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 »

Just what was the BMA opposing in 1948?

Filed Under (Aneurin Bevan, BMA, Health Policy) by Paul on 30-04-2012

A couple of weeks ago I reiterated the position that I often take about the BMA – the one that reminds us all that in February 1948 over 90% of the BMA said that they, as doctors, would not be a part of the NHS. Then, in July of the same year over 90% of GPs joined. Read the rest of this entry »

Q. What are the two things that could survive a nuclear holocaust?

Filed Under (Localities, National Commissioning Board, Regional Health Authorities) by Paul on 26-04-2012

A. Cockroaches and Regional Health Authorities.

I must right away give acknowledgement to the author of this joke. It comes from Nigel Edwards who worked for the NHS Confederation for a long time and has seen his fair share of NHS reorganisations. Read the rest of this entry »

A final post (for now) on central state power, doctors and the NHS.

Filed Under (GPs, Health Policy) by Paul on 25-04-2012

I will come back to this later on in the summer, but I just want to raise an issue that really puzzles me about some of the supporters who work in the NHS, and who also support a centralised, Whitehall run NHS.

Many of the people who support this form of organisation look a bit rebellious to me. Looking at the things they say on their blogs and on Twitter they don’t strike me as people who like doing what they are told to by the state – or anyone else. Read the rest of this entry »

Why did Bevan favour “centralised financial responsibility and de-centralised administration at the periphery.” for the NHS in 1948?

Filed Under (Labour Party, Nye Bevan, Reform of the NHS) by Paul on 24-04-2012

For readers interested only in the NHS I’m afraid this is going to be a bit of history lesson of the world of left-wing politics in the mid 20th century. For younger readers interested in politics it will be a small lesson from history that may explain some of the ways in which politics work today. Read the rest of this entry »

Bevan’s view of the NHS was more nuanced and more clever than that of some of his current ‘followers’.

Filed Under (Health Policy, Nye Bevan, Reform of the NHS) by Paul on 23-04-2012

Last week I began a process of asking questions about the different things that different people want to ‘save’ about the NHS.

I’m continuing the theme with this post – but from the other end of the telescope. This post considers an interesting phrase that Nye Bevan used to describe the NHS that he was creating. Read the rest of this entry »

Changing the NHS in order to save it. The alternative to central command.

Filed Under (Health Policy, Reform of the NHS) by Paul on 19-04-2012

On Tuesday I tried to make the argument that one of the main aspects of the NHS that some people were campaigning to save is that of central control. I suggested that there was some confusion between means and ends and that it was perfectly possible to save the basic principles of funding and preserving the equality of the NHS without the necessity of having central control for the whole organisation. Read the rest of this entry »

Saving the NHS: – A health care system free at the point of need with equal access for all.

Filed Under (Health Policy, Reform of the NHS) by Paul on 18-04-2012

The role of public information matter in creating greater equality of access.

Yesterday’s post made the point that some of the fiercest arguments about ‘Saving the NHS’ have been about the way in which the state has organised the NHS rather than about the basic principle of equal access for all – free at the point of need. Read the rest of this entry »

Saving the NHS: – A health care system free at the point of need with equal access for all…

Filed Under (Health Policy, Reform of the NHS) by Paul on 17-04-2012

…but first achieve the equality that you want to save.

Let me be clear about my personal position.

What Save the NHS means to me is this. This is a payment system which takes the financial anxiety out of accessing the health service and means that if you need to either go and see your GP or need a major heart operation, you don’t have to worry about how much money you have in your bank account. Read the rest of this entry »

Save the NHS! But what if different people want to save different things?

Filed Under (Reform of the NHS) by Paul on 16-04-2012

Change the NHS! …and if people want to change different things?

One of the near universals in British society is the strength behind both the campaign and the slogan to “Save the NHS”. As the coalition government has discovered if the impression forms that the NHS is ‘under attack’ the consequent mobilisation of large numbers of people around the slogan ‘Save the NHS’ becomes an important part of the politics of the nation. Read the rest of this entry »

The long march through the Royal Colleges.

Filed Under (Big Society, Health Policy) by Paul on 12-04-2012

In the last few months, during the political tussle that took place before the final passage of what is now the Health and Social Care Act, some very strange claims were made about the power of various Royal Colleges to reverse government policy.

There was a strong belief amongst medical opponents of the Bill that if all the Royal Colleges called for its withdrawal this would have stopped the Bill. I commented at the time that this was an odd view of political power, but was understandable coming from people who were rarely involved in the politics of legislation. Read the rest of this entry »