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 »

But if the Bill does pass – what happens next …

Filed Under (Health and Social Care Bill, Uncategorized) by Paul on 16-01-2012

A couple of people said over the weekend that they thought my post on Friday about the passage of the Health and Social Care Bill was a bit of a tease. They wanted me to explain what I thought would actually happen next if the Bill is passed. I think there are three potentially different outcomes – each of which needs a post in itself.

Firstly there is the immediate politics of what happens if the Bill is passed – how do the Government – as victors – behave? How do those that wanted the Bill defeated behave – as losers? Read the rest of this entry »

What’s going to happen with the Health and Social Care Bill?

Filed Under (Health and Social Care Bill) by Paul on 13-01-2012

It’s the question I am most frequently asked when working with health care providers of NHS services and NHS Commissioners…

…and in terms of real outcomes it’s a very difficult one to answer.

Some things we do know. Read the rest of this entry »

We’re still trying to understand what the Government is doing with the NHS.

Filed Under (Narrative of reform, Nursing) by Paul on 11-01-2012

Last week the Prime Minister made a speech about nursing. Whilst he praised nursing he also made a series of critical points about how some nurses should improve the way in which they care for their patients.

Both its content and the fact that the PM was making a speech that criticised some nursing caused controversy. Read the rest of this entry »

The progressive argument in favour of lifting the private patient income cap for Foundation Trusts.

Filed Under (Foundation Trusts, Health Policy, Private Sector, Public Health, Reform of the NHS) by Paul on 10-01-2012

As I commented last week, I have given up waiting for the Government to make a coherent case for its reforms. So when, in late December, the Times published the story that a new amendment had been laid in the Bill to increase the level of the private patient income cap for Foundation Trusts, I did not expect too much from the Government by way of an explanation about why this was an important and necessary aspect of the whole NHS reform programme.

I was not disappointed. Read the rest of this entry »

Events, dear boy, events

Filed Under (Health Policy, Narrative of reform, Public Health) by Paul on 09-01-2012

I don’t really want to turn this blog into a set of explanations of the way in which those steeped in politics understand the world, but following some of last week’s feedback on my post about Nixon’s recognition of China, I think some people might find it useful for me to explain something of the ways of NHS politics.

Over the last week there has, quite rightly, been a great deal of publicity about the silicone implant problems being experienced by a significant number of women. Watching the DH and the Secretary of State wrestle with this difficult problem and developing their argument has been a bit painful at times and people have asked me how issues like this might be dealt with in a better way. Read the rest of this entry »

The BMA’s legendary political consistency strikes again

Filed Under (BMA, Clinical Commissioning Groups, Primary Care Trusts) by Paul on 05-01-2012

Before Christmas I wrote a post that called into question the depth of the BMA’s love for current PCT staff. I pointed out that in their latest guidance they were extolling the virtues of current PCT staff to BMA members leading clinical commissioning groups as being the best experts in commissioning. I suggested that they were doing this because in the last couple of years they have become fearful of new private sector firms selling their services to GP led commission groups. Read the rest of this entry »

The reform of the NHS and Nixon’s recognition of China – a lesson from history?

Filed Under (Reform of the NHS, Right wing ideology) by Paul on 04-01-2012

Over the Christmas break a couple of people used a very powerful political metaphor to explain to me why they think it was inevitable that the Conservatives would mess up their reform of the NHS.

The analogy, now 40 years old, springs from the way in which long term peace was made between the People’s Republic of China and the US in the early 1970s. Only my very oldest blog readers will remember that after World War 2 civil war in China continued with Chairman Mao and the Communists eventually winning on the mainland. The defeated nationalists retreated to the island of Taiwan. The US did not recognise Communist China, choosing instead to recognise Taiwan as representing the Chinese state. Read the rest of this entry »

How do Government plans for the NHS look as we enter 2012?

Filed Under (GP Commissioning, Health and Social Care Bill, Health Policy, Reform of the NHS, Secretary of State) by Paul on 03-01-2012

One of the first things I should say is that if we look back a year and think about the predictions made in early January 2011, it demonstrates that trying to predict the future politics of the NHS is a mug’s game.

Back in January 2011 the Government had just published its Health and Social Care Bill. The Bill was a true reflection of the White Paper that had been published the previous July and contained the ‘revolutionary’ changes outlined in it. Everyone was pretty confident about the reform programme – which had just been vetted by Oliver Letwin. Read the rest of this entry »