Filed Under (Health Policy, Resources, Speaking) by Paul on 30-09-2009
Meeting for the Smith Institute
Off to the seaside to talk at a fringe meeting at Labour Party Conference. For those who have never been to political party conferences it is not the main set pieces in the Conference that are the main attraction but the fringe meetings. Hundreds and hundreds of meetings packed into lunchtimes, breakfasts and early evenings. At the beginning of the week people usually fill their diaries with events they want to go and then spend all their time rushing between them.
If you are lucky you get to hear some real debate. If you are unlucky you get only a free egg sandwich or a soggy croissant.
For the last few years all of the health fringe events at all Party Conferences have been helpfully organised into one ‘health hotel’ so that it is possible to move between them without racing all over Brighton or Manchester.
For much of the last 20 years I have been going to Labour Party Conference as work, and the notion of ‘enjoying it’, when my main task was ensuring that a Secretary of State got to his 6th speaking engagement of the day with the right notes and in the right place and only 30 minutes late, was something of an alien concept.
Now I am free of all that and on Monday 28th September I spoke at my first fringe meeting. “How can we pay for tomorrow’s NHS” organised by the Smith Institute. On the platform was Neill Churchill from Asthma UK, Dr Tim Cave from Novartis, the current Minister of State for the DH and, really interestingly, Alan Milburn Secretary of State for health 1999-2003 (and my old boss)
Let’s not forget that this was the Labour Party and therefore the audience really wanted the answer to “Can we pay for tomorrow’s NHS?” to be “yes”, and it will still come out of central taxation!
What was interesting and important was the audience response to the answer given from the platform that said, “Yes we can go on paying for tomorrow’s NHS, but only if it is TOMRROW’S NHS and not today’s.” So the audience was forced to confront the dilemma that radicals have to.
If we really want to save the funding mechanism and the basic principle of the NHS into the future then the only way we ensure this is by changing nearly everything else.
The platform offered variations on the strength of reform. But nobody said that we can secure the future by slowing it down.
Because he has the most experience, Alan Milburn articulated the most vigorous programme of reform. He felt that there were four main themes to current reform and what was vital was that their speed of direction needed to be increased.
- National Standards with an ever more powerful NICE
- Locally based commissioning with a clear mandate to use that money to improve patient care
- A bigger plurality of provision for NHS Commissioners to choose from
- More choice for patients
All four of these working together provided the movement that was necessary to ensure the system kept moving forward and delivered value for money.
He made clear his disagreement with the current Secretary of State, Andy Burnham, who said that he believed that NHS providers should be preferred by commissioners to others, as a matter of principle. Alan Milburn said that the only preference that a Secretary of State should have is not for this or that group of providers, but should be a distinct and unswerving preference for patient’s interests over any sort of providers. The NHS needs to buy the very best care from whoever provides it.
Most commissioners’ decisions will be made in such a way as to secure current NHS providers. But not all of them will have that end result.
The debate about the importance of maintaining competition will remain of crucial importance for the NHS in meeting tomorrow’s health and health care problems and will be a major issue for this blog in the coming months.