Nhs

An anti-cuts campaign website, False Economy, claims that 50,000 NHS jobs will be lost over the next four years. It’s a bald, headline grabbing figure and the response has been predictably feverish.   But tug a little, and the numbers unravel. One of the key points is made by False Economy themselves: that “most of the cuts are likely to be achieved through natural wastage” – in other words, by people moving on, or retiring, of their own accord. In figures highlighted by the Department of Health, for instance, one foundation trust expects to shed 14 per cent of its workforce through natural wastage by 2013. The health service may

Last week, Reform published its 2011 public service reform scorecard. It judged each major government department against the three criteria set out by David Cameron: accountability, flexibility and value for money. The report finds the Home Office’s policing reforms succeeding on all three fronts, but inconsistency across other government departments. The Government’s health reforms are awarded grade D overall, with an E for accountability, a D for flexibility and a D for value for money. Here’s how the coalition can get its NHS reforms back on track.   The government has recognised the need for fundamental reform of the NHS. The proposals announced in the July 2010 White Paper are

Last November, Margaret Forrester, a mental health worker for the Central North West London Mental Health Trust in Camden was suspended for giving a colleague a charity booklet called “Forsaken – Women From Taunton Talk About Abortion” to a colleague –  they’d been discussing the information they offered to patients. It had the stories of five women who had experienced what the author describes as ‘post-abortion syndrome’, including depression, relationship issues, suicidal feelings and fertility problems. So, the downside of abortion, then. To begin with – no problem. Her colleague didn’t seem offended. But a few days later her manager told her she was being sent home on ‘special leave

It is imperative that the coalition keeps its nerves and its composure during the months ahead. 2011 will try the coalition’s fortitude, its deficit reduction plan and its public service reform programme will both come under sustained attack. It is vital that the coalition continues to explain clearly and patiently why it is doing what it is doing. Watching the Andrew Marr show this morning, I was struck by how tetchy Andrew Lansley was during his interview. Right from the off, he seemed irritated at Marr’s questions. Some of this irritation was understandable. Lansley’s reforms are always treated as if they have come out of the blue, when Lansley talked extensively

A consensus has formed in the commentariat that besides George Osborne’s stewardship of the economy, Andrew Lansley’s healthcare reforms could become the government’s vote-loser. The political facts are as simple as the forms are complex. One, David Cameron ran a campaign based on a promise to protect the NHS. Many people thought that meant from cuts and culls alike. The Health Secretary’s reforms look, whatever the truth may be, like they are going back on the PM’s promise. Second, the reforms can only be successful if a range of stakeholders – voters, practitioners, analysts – have been brought along, and had a chance to debate the issues. What Michael Gove

The coalition is facing more protests today over its plans to abolish Primary Care Trusts. But PCTs are ripe for abolition. Their bureaucracy and management costs have ballooned in recent years and they have been wildly unpopular in some parts of the country for their role in pushing for hospital closures. They have failed to make the NHS more efficient and innovative and they have been responsible for many of the heart-wrenching cases of patients failing to get drugs for conditions like cancer.   In contrast, GPs are one of the most trusted groups in the NHS. Yes, there are examples of poor practice, but generally patients have high respect

More women than ever are having their babies by Caesarian section. Not the old last-resort emergency type, either; the ones where mothers howl for days, to the point of peril for self or child, until mercy descends in a scalpel — life-saving, but adding to existing trauma. No. This marked increase, by as much as 40 per cent in one year at the Liverpool Women’s Hospital, has been among women who elect a Caesarian; those who plan, often months in advance, to be delivered calmly, swiftly and relatively free of pain in a modern, controlled, 21st-century environment. In short: an increase in women who are aware that there is a choice and

Andrew Lansley’s rhetoric is strident: ‘It’s time for politicians to stop telling people to make healthy choices. Rather than lecturing people about their habits we will give them the support they need… we will support leadership from within communities.’ One could be forgiven for thinking that the Health White Paper will inaugurate a completely new dawn. It doesn’t. Many of Lansley’s initiatives are resuscitated Labour policies: taxes on alcohol and tobacco and incentivising healthy living through choice are tried and tested formulas that have had limited past success in every field bar raising revenue. Lansley’s White Paper is not a testament of radicalism, but it is quietly revolutionary nonetheless. Of

Round n in the transparency revolution: Andrew Lansley has welcomed the publication of the latest Dr Foster hospital list, detailing post-operative failures in NHS care. The Observer reports: 1) Almost 10,000 patients suffered an accidental puncture or laceration. 2) More than 2,000 had post-operative intestinal bleeding. 3) More than 13,000 mothers suffered an obstetric tear while giving birth. 4) Some 30,500 patients developed a blood clot. 5) 1,300 patients contracted blood poisoning after surgery. Despite record investment and targets for standards, the NHS still suffers setbacks in the mundane that have severe consequences – according to the report, several hospitals have ‘dangerously high death rates’. A defender of the NHS’

It’s not just the embarrassing and the difficult that will be buried underneath the Wills ‘n’ Kate coverage tomorrow – some good news will be too. Among it is the coalition’s plan to expand the provision of personal budgets. According to the Lib Dem health minister Paul Burstow, speaking today, some one million elderly people will be given control of their own personal care budgets, up from 250,000 now. As I’ve suggested before, this is a worthwhile idea. Personal budgets promise to be one of the most concrete elements of what the Tories used to call their Post-Bureaucratic Age agenda, but has now been stuck with the Big Society label.

The front cover of the Times (£) provides a dreary snapshot of what the coalition can expect once the cuts start to bite. Unison have responded to job losses in the NHS by arguing that the government is “conning” the public over the impact on frontline services. And they’re threatening to all get all litigious about it. As one of the union’s spokeswomen tells the paper, “If we are not happy with the [government’s reply], we are reserving the right to issue urgent judicial review proceedings.” You wonder whether they’d have done the same against Labour’s proposed 20 percent cuts. And this will be just the start of it. As

With this autumn’s Spending Review set to be one of the most important moments in the life of the coalition government, Coffee House has linked up with the think-tank Reform to investigate what could – and should – be in the final document. This first post, by Reform’s director Andrew Haldenby, is the first in a series of “What you need to know” summaries, looking at each of the main policy areas – in this case, health. Other posts will cover specific policies, examples from abroad and Reform events. We’re delighted to get the ball rolling… What is the budget? The NHS is the biggest public service budget in England

It was inevitable that the government’s re-organisation of NHS management would incur a large upfront cost, but I didn’t expect quite such a large figure. £1.7bn has been siphoned off to pay for the re-structuring of NHS commissioning, seven times more than the planned target for management cuts according to the BBC. This is a godsend for the opposition, obviously. Insulating the NHS budget from cuts may have been a political masterstroke in 2007, and ‘I will cut the deficit, not the NHS’ may have been a sharp election slogan. But it is idiotic to ringfence the NHS simply to re-arrange the bureaucratic furniture and destabilise the system. We’ve been