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 »

“Our NHS will be much like what we have today.” – David Cameron 16/05/2011

Filed Under (Conservative party, Health and Social Care Bill) by Paul on 31-05-2011

Last week Whitehall was awash with rumours about the policy deals that had been completed with their resulting amendments to the redrafted Health and Social Care Bill. Parliament too was full of rumours about the political changes that had been completed in order to get the Bill through (or alternatively kill it off).

Others are better placed to blog about this gossip, what I want to do this week is to try and work out two political and two policy issues. Read the rest of this entry »

In 2011 there is still a debate over whether the public have the right to a better choice of GP.

Filed Under (GPs, Patient Choice) by Paul on 25-05-2011

One of the most interesting outcomes of blogging regularly is that I am often surprised about what is contentious, and what is not. Last week I discussed some evidence about the outcomes of patients being able to choose their GPs and received a range of different comments, most of which argued against giving the public the right to choose their GP. Read the rest of this entry »

The Development of Private Sector Offers to NHS Patients

Filed Under (Health and Social Care Bill, NHS Providers, Private Sector) by Paul on 23-05-2011

Since this issue has been so much in the news, and since those who are defending the NHS against intrusions from the private sector are all over the media at the moment, I thought I would return to a post I wrote when the White Paper came out last July. Read the rest of this entry »

Warning! Beware of invitations to come and help the Government.

Filed Under (Culture of the NHS, Narrative of reform, Patient Choice) by Paul on 20-05-2011

Over the last few weeks a few people have been surprised to receive an invitation to breakfast – or a meeting – in an embossed envelope. The embossed mark over the flap looks important and, when they open it, most of them will have been surprised and even a little bit thrilled to find it was an invitation to meet with the Prime Minister to talk about the NHS. Read the rest of this entry »

Love Story 2 – the Conservative’s love affair with the NHS continues

Filed Under (Conservative party) by Paul on 19-05-2011

I was pleased to notice that the Guardian, in its editorial on the Tuesday 17th, picked up on the odd way in which the Prime Minister talks about how much he loves the NHS.

Back in April I mentioned the very strange leaflet that was produced by the Government (using public money for what was a profoundly political leaflet) which went on rather oddly about how much they love the NHS. Read the rest of this entry »

Competition between GPs and its impact upon other local GPs

Filed Under (BMA, Competition, GPs) by Paul on 18-05-2011

This post continues my interest in the role that leading organisations in the medical profession have in trying to persuade the Government to come out against competition and especially the introduction of new entrants into the NHS.

If the BMA really believed in their position of being both against the private sector providing services and competition, there seem to me to be a number of powerful things they could do. The first would be to ban their members from taking part in private medicine. By this single action they would greatly restrict the impact of the private sector on British health provision, thereby advancing a policy they favour. Read the rest of this entry »

One year on – the Prime Minister (at last) makes a case for change, and immediately rules the changes required to deliver it.

Filed Under (Narrative of reform, Public service reform, Reform of the NHS) by Paul on 17-05-2011

New depths of confusion.

On May 16th 2011 (I add the year because it would have been a great idea for him to have made the first half of this speech in 2010, at the beginning of this process, rather than in 2011 towards the end of it) the Government’s NHS reforms hit new depths of uncertainty. Read the rest of this entry »

Losing even more control of your health policy. Lessons 6 or 7 from the Coalition Government.

Filed Under (Health and Social Care Bill, Health Policy) by Paul on 16-05-2011

A few weeks ago the Chair of the Select Committee, Stephen Dorrell MP, said that the Government had lost control of its health policy. Since that date there has been almost daily evidence of just how far that loss of control has gone, and we are seeing very different groups of people, with very different interests, wrestling for the control of NHS policy that the Government has given up. Read the rest of this entry »

On the relationship between competition and integrated services.

Filed Under (Competition, Reform of the NHS) by Paul on 12-05-2011

The RCGP document The Government’s Health Reforms. An Analysis Of The Need For Clarification and Change has continued a very important debate about the relationship between the need for integration and the development of competition in the NHS. Read the rest of this entry »

Why should the NHS maintain a monopoly position allowing only existing GP organisations to compete for patients?

Filed Under (Competition, GPs, Primary Care Trusts, Third party provision) by Paul on 11-05-2011

By all accounts Dr Clare Gerada, from the RCGP, is not just a good medical politician but also a first class GP. And one the good things about the reforms in GP services up until now is that very good doctors have been able to provide good services for more patients because they have won tenders to provide those services. The tendering process has ensured that the commissioners of NHS care have the opportunity to get the best services for their local people and it is through competition that this has been achieved. Read the rest of this entry »