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 »

How will Liberal Democrats reconcile their policy of keeping Britain in Europe with their policy of not using competition to improve the use of NHS resources?

Filed Under (Clinical Commissioning Groups, Coalition Government, Competition, Liberal Democrat Party) by Paul on 11-03-2013

We have learnt that Coalition Governments get into a rhythm. Every year now, in early March, there is an attempt by the Coalition to change some or other policy just before the spring Liberal Democrat Party Conference so that party members can feel that they are having an impact on the Government. Read the rest of this entry »

On level playing fields and the competition for providing services to NHS patients.

Filed Under (Competition) by Paul on 12-12-2012

It’s no secret that the very existence of any kind of competition for providing services to NHS patients is a controversial issue. Between December 2010 and March 2012 whilst the NHS Health and Social Care Act was wending its way through Parliament, the two very different issues of competition and privatisation caused the most controversy. Read the rest of this entry »

How competition between hospitals improves quality and integration of services. A report from the Cooperation and Competition Panel.

Filed Under (Competition, Cooperation and Competition Panel, Health and Social Care Bill) by Paul on 24-07-2012

Readers will remember the high noise level of the row that took place about the role of competition in the NHS in the last three months before the Health and Social Care Bill was passed. It was ferocious – with those opposed to competition claiming that one of the main things wrong with it was that there would be an increase in competition. Read the rest of this entry »

Competitive dialogue – a better way of commissioning NHS services?

Filed Under (Competition, GP Commissioning) by Paul on 24-05-2012

Over my decades of working in the public sector, nearly all of my experiences of public sector service tendering have been a variation on some truly awful and nervous experiences. This was as true of my time as a public sector manager tendering for services as it is now – as a private sector person bidding to supply them. Nearly every part of every experience has been hedged around by the fear and anxiety of putting a foot wrong or saying a word out of place.  Read the rest of this entry »

Was amending the Health and Social Care act to prevent European Competition Law applying to the NHS a pointless exercise?

Filed Under (Competition, Health and Social Care Bill, Liberal Democrat Party, Narrative of reform) by Paul on 16-03-2012

The Liberal Democrat spring conference saw a spectacular falling out between two powerful women of the left. Shirley Williams launched an attack upon Polly Toynbee because the latter had previously attacked her support for the Bill. The argument became quite heated – accusations of lying were made – and later in the week Polly Toynbee retumed the fray in a Guardian article. Read the rest of this entry »

There is a way the Liberal Democrats can prevent European Competition Law being applied to the NHS – tear up the Maastricht Treaty.

Filed Under (Competition, Liberal Democrat Party, Reform of the NHS) by Paul on 01-03-2012

One of the apparent aims of the most recent Liberal Democrat amendments to the Health and Social Care Bill being discussed in the House of Lords is to ‘stop the application of European Competition Law to the NHS’. Read the rest of this entry »

If competition is already in the NHS – why do we need Part 3 of the Bill?

Filed Under (Competition, Health and Social Care Bill) by Paul on 20-02-2012

I hope readers of the blog will appreciate the even-handed approach I am taking in my analysis of the bill. Last week, after a number of posts outlining mistakes in the Government’s narrative for reform, I ended with an explanation of what I think is wrong with the narrative of many of the reforms’ opponents. Read the rest of this entry »

Yet another problem for the Government – caused by developing NHS reforms through a Bill.

Filed Under (Competition, Health and Social Care Bill, Narrative of reform, Reform of the NHS) by Paul on 17-02-2012

Another new set of arguments were launched against the Bill last week which tap into another vein of opposition.

It’s really interesting that when there is no narrative for reform to dominate the argument, a whole host of very different ones can and do emerge. Arguments against the Government’s NHS reforms have already been set out and now variant forms of those arguments are appearing – resulting in the reforms now being assailed from not only all sides – but also from above and below. Read the rest of this entry »

Dealing with failure is vital for the NHS to succeed.

Filed Under (Competition, Health Policy, Reform of the NHS) by Paul on 18-07-2011

Last week saw the latest episode in one of the longest running policy development sagas within NHS reform – the failure to create a failure regime for NHS hospitals.

This is a policy that has been much announced since the NHS plan in 2000. However little has been delivered in the 11 years since then. Three separate Governments have failed to create a failure regime. Each of them has recognised how important it would be to have one, yet each of them, as they come close to publishing one, has backed away. Read the rest of this entry »

When hesitation and retreat becomes a habit, it’s very hard for governments to shift into forward gear again.

Filed Under (Coalition Government, Competition, Public service reform) by Paul on 04-07-2011

Armies and governments can get used to retreating. In becoming expert at doing so they may forget that they are giving ground all the time, and when reviewing their week’s work, think it good – because they retreated well.

When the strategy is to give ground, the tactics are to do it well. Read the rest of this entry »