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 »

“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.

“We will scrap politically motivated targets…”

Filed Under (Coalition Government, Conservative party, Health Policy, Manifestos, Targets) by Paul on 16-05-2012

(Conservative Manifesto 2010)

It was always going to be interesting to see how the Coalition government would live with this pledge.

Over the last weekend, just prior to its conference, the Royal College of Nurses published a survey of its members reflecting their experience of patient waits in A and E. Their President was on the airwaves saying that the progress that had been made on speedier and better working with A and E patients was being lost as more were being treated on trolleys. Read the rest of this entry »

The Liberal Democrats Manifesto

Filed Under (Health Policy, Liberal Democrat Party, Manifestos) by Paul on 16-04-2010

One of the biggest problems for NHS policy is how do you maintain the vital principle of a NATIONAL health service that is paid for out of national taxation and is therefore fair across the country, with the necessity of actually commissioning and delivering that system locally. Whilst this is an issue in all policies- what is national and what is local- it is a much more central issue for the NHS because – well the tip is in the title – the public really want this service to be NATIONAL.

That means the public have shown time and again that whilst they want local input into the NHS, they are very angry at the local variations in service that have become known as the postcode lottery.
Read the rest of this entry »

…and today – the Conservative Manifesto

Filed Under (Conservative party, Health Policy, Manifestos) by Paul on 13-04-2010

The politics of the Conservative electoral strategy on health is not to have it as an issue during the election.

At the moment when the public are asked to choose who has the policy that they approve of the most, a larger number of people choose the Labour Party than the Conservative Party. Therefore, politics would tell us that if the entire campaign was fought about health policy, people would see the most important issue – health policy – as one where they think Labour are better than the Conservatives. After a campaign such as that more people would vote Labour.
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Manifestos this week – First, Labour

Filed Under (Health Policy, Labour Party, Manifestos) by Paul on 12-04-2010

This is the week of the election manifestos. And for the first three days I will give an analysis of what their health policies might add up to. 

Starting with the Labour Party today.

I’ve all but given up reading the Sunday papers but in Sunday 11 April’s Observer there was a very shrewd article by Andrew Rawnsley which outlined the issue about Manifestos.
Read the rest of this entry »