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 »

The Budget, the Big Society and the NHS

Filed Under (Budget, Coalition Government, Health Policy, NHS Providers, Third Sector) by Paul on 11-04-2012

Whilst the content of my posts rarely stray far from the NHS there are occasions when other page 1 news on strays into the NHS.

This one starts with a process which was the hallmark of the NHS, the Government trying to implement one policy by going against its own policy in another area. Read the rest of this entry »

Question: How did a Government committed to social enterprise manage to close down those parts that were meant to build third sector capacity?

Filed Under (Health and Social Care Bill, Reform of the NHS, Third Sector) by Paul on 27-02-2012

Answer: Because it lost control of NHS reform.

Today – or if they don’t get to it on Wednesday – the House of Lords will stage a further debate about stopping the development of the third sector in the NHS.

Long term blog readers will remember that their Lordships debated this issue in November 2011 and that I commented on the issue at the time. In that post I asked if the Department of Health would become the only Government department forbidden by law to develop the capacity of the third sector.

This part of the mess  that is the Government’s NHS reform policy stems from their ‘U’-turn last June. Then, in order to persuade the BMA that they were not in favour of greater private sector involvement in the NHS; they said that they would pass legislation,

“…to outlaw any policy to increase the market share of any particular sector of provider”

and amended the Bill to that effect.

This does not reflect the policy of any other Department of State. So, for example, the Department for Education or Department of Communities and Local Government can argue that the third sector should be providing more services – for example for young people or environmental services.

But this will be illegal for the National Commissioning Board and the NHS.

And the passing of this law will have an even bigger impact.

We know that NHS bodies are always anxious to avoid breaking the law. This makes it likely that the NHS Commissioning Board – and the NHS in general – will interpret the Health and Social Care Bill as meaning that capacity building – and other policies which support the development of social enterprises and voluntary and community organisations -would become illegal. As a result, it could make it harder for charities and community groups to provide the services and support that many (particularly those who are vulnerable and hard to reach) rely upon.

Which means that the NHS will not only be the only part of Government that cannot have a policy to develop a higher proportion of services through the third sector, but they may also be unable to spend taxpayer’s money on improving the capacity of the third sector to provide health services for NHS patients.

Let’s remember that when this Government published its White Paper in July 2010 it said that it wanted to create in the NHS, “the largest social enterprise sector in the world.”

The gap between their intentions of July 2010 and the practice of February 2012 is now enormous.

They have reached this state of affairs by trying to change the law to appease the BMA’s anxiety about introducing more competition into the NHS.

It didn’t change the mind of the BMA – it just created a mess.

This is what happens when a Government loses control of its policy on NHS reform.

First signs of a real shift in power. Watching who is under attack can reveal who really matters.

Filed Under (Coalition Government, Narrative of reform, Reform of the NHS, Third Sector, Uncategorized) by Paul on 14-06-2011

One of the more interesting consequences of the Government’s outsourcing of their NHS reform policy is that those now under attack for wanting change are not the Government but the leaders of the Future Forum.

Today’s Times contains an article arguing for greater choice in the NHS. For me it makes a better common sense argument for choice than anything that the Government has tried to stitch together in the last 12 months. Read the rest of this entry »

The White Paper – Liberating the NHS and the independent sector

Filed Under (Creating public value, Health Policy, NHS Providers, Reform of the NHS, Third Sector, White Paper) by Paul on 23-07-2010

If there is one group that should have received the White Paper with unalloyed pleasure it is the private sector health care companies who are trying to sell their services into the NHS. Read the rest of this entry »

An example of ‘disruptive innovation’ from the third sector for NHS services

Filed Under (Health Improvement, Public service reform, Third party provision, Third Sector) by Paul on 19-07-2010

A little while ago I argued for the third sector developing a new business model for the delivery of NHS services. Last week ACEVO published my pamphlet on this subject coincident with my speaking at their 14th July conference. Read the rest of this entry »

Saving for the NHS by building a new business model for the health care of people with Long Term Conditions

Filed Under (NHS Providers, Public Health, Reform of the NHS, Third Sector) by Paul on 06-07-2010

The NHS, alongside all other health care systems in developed countries will soon run out of money. All of these systems have become used to increases in resources that have more than kept pace with the increased demand for health care caused by an aging population and increased public expectations.
Read the rest of this entry »