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Last Updated: Tuesday, 4 May, 2004, 00:55 GMT 01:55 UK
Bringing patients in from the cold
By Ray Dunne
BBC News Online health staff

The government has spent millions of pounds trying to improve access to the NHS. But has it been money well spent?

Ricky Tomlinson as Jim Royle in the Royle Family
What channel is NHS TV?
Millions of Britons will soon be able to reach for their remote control and switch onto NHS Direct TV.

The digital television channel, which is due to go on air over the summer, will offer health information and advice at the touch of a button.

The 15m project is the latest in a long line of government initiatives aimed at improving people's access to medical advice and the NHS.

These include a national telephone helpline, an internet website and a chain of walk-in centres.

Tony Blair promised four years ago to try to encourage more people to use the NHS.

A string of studies have shown that many people living in the UK are missing out on the medical care they need.

Men in the UK and people from ethnic minorities are among those least likely to be seen by a GP, while people living in deprived areas have traditionally had problems accessing GPs.

This is despite the fact that all these groups among those most in need of regular medical care.

Men, for instance, are much more likely to die young compared to women.

People living in deprived areas are much more likely to die from cancer or heart disease than those in more affluent regions.

Ethnic minorities have higher rates of diabetes and other serious conditions.

"It is something we had to address," says Dr David Colin-Thome, the government's primary care tsar.

"Chronic diseases are the number one health issue of the next few years. It is vital that we diagnose people with these conditions early.

"It is essential that they access the NHS and are seen by professionals."

Big demand

A recent report by Dr Colin-Thome suggested progress is being made in this area.

It showed that the number of people using the telephone helpline NHS Direct and the 43 NHS walk-in centres has soared in recent years.

Some people are not accessing NHS services
According to the report, there were 1.4m visits to NHS walk-in centres in England last year - up 100% since 2000.

NHS Direct took 6.3m calls last year while the NHS Direct website registered 3.9m hits. That compares to 1.6m calls and 1.5m hits in 2000.

However, there is some concern that they are simply being used by the same people who use other NHS services.

A recent study by researchers at the University of London, published in the British Journal of General Practice, gave a mixed verdict on walk-in centres.

They found that while some clinics were attracting a greater proportion of men than local GPs, they were still failing to attract other groups.

The researchers concluded that the clinics were not succeeding in improving access.

"Walk-in centres do not address access inequalities, attracting largely white middle-class patients with minor and self-limiting complaints," they said.

The researchers were even more critical of NHS Direct.

"NHS Direct callers appear to be the same people who already make use of pre-existing health services - the white, healthy, middle class."

So was the government right to set up these services?

"The question that has to be asked is whether the money used to fund these services could have been used somewhere else," says Dr Chris Salisbury.

He and colleagues at the University of Bristol carried out a review of NHS walk-in centres in 2001.

They concluded that while patients like the clinics, they are only being used by those who access the NHS anyway.

"What they do, they do well and people who use them are very satisfied with the care they receive," says Dr Salisbury.

"But they are quite an expensive way of providing care."

Millions spent

The government has pumped millions of pounds into these new initiatives. NHS Direct cost 200m in its first two years alone. NHS walk-in centres have been costing in the region of 30m annually.

The Department of Health insists it has been money well spent.

It is planning to open another 22 walk-in centres this year as well as rolling out NHS Direct TV.

Officials believe the new television channel will help it to reach more people.

"We have had very promising results from a pilot we ran in Birmingham," says Dr Colin-Thome.

"The service was very popular with people of lower socio-economic groups as well as men over the age of 50 - two groups we are trying to target.

"The figures were higher than we expected. I think the TV is easier to use than going online. It is certainly much easier to access."

The primary care tsar is confident the NHS's foray into television will pay off and will encourage more people to use the NHS.

"It's about trying to make it easier to access healthcare," he says.

"It's about giving people multiple information and access points.

"It's about improving health and ensuring patients can get the care they need."

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