One of the many things that Ara Darzi got right in his 2008 report was the importance of care planning for people with long term conditions. The crucial issue if you have a long term condition is the very specific way in which the disease interacts with you and your life. Having asthma or depression affects you in different ways from me. Your body has different lungs for coping with asthma and might also react to depression in a different way. And your mind will deal with the stresses of both conditions in a different way from mine. Your life, your friends and your family will give and take different things from you. Of course given the millions suffering from these conditions, there are patterns but each sufferer also needs to be understood as an individual – differing from patient to patient. Read the rest of this entry »
If we look at the history of NHS medicine over the last 20 years, one of the conditions that has seen the most development has been the treatment of people with HIV. Much of this capacity to save and improve lives has been brought about by important developments in drug treatment, but as important has been the improvement of treatment and self management patterns that are, for patients with HIV, now much more inclusive. Read the rest of this entry »
There is quite rightly a great deal of discussion about the public’s need to be active in the prevention of diseases that could ruin or even shorten their lives. It is of course much more sensible to, for example, lose weight before you get type 2 diabetes; or start an exercise programme before you get very depressed. But for many the motivation to do something to prevent the onset of something bad in the future is just not high enough. People don’t believe that it will happen, and given how hard it is to change their behaviour, don’t bother. Read the rest of this entry »
Listening Group 2 – Patient Governance and Patient Involvement
Filed Under (Accountability, Health Improvement, Health Policy, Listening Groups) by Paul on 18-04-2011
I am running through the four different groups that the Government have set up to organise listening during their 2 month gap.
As I did with the previous listening group, the way in which I would like to frame this policy discussion is controversial. Read the rest of this entry »
Listening Group 1 – Choice and (today) competition
Filed Under (Innovation, Listening Groups, Patient Choice, Reform of the NHS) by Paul on 15-04-2011
In my previous two posts in outlining the arguments against increasing patient choice and the repercussions of that choice in terms of the flow of resources, I have tried to substantiate that, for a few people, there is a strong moral case against NHS patient choice. But the moral case against choice per se goes strongly against the mainstream grain of our society. In England not many believe that the state should tell us what to do in so many aspects of lives – which clothes to wear, and even which school or college to go to. Equally there are not many who believe that resources should be distributed to organisations irrespective of whether people have chosen to use services from those organisations. Most of us feel that making consumer choices – and having resources follow those choices – are a part of the way in which we live our lives. Read the rest of this entry »
Choice and competition – Listening Group 1
Filed Under (Health Policy, Listening Groups, Patient Choice, Reform of the NHS) by Paul on 14-04-2011
Yesterday I attempted to tackle some of the arguments against the extension of patient choice into the NHS. One of the reasons for extending this much further is to demonstrate that socialised medicine, paid for out of general taxation, can provide the taxpayer/consumer with the kind of experience that used to be only available to those that paid privately. Read the rest of this entry »
Is anyone really listening? NHS reform – starting with choice and competition
Filed Under (Health and Social Care Bill, Listening Groups, Reform of the NHS) by Paul on 13-04-2011
Last week the Government announced that they would listen to discussions about reforming the NHS. Yesterday the four chairs of the groups set up to organise some of the themes that need to be listened to met Dr Steve Field – the person who is co-ordinating the inputs – and DH staff. Read the rest of this entry »
The NHS and the Tory Party – is it really true love?
Filed Under (Conservative party, Culture of the NHS, Health and Social Care Bill, Reform of the NHS) by Paul on 11-04-2011
This ‘listening exercise’ – even if it is not a serious attempt by the Government to change course – does give the rest of us two months to mobilise both policy and argument for sensible reform after this 11 month disaster. Read the rest of this entry »
Sometimes it doesn’t make you feel good to be proved right. But last week I pointed out that a Government that could not construct a narrative about its NHS reforms when it was going forward, would find it very hard to tell a coherent story when it’s going backwards. Read the rest of this entry »
What does it look like when a Government loses control of its health policy(2)?
Filed Under (Coalition Government, Health and Social Care Bill, Health Policy, Reform of the NHS) by Paul on 07-04-2011
Monday April 4th was a very bad day for Government policy on NHS reform.
Tuesday saw the Deputy Prime Minister variously promising significant or substantial changes in the Health and Social Care Bill. When journalists took this message to the Department for Health they were told that the changes would be neither significant nor substantial. Read the rest of this entry »
