The fairy godmother has spoken

Our Editor, in his comment on the White Paper ‘Our health, our care, our say’¹ rightly points out that ‘the difficulty of provision for disadvantaged groups is a stain on the face of primary care.’ He later says that the proposition that life checks for all, as proposed in this government White Paper, are likely to be of marginal value.² This might be true of the articulate worried well. However, some disadvantaged groups are very likely to benefit considerably from structured relevant health checks, for example, people with severe learning disabilities.³

As far a people with learning disabilities are concerned, a previous government White Paper (2001)⁴ promised Health Action Plans (HAPs), for all patients with learning disabilities, by June 2005. A sample of 451 practice managers responded to a questionnaire about the Valuing People targets in November 2005. This suggested that ‘the targets for the White Paper have not been met, and in particular most practices seem unaware that they exist … 76.7% of practices overall did not know how many of their LD [learning disability] patients had been offered a HAP’. Health checks are necessary to inform HAPs. Nearly 67% of practices said they could identify their patients with learning disabilities and 36.4% said they offered health checks, mostly annually' (personal communication, 2005). With regard to people with learning disabilities this new White Paper says that the Department of Health ‘has previously committed to introduce regular comprehensive health checks for learning disabled people … We will review the best way to deliver on this earlier commitment.’ (page 100)¹ As David Jewell says of the new White Paper, ‘It is government as fairy godmother … No doubt we should all like to go to the ball, but … who is going to pay?’¹

Those with learning disabilities often, like Cinderella,⁵ remain as our submerged silent minority patients. While reviewing the best way to deliver, why not get on with delivery now? If a third of practices are already providing some form of health check service to their patients there should be plenty of experience on which to draw.

What is needed is cash rather than further procrastinating reviews. Why not ensure fulfiling 100% of current targets now, which if done properly, will involve appropriately structured health checks? GPs, in working with their patients, carers and nurses, should be well able to deliver. What is needed is government putting money where its mouth is. Fairy godmother has spoken again, this time she must also wave her wand.