Back in May 2010 the professional executive committee and NHS Lincolnshire board agreed to delegate the management of the minor surgery local enhanced service to the practice based commissioning (PBC) Groups. A lot of discussion and analysis had taken place prior to this decision. Practices had said that the historical budget was insufficient to meet […]
Tag: NHS reforms
Martin McShane: Nietzsche and commissioning
As part of the development of our Clinical Commissioning Groups (CCGs) the seven GP CCG chairs now have a place at the NHS Lincolnshire Board meetings. The agenda was not particularly unusual. We were required to approve the Equality and Diversity Strategy. We had a couple of papers dealing with our legacy document and the […]
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: Appeasement
The changes the government is proposing in response to the NHS Future Forum might satisfy most of the people for some of the time but their implementation immediately struck me as posing a number of problems. Where the changes stick to principles, for instance around the NHS constitution, the role of the secretary of state, […]
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: 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 […]
Annabel Ferriman: What a way to decide the future of the NHS
Suddenly Health Secretary Andrew Lansley’s proposals to “reform” the NHS look safe. For more than nine months, since the publication of Liberating the NHS last July, doctors, nurses, think tanks, and academics have been begging Lansley to re-think his ideas. By the start of the “pause” in April, it looked as though the government would […]