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.

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First Conservative casualty of a Conservative policy that is facing both ways – going forwards and backwards in health care.

Filed Under (Coalition Government, Health Policy, London, Reform of the NHS, Secretary of State) by Paul on 27-05-2010

In the last week followers of my blog will have read several posts outlining what I see as one of the essential contradictions in modern Conservatism in general and how it is working its way through health policy within the current Government.
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How the policy of making it harder for hospitals to change today messes up the policy of improving the economics of the NHS of tomorrow

Filed Under (Conservative party, Creating public value, Foundation Trusts, Health Policy, Incentives, Reform of the NHS, Secretary of State) by Paul on 26-05-2010

Most of the policy announcements made by the new Secretary of State have so far been made in front of hospitals that he is either ‘saving ‘or ‘reopening’. I have written on another web site how the preservation of hospitals “in aspic” represents one part of our society that the modern Conservative Party wants to “hold still” but why, given the amount of change they are pouring into the NHS system through the use of markets, this wish will probably fail.
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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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Coalitions are one thing but there are strong contradictions within the Conservative Party itself and they will tear their NHS policy apart within 2 years

Filed Under (Conservative party, Creating public value, Health Policy, NHS Providers, Reform of the NHS) by Paul on 20-05-2010

Regular readers of the blog will have come across the way in which I have explored the difference between policy and politics in the Conservative stance on NHS change over recent months and in the first few days of the new Government. Policy argues for a fundamental change brought about by the development of markets within the NHS. More incentives must be given to GPs as commissioners to drive change throughout the system. There must be a policy of “any willing provider” and the NHS must get used to empowered patients with much better information flowing around the system.
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Every government needs one…

Filed Under (Conservative party, Secretary of State) by Paul on 19-05-2010

Andrew Lansley has, within a week, become the Frank Dobson of the Tory party. Irony is of course a foreign country to the modern Conservative Party (and one from which no migration is allowed ). So they won’t get the irony of this.

It has just been reported that Andrew Lansley (politician) has ordered a review of Ara Darzi”s (clinician) review of health care for London. 

Apparently Lansley ‘hates’ health care for London.

What of course is such fun is that he stood on a policy of stopping political intereference in clinical decisions. Yet, within a week, he is up to his shoulders in defending the expensive and unsafe NHS of the past against modern clinical change!

Happy families in the NHS? – or time for some PCTs to leave home?

Filed Under (Culture of the NHS, Expenditure, Health Policy, Primary Care Trusts, Public service reform, Reform of the NHS, Secretary of State, Uncategorized) by Paul on 18-05-2010

One of the few consistent and long term insights that ‘management literature’ has given me is transactional analysis. Managers may be treated by those they manage as “parents” and managers can treat those they manage as “children”.  Sometimes managers are good parents and sometimes they are very bad parents.  Sometimes children are naughty and demand to be punished, and sometimes they want to leave home and set up for themselves.
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What are the pressures on the new Secretary of State that might lead to a new direction?

Filed Under (Election campaign, Health Policy, Secretary of State) by Paul on 11-05-2010

After an election a Secretary of State for Health exists in a vortex of three major pressures.

The relative power of each of these three determines outputs.

They are the policy; the politics, and the public finances, and to understand what is going to happen we need to understand the relative power of these three forces. In May 2010 these clearly have different strengths.
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Be careful what you wish for! Now let’s see how the nation gets on without strong politics power

Filed Under (Election campaign) by Paul on 08-05-2010

For once and only once I am going to allow myself a post which does not concern itself with health care practice, policy or politics but does deal with the bigger picture of outcome of the May 6th election. Let’s look at the wider issue of politics and politicians in general.

I have spent most of my life closely working with and within politics. And the people who practice it – politicians- are also my very closest friends. It is the main topic of our conversation on most days. This means it matters to me not just in the abstract but concretely through the real people I love doing real things with their lives.
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Further evidence of post election changes from today’s Times

Filed Under (Conservative party, Election campaign, Health Policy, Labour Party, Liberal Democrat Party) by Paul on 04-05-2010

The Times on May 4th picks up on the big issue of post election NHS politics by highlighting the coming significant changes in hospital services. As with my own posts of last week they recognise the significance of the advice from patients’ groups and doctors to bring about improvement and value for money.
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