Health Matters | Paul Corrigan's blog

Yesterday we woke up to the main item on the 6 o’clock news on the Today programme being the fact that the Royal Colleges of Nursing and Midwives both  want the Government NHS reforms stopped completely. The newsworthiness of this announcement was that in the past the nursing colleges had had criticisms of the Bill – but now they were completely against it. Read the rest of this entry »

One of the first things I should say is that if we look back a year and think about the predictions made in early January 2011, it demonstrates that trying to predict the future politics of the NHS is a mug’s game.

Back in January 2011 the Government had just published its Health and Social Care Bill. The Bill was a true reflection of the White Paper that had been published the previous July and contained the ‘revolutionary’ changes outlined in it. Everyone was pretty confident about the reform programme – which had just been vetted by Oliver Letwin. Read the rest of this entry »

The car crash that is the Government’s policy-making process for NHS reform has somewhat hidden the fact that there is an entirely different policy-making process going on. Constitutionally this has no real relationship with the Government’s process. This is the Francis Report on Mid Staffs.

Make no mistake about it, though this may look like a Public Inquiry into a hospital that let down its public, it is actually an organisation writing the next round of NHS policy. Read the rest of this entry »

I can understand how impatient the current Secretary of State must be to get the discussion about the nation’s health back to ‘the big picture’ and away, for example, from the detail of who, out of the NCB, Public Health England, the local Health and Well-being boards and the local Clinical Commissioning Groups is actually responsible for commissioning services that will decrease the number of smokers. (The answer being of course, all of them). Read the rest of this entry »

Now I’m not saying that when I was advising new Labour Ministers on health reform that we didn’t sometimes do the wrong thing. Of course we did. But generally when someone came up with a really crazy idea someone would say “Hang on – let’s just think about that for a bit longer shall we?” A warning bell would go off in somebody’s head – and we would all calm down. Read the rest of this entry »

I crave a little self indulgence from the reader for the first half of this post since it covers an issue that stayed near the front of my mind every week for six years of my working life.

Last Friday saw several of the broadsheets rehearsing the history of the use of targets in the NHS over the last decade. They were doing so because the current Secretary of State, having spent 7 years railing against politically motivated targets, set his own last Thursday. Read the rest of this entry »

Last Thursday I blogged about a report which examined different approaches to losing weight, and received some interesting comments which I will talk about later in the week.

But by chance this post was published on the day that the agreement between the Government and Circle at Hinchingbrooke was finally signed and some people want to know my thoughts about this. Read the rest of this entry »

As I mentioned yesterday I spoke last week at the National Association of Primary Care Conference. What was really interesting was listening to the Secretary of State speak just before my panel session began. Read the rest of this entry »

Last week I spoke at the National Association of Primary Care Conference and was interested to hear the Secretary of State. As I shall explain tomorrow it was good to hear him articulate a narrative explaining why his reforms were important to an audience of future leaders of Clinical Commissioning Groups. (Even if that narrative failed to encompass the real life experiences of creating CCGs that those in the room expressed to him). Read the rest of this entry »

(In yesterday’s post I made the point that I felt that the Secretary of State had shifted his position and now wanted to act to stop the bad results of the variation of practice with the NHS. This met with a number of responses from readers. Some of the early Twitter comments felt I was being incurably optimistic that the Secretary of State would really begin to tackle variation of practice by radically changing hospital organisation. It’s strange to be in the position of defending a very damaged Secretary of State, but I feel he has come to this position not through choice, but because he has had to.

18 months into the job he becomes responsible for the NHS and everything that happens to it. That means that the results of the CQC inspection that was published the week before stops being ‘the fault of the Labour Government’ and becomes the fault of this Government. Given that he has now agreed a set of changes to his Bill which demonstrate that he is firmly responsible for the NHS, it’s about now in the Parliament when, so far as the public are concerned, he becomes clearly responsible.

Therefore when any credible body now criticises the NHS he will need to say what he is going to do and given that he will have to say what he is going to do, someone will start to hold him to account for it.

This will also happen to the Government in other areas of policy and economics. For as long as possible they will say that it’s the previous lot’s fault, but sooner or later the public will think that too much time has passed since the election and that argument will no longer work. This responsibility has come earlier in health than in other policy areas because the last 15 months have been such a noisy political mess over NHS reform. The public clearly know that so far as the NHS is concerned there is a new Government – because there has been so much noise and such a mess.

So my belief that the Secretary of State has changed his position on tackling variation in the NHS does not come from a naive position that he has suddenly changed his mind about his responsibility for improving bad practice. No, I believe he has started to take this seriously because the public and the voters have recognised that after 18 months in the job he is in charge. From here on in. It is his responsibility).

Today I want to comment on another part of his speech that will obviously become a theme. On 27 September I mentioned the fact that when the Secretary of State named 20 trusts that were potentially clinically and financially unstable because of PFI deals he managed – in one speech – to make the leadership of trusts come out in support of their PFI deals. Read the rest of this entry »