The internet can't replace doctors

Welsh Labour has abandoned its 2011 assembly election pledge to introduce annual medical checks for the over-50s carried out by family doctors.

Instead it will plump for an internet-based assessment system. It appears that when Labour put its manifesto together it failed to talk it over with the nation's doctors, who weren't keen on the extra work.

Health Minister Lesley Griffiths says research - presumably done after the promise was made - raised questions on the value of universal checks.

"The checks programme adopted will provide a modern gateway to prevention and health information services in Wales and take an innovative and holistic approach," Griffiths claims.

Sounds like a cobbled-together alternative to me - cobblers, in short.

What is it that induces this childlike belief in organisations that the web is always the best way of communicating with the public?

I would submit that in this case it may be inappropriate as the over-50s - and I'm sorry if I'm underestimating an age group to which I belong - will contain a fairly high percentage of computer-illiterate beings.

Besides which negotiating a complicated form without a helping human hand can be tricky for all age groups.

Griffiths believes that "people are increasingly going online to access services at a time and place that suits them."

Not many of the over-50s I know.

But all is not lost - community-based support will help in "alternative ways." Details on how this will work will be delivered by Public Health Wales and be introduced over three years.

The "innovative and holistic" approach appears to have one advantage, which is that it doesn't inconvenience doctors. This is a side effect of the rather big disadvantage where medical checks are concerned - that it doesn't involve doctors.

Wouldn't it have been better to engage with doctors to redesign the scheme to get them on board? Most over-50s probably see their doctors once a year anyway, and regularising this and involving a couple of health checks wouldn't be too hard. Or you could hold the checks every two years, or limit them to the over-60s.

The inconvenience of conducting these tests would be outweighed by the benefits accruing to doctors and more importantly their patients.

The situation as it stands is that in most cases illnesses aren't dealt with until they become very serious or chronic.

This means that people suffer greater pain for longer, there's a smaller chance of a cure and the treatment ends up costing more.

And once they became routine these tests would help in longer-term health planning through identifying what illnesses are suffered by the population and what the main causes of them are.

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In north Wales as elsewhere NHS administrators are grappling with cuts caused by an illness known as Bankers' Greed.

They're instituting a programme of hospital closures and centralising facilities, ensuring patients have to travel further to get treatment.

The public's reaction is to fight to keep facilities open. The biggest problem will be faced by the elderly, many of whom have no transport of their own.

North Wales's executive director of primary care and community health services says: "We cannot give categorical assurances to provide transport for everyone affected by the changes."

So some people will have to walk...?

Health bosses have said they will invest £80,000 into helping cover travel costs for those affected.

The funds "could be" used to help improve local community transport.

Protests against hospital closures have not addressed this issue. At present people who will need to travel further to get to hospital face a privately owned public transport system, mostly by bus, that provides a minimal, expensive and complicated service.

The proposed centralisation of health services will only make things worse unless transport is part of the plans and not an afterthought.

Health boards, local councils and bus companies need a comprehensive, enhanced plan for community transport schemes linked to hospital switchboards.

If the health boards want a 21st-century health service transport must be part of it.