The State of Healthcare 2005 reveals that though many improvements have been made in health provision, a group of “Cinderella services” is being badly neglected, including dentistry, sexual health and parts of primary care.

The review, carried out by the Healthcare Commission, concludes that the NHS still has a long way to go to achieve a “patient-led” service, a key ambition of the Goverment. While praising the progress made in the treatment of conditions such as cancer and heart disease, the health inspectorate found some areas of the NHS to be severely wanting.

In its analysis of primary care, the commission found that access to a GP remained a problem for many people, with around 25 per cent waiting more than 48 hours for an appointment. Ministers have claimed that the problem affects fewer than 2 per cent of surgeries. In London, demand for services is such that four out of five GPs are unable to take on new patients.

The review, which was presented to Parliament yesterday, offers further evidence of the well-documented pressures on NHS dentistry. It said that nearly 60 per cent of NHS dental practices were not taking on new patients — an increase from 40 per cent in 2001 — and in some areas no dentists are taking on new NHS patients.

Poor communication between doctors and patients was identified as another problem, with people left in the dark about the type of medications they were prescribed, their treatment options and the specifics of their conditions. The commission said it was particularly worrying that more than a third of patients were not given information on the side-effects of medicines.

One in seven patients also took issue with surgery receptionists’ manner, while up to a quarter of patients in some trusts reported that the staff talked about them “as if they weren’t there”.

The commission also highlighted poor standards in maternity care, which were documented in its recent report into services at Northwick Park, in north London.

Staff were found to be overstretched, working in cramped conditions with inadequate equipment. Poor management was identified as more at fault than lack of money.

The report also reveals the long waits for sexual health services, with 28 per cent of people needing to be seen urgently having to wait more than 48 hours, and 29 per cent of people with symptoms waiting more than two weeks.

Only half of sexual health clinics were found to be open more than 21 hours a week. The commission said that half of people with depression were not receiving treatment and 23 per cent on mental health and learning disability wards were still in mixed-sex rooms.

However the review also welcomed many improvements, including the greater choice given to people over where they had their treatment and the ability to choose quicker treatment in some areas.

Sir Ian Kennedy, the commission’s chairman, said there were many achievements to celebrate in healthcare provision.

“Services subject to targets and the requirements of national frameworks have produced significantly better outcomes, particularly for people with cancer and heart disease,” he said.

“The Government has set itself the aim of a ‘patient-led NHS’. But our health services still have a long way to go before we can say that they are really putting patients first.

“Being an NHS patient is too often a frustrating experience. Services can seem fragmented and seem to be designed more to suit the needs of those providing them than those using them.

“People want better access to services, and they also want to understand what doctors tell them and to be treated and spoken to in a caring manner. They need more comprehensive information about their health and appropriate involvement in the decisions about their care.”

THE BAD

• 58 per cent of dental practices are now not taking on new patients, up from 40 per cent in 2001
• Only half the adults who have serious mental health problems receive treatment
• 28 per cent of people needing urgent sexual health care are having to wait more than 48 hours for an appointment
• A quarter of patients are not being seen by their GP within the 48-hour target
• One in seven patients reports problems with the manner of GP receptionists

  THE GOOD

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