Chris Ham: Learning from others—devolved governance in the Australian state of Victoria

I spent a week working in Australia earlier this month and it made me reflect on similarities and differences with the NHS in England. The funding context feels quite different, with healthcare spending in Australia having risen by 5% per year in real terms over the past decade. On the day I departed, a report […]

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Latest spending review: Hail to the chiefs . . . but major challenges remain

As the details of the spending review were announced this week, the scale of the achievement by Jeremy Hunt and Simon Stevens in securing a frontloaded NHS settlement became clearer. The spending review is, in the words of the Institute for Fiscal Studies, “one of the tightest in post-war history.” Unprotected departments will see cuts […]

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Peter Killwick: Risks associated with conflicts of interest at CCGs

Conflicts of interest are an inevitable part of the commissioning environment. There are obvious advantages to having local GPs at the heart of commissioning and in many areas they have made a very positive contribution. But the governance challenges associated with commissioning are enormous. In recent months, we have been working with a number of […]

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David Zigmond: Arguments about money are often about much else

When partnerships break down, money is an expected battleground. One of the most public and fiercely destructive examples is in the disintegrated marriage. Charge and countercharge escalate; then these are translated into monetary forms. Understanding this translation is crucial to any hope of understanding or containing the human agenda. For money is so often the […]

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