Peter Hoskin

NHS on life support

NHS on life support
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Earlier, Fraser mentioned the work of the think-tank Reform, and today that same group released an insightful - and scathing - report on the state of the NHS.  Download it, read it, and internalise it, as it should set the healthcare agenda for the momentous year ahead.


The report's key message is that the Government is talking the talk on beneficial NHS reform, but not walking the walk.  This floundering situation is all the more worrying as we're about to enter healthcare's equivalent of a "perfect storm" - during which demographic, lifestyle and technological changes will place an unprecedented level of stress on the already-creaky health system.

The answer isn't the new charter that we've been lead to expect from the Government, nor is it Brown's faux-Blairism.  Instead, Reform outline an economic constitution; a set of principles by which a well-managed, less-costly and customer-orientated healthcare system could be formed.  Here are their guidelines in full:

• "More power to customers. The constitution should be based on informed choice of both commissioner and provider. This would be a major advance due to the introduction of choice for non-consultant-led services. It should also increase the use of direct payments."

• "Stronger independent commissioning. There should be clear and distinct separation of roles at all levels."

• "Provider pluralism. The economic constitution would set out the priority of developing a variety of providers. A viable market can only develop where the NHS accepts that its own capacity is going to reduce over time in order to allow a market to develop. The biases against a genuine level playing field, in particular subsided public pensions, must be eliminated."

• "Flexible labour markets. The inability of central agencies to plan manpower, salaries and training make these a priority."

• "A clear success and failure regime, on the model of the private sector."

• "Flexible prices determined by quality and cost."

• "Separation of central regulatory and political/strategic responsibilities."

Now, if only Brown would truly take on this pro-reform agenda, rather than just telling us he is... 

P.S. Two of the report's co-authors have written an article for Conservative Home.