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 White Paper – some issues. 4. What are the transactional relationships between commissioners and suppliers and how are they organised?

Filed Under (Economic Regulator, Health Policy, Reform of the NHS, White Paper) by Paul on 30-07-2010

Over time this part of the reform programme will become less and less visible. Patients should not have to care about the way in which the NHS moves; they should be interested in its outcomes for them and the fact that they can rely on safe free speedy modern services when they need them.

But as the reforms are developed, as they are bedded in, this aspect of the reform programme is probably more important than the others. It signifies the big shift in power from the NHS HQ which at the moment resides in the Department of Health and is run by a Permanent Secretary who is the CEO of the NHS, to an organisation that is completely different – the economic regulator. Read the rest of this entry »

The White Paper – some issues. 3. Who is providing health care and how are they organised?

Filed Under (Health Policy, Reform of the NHS, White Paper) by Paul on 29-07-2010

One of the most striking phrases in the White Paper comes on page 36

“Our ambition is to create the largest and most vibrant social enterprise sector in the world”

I am always excited by ambition in a Government White Paper. Read the rest of this entry »

If you want a revolution don’t get the senior staff of the status quo to organise it for you, or “Meet the new boss – same as the old boss”.

Filed Under (GP Commissioning, Health Policy, Primary Care Trusts, Reform of the NHS, Secretary of State) by Paul on 27-07-2010

or meet the new regional office of the National Commissioning Board – just like the old SHA.

The current Secretary of State for Health has called his White Paper “revolutionary”.

Because I know a thing or two about the theory and practice of revolutions, I was always careful not to call any of New Labour’s NHS reforms revolutionary. They were not revolutions they were just that – reforms. Read the rest of this entry »

If nationalising GP commissioning is the answer then the Government is asking the wrong question

Filed Under (GP Commissioning, Health Policy, White Paper) by Paul on 26-07-2010

Since the publication of the White Paper I have outlined some of the problems that come from each of the main architectural themes of the White Paper reforms and hopefully some possible solutions

  1. What is the responsibility of the National in the English NHS?
  2. Who is commissioning health care and how are they doing it?
  3. Who is providing health care and how are they organised?
  4. What are the transactional relationships between commissioners and suppliers and how are they organised?

2 Who is commissioning health care and how are they doing it?

This is the issue at the heart of the Government reforms and this is the policy implementation that unless it remains unchanged will destroy their impact. 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 »

The White Paper – Some issues (2)

Filed Under (Conservative party, Public Health, Reform of the NHS, Secretary of State, Uncategorized, White Paper) by Paul on 20-07-2010

What is the responsibility of the National in the English NHS? (Part Two)

The White Paper aims at very major changes to the responsibility of the National in the English NHS. Let’s go through these one by one:

  1. A National Commissioning Board will be created.
  2. The Secretary of State will no longer be responsible for the day-to-day running of the NHS but will lay out a ‘short formal’ mandate for the NHS Commissioning Board. This will hold the Board to account.
  3. BUT the Secretary of State keeps political control of the outcomes of all reconfigurations that political local government refers to him.
  4. The Health Bill will put NICE on a firmer statutory footing securing its independence and core functions.
  5. The Department will publish an information strategy.
  6. The Department will create a set of tariffs (although later on this becomes the role of Monitor).
  7. A National Public Health Service will be created and a public health white paper will be published this autumn.

Today I’m blogging about points 3-7 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 »

The White Paper – Some issues (1)

Filed Under (Public Health, Reform of the NHS, White Paper) by Paul on 15-07-2010

What is the responsibility of the National in the English NHS? (Part One)

In fact there are several really important issues contained within this theme and it will take several blogs to cover it all!

The White Paper aims to make very major changes to the responsibility of the National in the English NHS. Lets go through these one by one. Read the rest of this entry »

The White Paper – Some issues (Introduction)

Filed Under (GP Commissioning, Health Policy, Reform of the NHS, Secretary of State, White Paper) by Paul on 13-07-2010

How does the political philosophy of “Liberating the NHS” work and where are the limits of this new liberation theology?

Over the next few days I will outline some of the problems that come from each of the main architectural themes of the White Paper reforms and hopefully some possible solutions. Read the rest of this entry »

The NHS White Paper – Overall architecture of the reforms

Filed Under (Economic Regulator, GP Commissioning, Health Policy, Reform of the NHS, White Paper) by Paul on 12-07-2010

Tagged Under :

Over the rest of this week I will be posting a number of entries to the blog covering different aspects of the reforms in the White Paper. Here, on the day it is published, I thought it would be useful to take the White Paper at face value and assume it is all implemented as the Government would want it to be.
Read the rest of this entry »