Health Matters | Paul Corrigan's blog

Regular readers of the blog will not be surprised that I am returning to the problem of the Government’s narrative about the NHS. What story is it trying to tell? Read the rest of this entry »

One of the outcomes of the Government’s June 2011 reform of its July 2010 NHS reforms has been the increased centralisation of Government control. As I will explore later in the week, the first set of reforms that was intended – in the heady days of July 2010 – to liberate the NHS and localise decision making is now set to provide much more national centralisation of commissioning than has ever previously existed. Read the rest of this entry »

Luckily this blog does not have to engage too deeply with the politics surrounding the Coalition Government’s policy on public expenditure cuts. That means the efficacy or otherwise of last Saturday’s TUC march and the Labour Opposition’s policy on the cuts is not a core issue for us. Read the rest of this entry »

July 7^th has seen the first of the attacks from both sides that the Government health team will experience for the duration of their stay in charge of the Department. How they deal with both of these attacks will determine whether their stay in charge of the NHS is measured in weeks or years.
Read the rest of this entry »

At first sight the Government’s plan – published on May 20^th – appears to provide a confused answer to the question of who is going to commission NHS health care from 2012.
Read the rest of this entry »

One of the few consistent and long term insights that ‘management literature’ has given me is transactional analysis. Managers may be treated by those they manage as “parents” and managers can treat those they manage as “children”.  Sometimes managers are good parents and sometimes they are very bad parents.  Sometimes children are naughty and demand to be punished, and sometimes they want to leave home and set up for themselves.
Read the rest of this entry »

Sometimes I write about things that start off looking so esoteric that I nearly lose my nerve in starting to write about them, let alone encourage the reader to read them.

But here goes.

In the autumn of 2003, when New Labour was in the last set of trenches getting the NHS Foundation Trust legislation through the Houses of Parliament, someone came up to me and congratulated me on creating the fuss around Foundation Trusts as a smokescreen for the really important change. They said that whilst FTs were important they were acting as a smokescreen for the creation of a pricing mechanism for the NHS – what came to be known as “Payment by Results”.
Read the rest of this entry »

Last Monday January 25^th every PCT in the country finished its Commissioning Strategy Plan (CSP) for the next three to five years. Over the next month these will be published and somebody should be making sense of this “bottom up” approach to planning the future of the NHS. In a way, since this is the commissioning intent over five years for about £500 BILLION, it is more important than any DH operating plan or white paper. The collective wisdom of these documents should be describing the future of the NHS.

Even more significant is the problem that if the PCTs do not have the capability to bring these plans into reality the NHS will probably have no future.
Read the rest of this entry »

As I have said on this blog on many occasions, the reforms in the NHS are still incomplete. This means that the old culture that has run through the NHS, like names through a stick of rock, still has an enormous impact on how people make things happen. 

Given the reforms are so incomplete it is hardly surprising that, in facing the coming drop in the growth of public spending on the NHS, there are two distinct ways in which the NHS is going to try and work through it.
Read the rest of this entry »

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.
Read the rest of this entry »