Health Matters | Paul Corrigan's blog

On Tuesday evening I heard an inspiring speaker talk about the role he and his company are playing in the development of efficient hospitals in India. This was the third such talk I have heard over the last 6 months or so – all from Indian entrepreneurs who are driving down the cost of health care and thereby bringing it to many more people than under current provision.

This man, Shivinder Mohan Singh, unlike the others, is not a doctor. But like the others he is developing some very straightforward organisational principles and driving them into creating much more efficient hospitals. In fact he concluded his talk with the phrase “Keep it Simple” – all the time trying to apply very simple improvement techniques to what we all know are complex organisations.

During the Q and A it became clear that both he and the audience recognised that it would not be possible to simply apply what he was achieving in India in this country. In fact I recall that last year when a doctor who had revolutionised access to heart care through his hospital was asked if he would come and replicate what he was doing in this country he said that he would be mad to do so.

So at the end of the evening I was left with some complex thoughts.

First, entrepreneurs have a set of skills and capacities which would be immensely useful for the development of the NHS. What they do is bring very different approaches to the way in which value is achieved and those skills can help the NHS deal with the very hard tasks it is facing.

I don’t think they are the answer, but I do think they can add to our stock of answers. The main place I see that happening within the NHS at the moment is through the experiences of a number of non-executive directors (NEDs) in FTs. Increasingly the boards with which I work are trying to understand how they can develop new business models to provide better services. Frequently NEDs recognise they have a wide range of experiences which have achieved better value in previous worlds in which they have worked. Often the insights, precisely because they are from outside the NHS, point to a clear way forward. Sometimes their experience can’t be translated to the NHS.

Over the last 5 months or so I am hearing these voices make a bigger and bigger contribution to sustaining the NHS.

My second thought was a bit more depressing. There are thousands of people who care deeply about the NHS who see entrepreneurs such as Mr Singh as being not just outside of the NHS – but its enemy. The anger and alarm about the private sector and its involvement in the NHS that has swept through the debate about its reform over the last year has been the clearest example of the Government’s lack of narrative.

The debate has now settled into a common set of assumptions about the bad impact that the private sector would have on the NHS. This means that Mr Singh is experienced by some in the debate as an enemy.

This is very sad. The NHS cannot afford to turn its back on skills and processes which will help it deliver the much better value health care needed in the future.

This Government has completely failed to make that case.

But it still needs to be made.

Yesterday’s Health Select Committee report makes an important case against the Government’s NHS reforms. It argued that the reform programme has and will act as a diversion from the main task of improving value for money for the health service. Read the rest of this entry »

One of the more interesting possibilities that writing this blog offers is to try and bring together very different parts of the very different worlds that impact upon the NHS. At this moment all of the major medical organisations within the NHS are concentrating on the Bill and its passage through the House of Lords, which is an important issue for NHS policy since it now looks as if every organisation in the NHS is against it. Many expect the Bill to be defeated. Read the rest of this entry »

Last week I posted on the necessity for the Labour opposition to construct a set of medium to long term policies for the NHS which would clearly see them work with it over a period of time that I think of as ‘the long austerity’.

I received a number of comments from people who felt that the reforms in which as special adviser to Alan Milburn, John Reid and Tony Blair I was involved from 2001 – 2007 had laid the ground for the current reforms and that I should take some of the blame for the current Government. Read the rest of this entry »

Yesterday we woke up to the main item on the 6 o’clock news on the Today programme being the fact that the Royal Colleges of Nursing and Midwives both  want the Government NHS reforms stopped completely. The newsworthiness of this announcement was that in the past the nursing colleges had had criticisms of the Bill – but now they were completely against it. Read the rest of this entry »

Nearly a year ago, at the end of January, during the Health and Social Care Bill second reading in the House of Commons a number of Conservative and Liberal Democrat MPs, following their briefing from Government whips, all made the same point about what they hoped from the Bill.  Each of them said that part of their local hospital had been threatened with closure – or actually been closed = and they knew that under this Bill such closures would not have happened.

That was why they were supporting the Bill. Read the rest of this entry »

As I said on Monday, in a few months’ time the Government will look back at the struggle it had to get the Act through Parliament and see it as a really easy risk—free activity compared to its implementation.

By the time the Bill is passed there will be about a year left for most of its implementation to take place from 1 April 2013.

There is a lot of complex new activity to develop in that year. Read the rest of this entry »

If the Health and Social Care Bill passes through Parliament before Easter, it will mark the end of a political period in NHS politics. For the last 18 months it has been possible to define one’s overall political position as being for or against the Bill. This has meant that the Labour Party has been able to define its policy on the NHS through its stance on the Bill. That is perfectly legitimate for an opposition party. The Government proposes and the opposition – usually – opposes.

Given that the election took place in May 2010 it is also legitimate for an opposition to spend some time working through its policy rather than setting out its stall so far in advance of another election. Read the rest of this entry »

A couple of people said over the weekend that they thought my post on Friday about the passage of the Health and Social Care Bill was a bit of a tease. They wanted me to explain what I thought would actually happen next if the Bill is passed. I think there are three potentially different outcomes – each of which needs a post in itself.

Firstly there is the immediate politics of what happens if the Bill is passed – how do the Government – as victors – behave? How do those that wanted the Bill defeated behave – as losers? Read the rest of this entry »

It’s the question I am most frequently asked when working with health care providers of NHS services and NHS Commissioners…

…and in terms of real outcomes it’s a very difficult one to answer.

Some things we do know. Read the rest of this entry »