Health Matters | Paul Corrigan's blog

I learned yesterday (30/06/2010) that there will be a further Government white or green paper on public health – due out in September. Whilst the July White Paper on the NHS will be talking about the spending of £100 billion of public money on NHS commissioning of health care, it can probably be written with just a nod in the direction of other Government Departments. But this public health paper could end up being more important BOTH for what is left of the Department for Health and other Government Departments.
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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.
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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.
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…except in the NHS where he keeps telling us he won’t be

David Cameron made an interesting speech to the Welsh Conservative Party at the weekend. His political problem is that whilst I am the sort of nerd to find code breaking interesting, most people don’t really know what he means. I know, I am sad, but there’s nothing that is more fun for me that decoding the weird text of a senior politician.
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If some of this post reads oddly it’s because it reports on a seminar that was held under Chatham House rules. These rules mean members of the seminar are not allowed to say what someone said at the seminar but you are allowed to say that it was said. This allows people to say what they think without fear of attribution leading to a consequently free-er discussion.
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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 December 2009 David Nicholson Chief Executive of the NHS gave an interesting interview in the Financial Times in which he said,

“One of the mistakes that the ideologues around reform make is that they think that all you have to do is put the right incentives and penalties into the system and the service will respond”

NHS culture always demonstrates it’s a bit rattled when it calls people it disagrees with ideologues.

What they mean is that we inside this warm and cosy NHS culture work with common sense. Those people outside trying to change us only have a nasty foreign thing called ideology which we don’t need.
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On September 17th the Secretary of State said that he had a preference for NHS providers over others. This change in policy has caused some concern but that debate has not been held in public. In this weeks HSJ it now surfaces in a public debate about the future of commissioning. I have written an article (1,2) and so has the Secretary of State (1,2). The editor has a leader on the topic.

I am sure this debate will contnue in public for some time now before it reaches a settled position. The Financial Times commented in an article published on 29th October 2009

All staff in Primary Care Trusts should recognise the structure of this post on my blog.

Between now and December 18^th all PCTs are preparing their Commissioning Strategy Plans. In the New Year they will be visited by a Panel chaired by their SHA, and will for a day, be inspected against a set of criteria. This will lead to a judgment about where they are in terms of their competency as world class commissioners. There are 11 competencies that they will be judged against.
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