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 »

Gloomy settlements and the NHS

Filed Under (Spending Review) by Paul on 29-10-2010

This is yet another post on the repercussions of the Comprehensive Spending Review and its implications for the NHS. It’s been interesting that since the review was published there has been more press comment on the belief that the NHS is going to run out of money than any of the public services that were actually cut. This is a genuinely puzzling psychology. Read the rest of this entry »

The NHS and the Big Society – 1

Filed Under (Big Society, Public service reform) by Paul on 26-10-2010

I have been to a couple of meetings about the Big Society and have generally left none the wiser. But a recent breakfast meeting at the Kings Fund was good…

The three speakers at this all had something interesting, important and above all concrete to say about how the NHS might relate to the Big Society. And each of them in very different ways had a big sweep of history in their view. Read the rest of this entry »

Why are there such big problems for this Government in trying to get extra funds into social care?

Filed Under (Accountability, Coalition Government, Health Policy, White Paper) by Paul on 25-10-2010

I think I should clarify something I said in last Thursday’s post on the Comprehensive Spending Review as some commentators have brought two things together and misunderstood. I’ll start the explanation by exploring why the coalition Government’s relationship with Local Government is so difficult. Read the rest of this entry »

The Spending Review and the NHS

Filed Under (Coalition Government, Health Policy, Spending Review) by Paul on 21-10-2010

For the next few years the announcement of the spending review places the NHS is a very odd position both in the eye of the public and in the view of other public services.  There are some very high level issues here that will also have an impact on the day to day of NHS politics and practice. Read the rest of this entry »

Campaigning in Poetry and Governing in Prose – 2

Filed Under (Accountability, Coalition Government) by Paul on 19-10-2010

Poetry, in opposition, flows from all sorts of lyrical relationships. One of the most important forces of lyrical opposition comes from siding with powerful minority groups. They want their strident opinion to be imposed on majority activity when it would be merely useful, but not at all lyrical. Read the rest of this entry »

Like ET, FTs want to go home. It’s just that bit farther than the next galaxy…

Filed Under (Culture of the NHS, Foundation Trusts, Reform of the NHS, Secretary of State, Uncategorized) by Paul on 18-10-2010

As I have mentioned before’ there is a management consultant adage that “culture eats strategy for breakfast”. So it was evident that at some stage in the current Secretary of State’s reform programme that some of the cultural certainties that make the NHS go round would develop a life of their own and undermine the reform programme. Read the rest of this entry »

Campaigning in poetry and governing in prose

Filed Under (Accountability, Conservative party, Health Policy) by Paul on 14-10-2010

I know that not many of you have much respect for elected politicians but unlike most I think it’s hard work winning elections and representing people, and I recognise that without somebody having the nerve to carry out that role, our society would not be the democracy that we all want it to be. (Being married to one does rather impact upon me!). Read the rest of this entry »

NHS resources between now and the proposed abolition of PCTs in April 2013 – Will the sums add up or will there be deficits?

Filed Under (GP Commissioning, Primary Care Trusts, Reform of the NHS, Secretary of State, White Paper) by Paul on 12-10-2010

The problem with the organisation of NHS finances is that it has had less reform than almost any other area of NHS operation. It’s true that there are some prices, some contracts with some buyers and with some sellers, and that this has changed behaviour for some of the best FTs irrevocably. But the problem is that the view from the top of the NHS is that it still believes that it runs the finances of the NHS from Whitehall. Able to have ‘line of sight‘ of the money and being able to descend upon localities to tell them what to do. And to a large extent they are right. Read the rest of this entry »

The politics of NHS reform in October 2010 – Will the Change Process Work?

Filed Under (Conservative party, GP Commissioning, Reform of the NHS, Secretary of State) by Paul on 11-10-2010

This is the third of the four posts I promised last Thursday on the issue of where the politics of NHS reform stand, as of October 2010.

Will the change process between now and April 2013 work?

The first posted on 7th October looked at the issue of Andrew Lansley’s relationship with his Government colleagues and examined whether they were in this to support him for the long haul.

The second posted on 8th October talked about the necessity of stirring up some enthusiasm for these reforms.

Today’s asks the question “Will the change process between now and April 2013 work? Read the rest of this entry »

Where will the politics of NHS reform in October 2010 stir up some enthusiasm?

Filed Under (Foundation Trusts, GPs, Health Policy, Reform of the NHS, Secretary of State) by Paul on 08-10-2010

This is the second of the four posts I announced yesterday on the issue of where the politics of NHS reform stand, as of October 2010.

Yesterday I looked at the issue of Andrew Lansley’s relationship with his Government colleague and whether they were in this to support him for the long haul, Read the rest of this entry »