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 »

It’s the economy, stupid

Filed Under (Expenditure, Health Policy, Resources) by Paul on 29-06-2012

This phrase was first used on posters and “buttons” in all of the offices where Bill Clinton’s staff worked during the 1992 election campaign. It was a reminder to them all that whatever they talked about internally during the campaign the issue that worried the American people was the economy – and that given the importance of talking to the electorate about the things that worry them it’s stupid not to recognise that. Read the rest of this entry »

What happened to the South London NHS trust yesterday – and why was it so important?

Filed Under (Expenditure, Localities, Resources) by Paul on 27-06-2012

First I should say that I have some historical interest here. I was an executive director in the London SHA when this trust was created by the merger of three existing trusts. The trusts that were merged were not viable. But the trust that the merger created has also turned out not to be viable and I think we should have been more aware of this at the time. When the NHS did not really know what to do it merged problem hospitals into a single institution. (As you will see from my comments below, this is something the NHS still does all the time). Read the rest of this entry »

Much more money needs to be spent on social care for the elderly -so how can we develop the politics to make the case??

Filed Under (Expenditure, Health Policy) by Paul on 14-06-2012

Recently I went to an interesting seminar that was looking specifically at how to develop the case for extra public spending on social care for the elderly.

The seminar was held under Chatham House rules (you are allowed to report what was said but not who said it) which meant that people with a variety of different relationships to decision-making could say not only what they really thought but also what they really thought was going to happen. Read the rest of this entry »

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 »

Returning to the theme of “developing the NHS in the long age of austerity”

Filed Under (Expenditure, Health Policy, Investment, Reform of the NHS) by Paul on 28-03-2012

The phrase “developing the NHS during the long age of austerity” was one that I first used in December 2011. It’s one to which I will return frequently over the next few months. Read the rest of this entry »

During which month next year will the Government start being honest about the myth of protecting NHS resources?

Filed Under (Conservative party, Expenditure, Health Policy) by Paul on 19-12-2011

Regular readers of the blog will not be surprised that I am returning to the problem of the Government’s narrative about the NHS. What story is it trying to tell? Read the rest of this entry »

Centralisation, grip and improving NHS efficiency

Filed Under (Creating public value, Expenditure, Health Policy, Reform of the NHS) by Paul on 06-07-2011

One of the outcomes of the Government’s June 2011 reform of its July 2010 NHS reforms has been the increased centralisation of Government control. As I will explore later in the week, the first set of reforms that was intended – in the heady days of July 2010 – to liberate the NHS and localise decision making is now set to provide much more national centralisation of commissioning than has ever previously existed. Read the rest of this entry »

The politics of last Saturday’s march – a Tory MP muses

Filed Under (Conservative party, Expenditure, Health Improvement, Health Service Unions, Reform of the NHS, Trades Unions) by Paul on 02-04-2011

Luckily this blog does not have to engage too deeply with the politics surrounding the Coalition Government’s policy on public expenditure cuts. That means the efficacy or otherwise of last Saturday’s TUC march and the Labour Opposition’s policy on the cuts is not a core issue for us. Read the rest of this entry »

The Government’s problem with the politics of “Exempting the NHS from the cuts”. The beginning of the attack on Health Ministers – from both sides.

Filed Under (Expenditure, Health Policy, Reform of the NHS) by Paul on 07-07-2010

July 7th has seen the first of the attacks from both sides that the Government health team will experience for the duration of their stay in charge of the Department. How they deal with both of these attacks will determine whether their stay in charge of the NHS is measured in weeks or years.
Read the rest of this entry »

Government policy aims to move accountability for commissioning of £100 billion NHS care from the state to the private sector by 2012

Filed Under (Accountability, Coalition Government, Expenditure, GPs, Incentives, Primary Care Trusts, Public service reform, Reform of the NHS, Secretary of State) by Paul on 24-05-2010

At first sight the Government’s plan – published on May 20th – appears to provide a confused answer to the question of who is going to commission NHS health care from 2012.
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