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 »

More long term realism about the ability of the British economy to grow

Filed Under (Economics, Resources, US opinion) by Paul on 12-10-2012

There is a growing realisation amongst senior managers in the NHS that the future level of NHS resources are inextricably linked to the ability of the British economy to grow – or not. There is also a tight political boundary drawn by the fact that I cannot see any political party standing on a platform of charging for NHS services and winning general elections in 2015 and 2020. Read the rest of this entry »

Suggestions from the USA’s equivalent family doctor commissioners

Filed Under (GP Commissioning, Health and Social Care Bill, Reform of the NHS, US opinion) by Paul on 29-06-2011

There was a time during the last few months when those who were defending the NHS status quo turned the US into a pariah. I heard very sensible people say in public meetings “I won’t take any lessons from the USA about health care because their system is so bad’. This became a sort of “know nothing” rejection of an entire nation – and all of its knowledge. NOTHING from the USA was any good because their overall system was so bad. Read the rest of this entry »

Developing the Power of Nurses – US style

Filed Under (Health Improvement, Health Policy, Public Health, US opinion, USA) by Paul on 24-03-2010

One of the interesting meetings that I had whilst in Portland – the largest city in Oregon – was with nurses in one of their biggest hospitals – Providence.

I have been in the US with the excellent Helen Bevan – Director of Transformation at the NHS National Institute. One of the things we have been discussing in all our meetings is whether US hospitals would be interested in using one of the improvement tools developed in the NHS – the “productive ward”. The “productive ward” is a nurse-led project aimed at working with nursing staff on the ward to release staff to devote more time to care. It’s aimed at cutting out waste and is, in many ways, a classic time and motion study. The difference is that this study is carried out and implemented not by “men in suits” but by the nurses themselves. Some of the improved output figures are very good.
Read the rest of this entry »

NHS or US health systems? Who spends the most taxpayers’ money?

Filed Under (Expenditure, Health Policy, Public Health, US opinion) by Paul on 25-08-2009

The recent discussion about the US and English health care system has thrown up a number of important facts. Some of them are obvious but some are counterintuitive and need some exploration and discussion.

Whilst we all know that the US spends much more pre head of the population or as a proportion of GDP on their health services than we do, the assumption is that most of this is private expenditure. Surely there is nothing wrong with individuals in a rich country spending their own money on health in the same way as they might spend their money on a third or fourth luxury car. This is private income being spent privately on their health – a set of personal consumer choices.
Read the rest of this entry »

The politics of the NHS in England and the US. Good times for the left.

Filed Under (Health Policy, Public Health, Public service reform, Reform of the NHS, US opinion) by Paul on 18-08-2009

At the moment, if you are on the left, you rarely get the chance to play a role in developing the political climate of a European country, so to find your politics simultaneously playing a developmental role in the US feel s like the icing on the cake. Then to find reverberations from the US having a positive impact on the politics of England puts the cherry on the top! But such has been the politics of the NHS on both sides of the Atlantic in mid August 2009.
Read the rest of this entry »