Chris Ham’s article in last week’s Observer newspaper (“Politicians have ducked hard decisions on the NHS for far too long” Sunday 19 June 2011), and a news story in this week’s BMJ (BMJ 2011;342:d3921), claim that up to 20 hospitals, around 10% of the total in England, may not be financially sustainable. This is highly probable […]
Category: NHS
Martin McShane: A tale of two citizens?
Four years ago I participated in scenario planning. The document that emerged is as relevant today as it was then – perhaps because it was looking “Over the Horizon,” taking a ten year view and considering plausible alternative futures for health care. We envisaged four scenarios: Fools Gold, Swimming Upstream, Red Arrows, and A Tale […]
Kailash Chand: The Health and Social Care Bill remains flawed and unpopular
The government has set out its stall in detail on the changes it will make to the Health and Social Care Bill. Many of the BMA’s concerns were addressed by the NHS Future Forum and the government’s response. This includes restoring health secretary’s responsibilities, modifying Monitor’s duty to promote competition, and the need for clinicians […]
Douglas Noble on reforming the reforms
The pause ended in dramatic fashion last week with the publication of the NHS Future Forum’s recommendations. Most interesting was the orthopaedic surgeon at Guys Hospital who confronted the prime minster and deputy prime minister in a rage because the camera crew were not suitably dressed for a hospital. It hit home on all sorts […]
Richard Smith: The NHS debate – missing most of what matters
I’ve stayed out of the NHS debate. These days I spend lots of time in countries like Bangladesh, Kenya, and Guatemala, and viewed from those countries – where health workers and essential drugs are often missing – you wonder why the fuss over the NHS. Everybody has a doctor, primary care is strong, and access to […]
Martin McShane: Director’s cut
I picked up a book recently co-authored by Colin Price, the essence of which can be found in this slide deck. One of the key points made is that if you are trying to transform the way you do things it is really important to have a clear narrative, a story which people can connect […]
Edward Davies: NHS Reforms – be careful what you wish for
David Cameron’s speech on NHS reform this week should have marked a substantial victory for doctors’ leaders. In recent months they have been even more outspoken than usual in their opposition to whatever it is the government’s saying this week and David Cameron let them know he was all ears. “I’ve heard the passion of […]
Peter Davies: Is it time to scrap the primary-secondary care divide?
Suppose a pathologist was to say, “Because I am not a GP I do not belong here.” Or a GP was to say, “Because I am not a cardio-thoracic surgeon I do not belong here.” No, (paraphrasing St Paul) we are all parts of one body of medical enterprise, and the patients need different doctors […]
Martin McShane: Toffee popcorn
I went to see a film with my son. He bought a packet of toffee popcorn. I love toffee popcorn but it has little nutritional value and in excess would be bad for you, but as it was available I couldn’t resist it! For some reason the experience came to mind when I read a […]
Martin McShane: No rules
I read the King’s fund paper on management in the NHS. It should be read widely. Some politicians and professionals understand that successful organisations have good management. Some even understand that bureaucracy is a product of a set of rules. A bureaucrat can’t be a bureaucrat without those rules. The rules I have to work […]