Report comment

Good debate here.
From a clinical perspective, I manage lung cancer, which is generally a disease of older age (average 72yrs in UK). Since it is also a smoking related, many patients have co-morbidities.
The more elderly and frail a patient becomes, the more their performance status drops off. This is crucial to clinical decision making. There is clear evidence that cancer treatments are less effective and potentially harmful to these patients. Therefore, they get less investigations and treatment, and are much more likely to get best supportive care.
This is just one area where being elderly and frail results is reduced consumption of resources.
It is also clear that late presentation is more of an issue in deprived areas. In fact, many patients die with undiagnosed cancers and other diseases. They just don't see their GPs enough. Complex reasons for this, but chaotic lifestyles and low expectations are examples.

This is clearly a very difficult area, but we do know that the social determinants of health are crucial.

We will never get an absolutely clear picture, but it make no mistake, Lansely's plans to abolish practice boundaries is not going to help matters.

Even if Lansley has a point, as Sheena has stated, he Has got the PR all wrong, once again!