The perverse care law

In a series of blogs between November 2022 and February 2023, we developed the idea of the perverse care law: 

• "Over the last decade primary care and out-of-hospital services have been starved of funding compared to hospital funding. Staffing in most of these out-of-hospital services is less than it was two decades ago. The care needs for elderly patients and younger ones with serious health problems have been treated through over-admission and revolving door admissions. The care is perverse because it is high cost and damaging for many patients. The inverse care law is about the lack of any care. The perverse care law is about the compulsion to use the wrong care."

The situation is neither inevitable nor irrevocable. Services such as those for HIV/AIDS and coronary heart disease, and overseas systems such as Finland, show how developments of community services and disease management can reduce demand and costs.

The core UK focus should be the development of neighbourhood teams, to provide continuity of care for people with long term conditions.