Neurology in 2016
We start 2016 with the rather disturbing news that came just before Christmas the post of national clinical director for neurology may not be continued after March 2016. This information was highlighted by Sir Bruce Keogh, NHS England medical director on Monday 14 December 2015 at a House of Commons Public Accounts Committee (PAC) meeting (PAC, 2016) where a hearing on neurology services was taking place. The hearing followed on from publication of the National Audit Offices (NAO) progress review of neurology services (NAO, 2015) which revealed disappointing improvements in neurology services since the prior review conducted by NAO in 2011 (NAO, 2011) A range of people gave evidence at the December hearing chaired by MP Meg Hillier, including the national clinical director for Neurology Dr David Bateman, neurologists Dr Geraint Fuller and Dr Paul Morrish, NHS England chief executive Simon Stevens, Keogh, Department of Health permanent secretary Una O'Brien, as well as Arlene Wilkie, chief executive of the Neurological Alliance. The hearing, accessible on parliament live television, makes interesting viewing if you have a couple of hours to spare and puts into perspective the challenges neurology services in England face (http:/tinyurl.com/j3xt6tv) One of the significant comments made during the hearing by Keogh was that the role of national clinical director for neurological conditions would not be continued beyond March 2016. This is surely short sighted and a fundamentally misguided decision as the small savings released by discontinuing Dr Bateman's 2 day aweek role will be minimal compared with the costs neurology services will experience by losing national clinical leadership. Additionally, the decision reinforces the perception that NHS England does not give sufficient priority or focus to securing much needed improvements to neurology services. Keogh and Stevens defended this decision by stating that progress in neurology services would be continued through current policy Five Year Forward View and the Strategic Clinical Networks for mental health, dementia and neurology, although this might be debatable.