My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

The political debate about NHS reform has now settled down to a “war of position”.

Filed Under (Conservative party, Labour Party) by Paul on 28-02-2011

This week I would like to explain what a “war of position” means. Today I’m looking at politics in general and tomorrow I’ll outline how that relates to the politics of the NHS in March 2011. Read the rest of this entry »

More U turns by Number 10 – caused partly by conflict over NHS reforms

Filed Under (Health Policy, Secretary of State) by Paul on 23-02-2011

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On January 17th after the Prime Minister had started to articulate a narrative for his NHS reforms, I made the following comment on my blog.

“The Prime Minster has made it clear that he sees himself as the “Chair” of the Government and not its CEO. So he has said he will not interfere and will not, for example, have health policy expertise inside No 10. As far as he’s concerned that is all a matter for his Cabinet. Read the rest of this entry »

David Cameron’s “need for speed” is causing very radical changes in hospital services.

Filed Under (Foundation Trusts, Health Policy, Reform of the NHS) by Paul on 22-02-2011

The government is insisting that the fast pace of its NHS reform is essential. The pace on which they are insisting was always going to be their biggest risk. Yet despite warnings from most in the NHS David Cameron seems to see it as essential that he carries out his reforms at breakneck speed. Part of the speed of his reform programme was contained in the White Paper’s insistence that all hospitals become either Foundation Trusts or parts of Foundation Trusts by the end of the financial year 2013/2014. Read the rest of this entry »

Supervision for nurses who work with the very dependent elderly

Filed Under (Uncategorized) by Paul on 21-02-2011

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Over the weekend, there was a great deal of debate about NHS care and the elderly.

It is interesting that in the midst of all of the discussion about the politics of NHS reforms it has been the NHS Ombudsman’s report on care for the elderly that has stirred up most people. And given that most of the people I know are into politics this says a lot for the power of that report. Read the rest of this entry »

On seeing Tony Blair’s Number 10 taking back control of public policy

Filed Under (Uncategorized) by Paul on 18-02-2011

Today – February 18th – David Bennett was appointed to chair Monitor as the new economic regulator for health care in England. David has a lot of experience in the development of private utility markets and will bring that experience to the regulation and management of the market in health provision. Read the rest of this entry »

Caring for the Elderly

Filed Under (Uncategorized) by Paul on 18-02-2011

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On the day that Ann Abraham’s report came out on NHS Care for the Elderly I was working in several parts of the NHS. Quite a few people had, as I had, woken to the reports on the six o’clock news; and some had taken time out to read through the report during the day. Read the rest of this entry »

There is evidence – and then there is evidence.

Filed Under (Health Policy) by Paul on 15-02-2011

I am sure a very great deal will happen to the current Secretary of State between now and January 2013, but for those of us who will still be making sense of the Government NHS reforms at that time, it is a date that will be an important one for us all to remember.

Around that time a new report will be published that will either crush the Government’s rationale for NHS reforms, or make the case. Read the rest of this entry »

Surgeons, and their take on the reforms

Filed Under (Coalition Government, Health Policy, Reform of the NHS) by Paul on 14-02-2011

One of the 40 talks I gave explaining the Government reforms between September and December last year was to a national conference of a group of specialist surgeons. There was one session for which I was responsible that came between detailed research outcomes and reports on new surgical techniques and outcomes. Read the rest of this entry »

GRIP 2 – More on the New Liberation Theology of the NHS

Filed Under (Foundation Trusts, GP Commissioning, GRIP, Health Policy, Primary Care Trusts, Reform of the NHS) by Paul on 11-02-2011

The story so far…

Last December the Government decided to support two opposing models of policy implementation for the NHS.

The first is for the medium term. It is the policy of liberating the NHS from the power of traditional NHS bosses and developing the different market mechanisms that they feel will bring greater efficiency. Read the rest of this entry »

Twin track transition – the new Liberation theology of maintaining GRIP on the NHS

Filed Under (Health and Social Care Bill, Reform of the NHS) by Paul on 08-02-2011

The last week has seen the start of two very different methods of implementing the Government’s NHS reforms.

The first is the Health and Social Care Bill which entered Parliament last week and its Commons Committee stage this week. Here there will be clause by clause debate about how the ideas that were outlined in the White Paper move into legislation. Over the next 9 months there will be a clearer and clearer justification from the Government about how this part of the system will articulate with that part. Inevitably, and not just with this Bill, there will be a recognition from the Government that changes will have to be made and they will bring their own clauses amending the Bill forward as they recognise that what they thought fitted together really doesn’t. But as the months pass we will get a clearer idea of how the whole new NHS will work. Read the rest of this entry »