David Brooks

NHS data book

1 Population.- 2 Socioeconomic factors.- 3 Mortality and morbidity in a district.- 4 Social pathologies.- 5 Inequalities in health correlates of social class.- 6 Structure and roles of NHS.- 7 Facilities and resources.- 8 Personnel in NHS.- 9 Education, training and careers.- 10 Utilization of resources and content of work.- 11 Prescribing.- 12 Psychiatry.- 13 Maternity services.- 14 Eyes and teeth.- 15 School medical service.- 16 Quality and outcomes.- 17 Complaints.- 18 Costs.

Facilities and Resources

The number of hospitals in England from 1959 to 1980 is shown in Figure 1 and Table 1. Hospital numbers decreased by 457 (or almost 20 per cent) during this period. Related to the population size the reduction was even greater — 25 per cent.

Quality and Outcomes

The structure and processes of medical and health care have to be related to the outcomes of such care. There has to be critical evaluation of benefits, if any, of such care.

Ischaemic Heart Disease

Ischaemic heart disease (IHD) is a collective term for a local cardiac manifestation of a generalized body disorder — atherosclerosis.

Glandular Fever (Infectious Mononucleosis)

There is still much to be learnt and discovered about glandular fever — infectious mononucleosis (IM). Both titles are rather unhelpful and somewhat confusing. Certainly, enlarged glands and fever are a feature of the syndrome and so are typical mononuclear cells in the blood, but the infectiousness is unusual in practice.

Utilization of Resources and Content of Work

There are three sectors of utilization of health care: self-care; primary professional care (general practice in NHS); hospital care.

Eyes and Teeth

There are three groups involved in eye testing and prescribing spectacles in the NHS: ophthalmic medical practitioners; ophthalmic opticians; dispensing opticians.

School Medical Service

The need for special health services for children in school is being questioned. The staff of the school medical service comprises many more nurses than health visitors and doctors (Figure 1) (Nurses: 2671; doctors and health visitors: 1827). In 1977 a study of the school nursing and medical services in the north Paddington district of London revealed that over one-third of children had problems (Figure 3). The proportions were higher in infant school (5–7) than in junior school (8–9). The types of problems were more physical than behavioural (Table 1).

Personnel in NHS

The National Health Service (NHS) is one of the largest employers in the United Kingdom. There are more than 1 million persons directly employed by the NHS (Figure 1 and Table 1).

Mortality and Morbidity in a District

In an NHS district (Figure 1) there will be over 120 general practitioners and 60 consultants providing medical care for 250,000 persons.