantial investment in allergy services in the NHS in England, says the House of Commons health select committee in its latest report, which describes the current provision as "manifestly inequitable."
"The current provision... owes nothing to the geographical spread of allergy in the population," the report says. "Rather, it comprises those centres where specialist research in allergy has taken place, on the back of which clinical services have developed ad hoc."
No comprehensive allergy service in England north of Manchester and west of Bournemouth currently exists, says the report. The committee calls for a minimum of one specialist allergy centre in each of the former NHS regions (serving a population of 5-7 million). As an intermediate measure, though, until appropriate staff are available, it suggests a specialist allergy consultant be in post in most large teaching hospitals.
"To make this happen," said David Hinchliffe, committee chairman, "the government needs to heed the advice of its own specialist workforce planners and increase the number of specialist doctor training posts in allergy."
He dismissed health minister Stephen Ladyman's claims to the committee that there was no real evidence of unmet need as unconvincing: "The very absence of services is contributing to a perception of no unmet need since there can be no waiting lists for clinics that do not exist," he said.
Mr Hinchliffe also called for better training in allergy for GPs and the development of a cadre of GPs with a special interest in the field.
"The government agrees there is a problem, but hasn't faced up to it yet," he said. "At the moment, the NHS is not a national health service at all, so far as allergy is concerned."
The absence of a specialist service means that patients, and often GPs, are ignorant of treatment options. "Patients are instead given drugs, often for years and years, to manage symptoms, when one or two visits to an allergist could ameliorate their conditions, without the use of drugs," said Mr Hinchliffe. The report recommends that primary care should eventually be the main provider of allergy services.
Patients are often given drugs for years when one or two visits to an allergist could ameliorate their condition, the report says
Credit: JAMES KING-HOLMES/SPL
The Royal College of Physicians and the British Society for Allergy and Clinical Immunology have given a warm welcome to the report. Andrew Wardlaw, president of the British Society for Allergy and Clinical Immunology, described the report as "excellent."
"Unless there is some kind of national programme to provide a service, it is never going to happen in the current climate through PCT commissioning," he said. "We've been pressing the Department of Health for years on this, and they have always resisted it. At the very least this report gives us more ammunition for our campaign."
Currently, allergy is taught, if at all, as part of the immunology element of a doctor's medical training, he said. "It tends not to get a look in," he added.
Stephen Holgate, chairman of the Royal College of Physicians' allergy working party, also welcomed the report.(Lynn Eaton)
"The current provision... owes nothing to the geographical spread of allergy in the population," the report says. "Rather, it comprises those centres where specialist research in allergy has taken place, on the back of which clinical services have developed ad hoc."
No comprehensive allergy service in England north of Manchester and west of Bournemouth currently exists, says the report. The committee calls for a minimum of one specialist allergy centre in each of the former NHS regions (serving a population of 5-7 million). As an intermediate measure, though, until appropriate staff are available, it suggests a specialist allergy consultant be in post in most large teaching hospitals.
"To make this happen," said David Hinchliffe, committee chairman, "the government needs to heed the advice of its own specialist workforce planners and increase the number of specialist doctor training posts in allergy."
He dismissed health minister Stephen Ladyman's claims to the committee that there was no real evidence of unmet need as unconvincing: "The very absence of services is contributing to a perception of no unmet need since there can be no waiting lists for clinics that do not exist," he said.
Mr Hinchliffe also called for better training in allergy for GPs and the development of a cadre of GPs with a special interest in the field.
"The government agrees there is a problem, but hasn't faced up to it yet," he said. "At the moment, the NHS is not a national health service at all, so far as allergy is concerned."
The absence of a specialist service means that patients, and often GPs, are ignorant of treatment options. "Patients are instead given drugs, often for years and years, to manage symptoms, when one or two visits to an allergist could ameliorate their conditions, without the use of drugs," said Mr Hinchliffe. The report recommends that primary care should eventually be the main provider of allergy services.
Patients are often given drugs for years when one or two visits to an allergist could ameliorate their condition, the report says
Credit: JAMES KING-HOLMES/SPL
The Royal College of Physicians and the British Society for Allergy and Clinical Immunology have given a warm welcome to the report. Andrew Wardlaw, president of the British Society for Allergy and Clinical Immunology, described the report as "excellent."
"Unless there is some kind of national programme to provide a service, it is never going to happen in the current climate through PCT commissioning," he said. "We've been pressing the Department of Health for years on this, and they have always resisted it. At the very least this report gives us more ammunition for our campaign."
Currently, allergy is taught, if at all, as part of the immunology element of a doctor's medical training, he said. "It tends not to get a look in," he added.
Stephen Holgate, chairman of the Royal College of Physicians' allergy working party, also welcomed the report.(Lynn Eaton)