Health Matters | Paul Corrigan's blog

One of the more interesting speculations that people make about the future of the NHS is about the nature and shape of what NHS secondary care might look like in ten years time. Everyone recognises that there will be continual change in what takes place in NHS secondary and tertiary hospitals, and that this will probably mean that the structure and organisation of that care will be very different from the trust form that holds sway at the moment.
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Fair question.

Understandably PCTs want to know what the policy of the main opposition Party would mean for them if, after the General Election, the Conservatives were to form the Government.  PCTs are looking at what leading Conservatives are saying in all the different forums to discover their future.
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In the last couple of weeks I have been posting about the gap that exists between the Tory politics of the NHS,

“Vote for me and I, as a politician, will keep your hospital open”

and their policy,

“Vote for me and I will make sure that politicians like me have no power over decisions and will leave them to clinicians”.

This is important at the level of shadow cabinet policy and politics. In the last few weeks it has also become clear that for the Conservatives to win the election they will have to have well over 100 new MPs. So it’s interesting to see where they stand on this issue of policy and politics.
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One of the odd things about bringing about change is how difficult it is to get really speedy research feedback from anything new that you bring in. You have to wait a long time before anything definitive can be said about new policy interventions.

It’s understandable that when you start something off people say, “Where is the research evidence for that new policy?” Understandable, but always impossible to answer for anything innovatory. It’s also the case that the long term accretion of habit that accounts for current practice never has, or needs, any research to back it up at all. So it’s only the new that needs the support of research
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The problem when everyone starts to talk about the same thing is that most people try to become experts in subjects they don’t really understand. That’s now become the case with productivity in the NHS.

If anyone wants to say anything about anything now they have to say something about productivity. Of course this is a good thing – in that it makes people think about the resources they are spending on their new idea – but the problem is that there are some very tenuous links between the idea, and actually improving productivity.
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Regular blog readers will have picked up that this blog is following the case of the third sector versus the Secretary of State to be heard before the Panel for Cooperation and Competition within the next 30 days or so.

The story so far is that on September 17^th last year the Secretary of State said that he had a personal preference for NHS providers as the health and health care provider from whom NHS commissioners should buy their health care.
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One of the aspects of Conservative NHS Policy that will cause most amusement over the next few weeks of election campaigning is their pledge to take politics out of the NHS.

We will have a political election campaign about the NHS pledging to take politics out of the NHS.

This is a contradiction that should be worth a laugh or two and occurrences will be posted on a regular basis on this blog. The first appeared in my HSJ column of 27^th January..
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Note: This article first appeared in the HSJ on 28th January 2010.

The NHS problem for the Tories is not with their policy – they obviously have recognised that no Government can be elected that threatens the basic principles of the NHS. No their policies contains straightforward themes of public service reform, but their problem is caused by the contradiction between their policies and their politics.
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