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 »

Delivering on the Nicholson Challenge: Today (Wednesday June 13) I’m speaking at the Reform conference.

Filed Under (Expenditure, Innovation, Nicholson Challenge) by Paul on 13-06-2012

One of the important aspects of rising to the Nicholson Challenge – raising between £15-20 billion from within the NHS budget over 5 years – is that it is now clear that the idea of this being a discrete challenge over a period of time, is coming to an end. Read the rest of this entry »


Filed Under (Uncategorized) by Paul on 12-06-2012

In the latest issue of Gesundheit!, the Stockholm Network invited myself and others from different arenas of healthcare policy to examine what they think the future holds for healthcare.

The article is available on their website.

Were civil servants to blame for not slowing down Lansley’s reforms – or the Prime Minister?

Filed Under (Health and Social Care Bill, Secretary of State, White Paper) by Paul on 12-06-2012

Yesterday I explained how sources are blaming the civil service for not preventing the government from carrying out some of its own policies. In particular government sources were seeking to excuse the Prime Minister from the bad political outcomes stemming from the Leveson Inquiry because, they claim, it was really the fault of the Cabinet Secretary for not preventing the Prime Minister from acting on his decision to have an Inquiry. Read the rest of this entry »

This summer’s government refrain – “Don’t blame us, the civil service should have stopped us”.

Filed Under (Health Policy, Prime Minister) by Paul on 11-06-2012

You can tell when a government is in trouble because it tries to find other people to blame for what are clearly and constitutionally its own policies.

Over the last few weeks there have been several occasions when ‘government sources’ have let it be known that they can’t be blamed for this or that policy going wrong, it’s the fault of the civil service for not stopping them – from implementing their own policy. Read the rest of this entry »

Value based pricing for pharmaceuticals

Filed Under (Health Policy, NICE) by Paul on 07-06-2012

This Government came into power promising to do a range of things about health reform. Over the last two years the rather curious political fact is that the Government have got into the most trouble for carrying out reforms that they said they would not do. Read the rest of this entry »

“No micromanagement of the NHS” was the Government’s election pledge – so how is that working out?

Filed Under (Foundation Trusts, Health and Social Care Bill, Hospitals, Manifestos, Reform of the NHS, Secretary of State) by Paul on 06-06-2012

Foreign Secretary William Hague is an experienced politician.

One would assume that over the years he has paid attention to the political manifestos upon which he has been elected.

Given that he has been in shadow cabinets – and now the cabinet – for some time one might reasonably assume that he also pays attention to their discussions about legislation.

Given also that he has been in the House of Commons for a very long time you might imagine that he looks hard at the legislation for which he is voting. Therefore when – in May 2010 – he signed off the Coalition agreement which stated that, “We want to free NHS staff from political micromanagement” we can assume that he meant it.

Similarly in December – when in Cabinet he agreed to the publication of the Health and Social Care Bill, and in January – when he voted for its second reading, we can assume that he agreed with the removal of the Secretary of State from ultimate responsibility for the NHS.

All of which makes his recent activities a bit of a puzzle.

In the Northern Echo’s 28th May edition he seems to be trying to drag the Secretary of State back into micromanaging the NHS. He has apparently had four meetings with Andrew Lansley about the loss of services at one of the hospitals in his constituency – the Friarage Hospital in Northallerton. These meetings have been to ask the Secretary of State to stop the downgrading of maternity and paediatric services at the hospital.

There are several hundred hospitals around England. Most of them are undergoing wide ranging service changes. If the Secretary of State has four meetings about each of them it’s going to take micromanagement to a new level of intervention.

The Secretary of State is famously good with detail, which is just as well because he will need to know the ward rounds of each sister to be able to hold detailed discussions with his colleagues.

William Hague will of course also remember that he voted through legislation to empower the quango, Monitor. His Friarage Hospital is a part of South Tees Hospitals which is itself a Foundation Trust. He will of course know that at the last election, and in the Act, he voted for the separation of Foundation Trusts from the powers of the Secretary of State to be almost total.

Therefore the Foreign Secretary will know that if he wants to try and save services in the Friarage his first point of call will be the Independent Board of the hospital. The second will be Monitor.

It is because William Hague voted in the way he did that the Secretary of State has no role to play.

Their meetings therefore are a bit of a puzzle.

At the time of the second reading of the Bill in January 2011 a number of Conservative and Liberal Democrat MPs made the point that if the Bill had already been law their maternity services and A and E departments would not have closed. They were wrong then, and they are wrong now.

William Hague will need to be a bit more careful about the platforms upon which he stands for election – and the Acts for which he votes.