Health Matters | Paul Corrigan's blog

Last week David Nicholson was quoted as describing as “nonsense” the idea that the provider arms of Primary Care Trusts should become Community Foundation Trusts. It would appear that the Chief Executive of the NHS is softening up the whole organisation for a complete U turn on how it is going to develop its community services.

This is the same Chief Executive who said something very different in his first operating framework for 2007/8. This was an important document for David because he had become Chief Executive in September 2006. This meant that the operating framework for 2007/8 was his first opportunity as the new boss to give the organisation its direction.
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It is no secret to say that reforms within the NHS are incomplete. It is even less of a secret to say that much of the culture of the NHS (by which I mean the way in which we do things round here) still resonates with the song of the unreformed NHS.

Why does this matter?

It matters because over the next 4 years the NHS faces an enormous challenge -caused by the mismatch between the increased demand for NHS services that comes from an aging population and, at the very best, an increase in resources that keeps pace with inflation.
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Something very strange is happening to current Ministers of Health in the run up to the election and at the end of this Parliament.

At periods of time such as these Ministers are usually trying to demonstrate both their surefootedness and their ability to make things happen in the NHS. They try to use Government to impress upon the electorate that they are powerful people who can make things happen. It’s not a bad tactic. 
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In the last few weeks, following the Secretary of State’s speech in which he stated his preference for NHS commissioners to buy care from NHS providers, there has been an increasing interest amongst managers and policy wonks in how he is going to put this into operation.

Because let’s be clear, it is his personal preference, it is not the manifesto on which he was elected in 2005. Back in the days when Labour Governments went into elections with the expectation of winning large majorities, the 2005 manifesto pledged the government to increase the range of provision available to NHS patients but would do so from a range of different providers.
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