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Welfare Reform on the Web (July 2010): National Health Service - reform - general

All action on the united front

J. Manning

Health Service Journal, May 20th 2010, p. 14-15

This article compares Liberal Democrat and Conservative health policies on the basis of their election manifestos, identifying areas of agreement and difference.

Better information, better decisions, better health

J. Taylor (editor)

Health Service Journal, May 27th 2010, supplement, 9p

This supplement presents an overview of the role, achievements and future development of the regional public health observatories ten years after their launch. It covers challenges and achievements relating to:

  1. management, sharing, presentation and interpretation of public health data
  2. collaboration among the 12 regional observatories
  3. support for local, regional and national decision makers through production of health profiles that help set local priorities, description and monitoring of health inequalities, and building workforce knowledge and capacity.

Calmer chameleon: the new face of Monitor

D. West

Health Service Journal, June 3rd 2010, p. 10-11

In an interview, Monitor's new chair Steve Bundred describes his intention to foster a less confrontational relationship with the Department of Health than that of his predecessor Bill Moyes. He is a believer in the foundation trust model and has his own proposals for extending their freedoms by separating their assets and liabilities from the state. He finally comments on the Coalition government's plans to develop Monitor into an economic regulator overseeing aspects of competition, access and price setting in the NHS.

'Creating NHS local': the relationship between English local government and the National Health Service

J. Glasby, H. Dickinson and J. Smith

Social Policy and Administration, vol. 44, 2010, p. 244-264

This article reviews a number of options for how a stronger relationship between local government and the NHS might be enacted in England. This is based on a belief that there are merits in having more meaningful local democratic input into decision-making about health resource allocation, and that there are significant limitations to the current primary care trust (PCT) model of local accountability. If local government is to function as a 'place shaper', then it needs significant influence over local health services, while the NHS needs to learn from the best of local government if it is to gain sufficient local legitimacy to take difficult decisions about reconfiguring services.

The eternal triangle: sixty years of the centre-periphery relationship in the National Health Service

R. Klein

Social Policy and Administration, vol.44, 2010, p. 285-304

The history of the NHS in England is marked by a paradox. On the one hand, central government has over time strengthened its grip on the service, moving from an exhort-and-hope system of governance to a command-and-control model. On the other hand, successive governments have proclaimed their belief in devolving power to the periphery. This paradox can be explained by the fact that the NHS as designed in 1948 incorporated the competing, and possibly irreconcilable goals, of the pursuit of equity, efficiency and democracy. The pursuit of equity and efficiency has provided the rationale for centralisation at the expense of democracy seen as control by elected local bodies.

Four-hour target in A&E will be scrapped, says Lansley

Anon.

Daily Telegraph, June 10th 2010, p. 10

The health secretary has announced that the four-hour waiting time target in hospital accident and emergency departments will be scrapped. Instead, the NHS will be asked to focus on what the clinical evidence makes clear directly contributes to delivering the best possible results for patients. (See also Guardian, June 10th 2010, p. 1-2 + comment p. 30)

Healthcare IT

H. Mooney (editor)

Health Service Journal, June 10th 2010, supplement, 8p

This special supplement offers articles on the future of the much criticised Connecting for Health programme; improvement of patient care through the use of wireless communication; and the benefits and risks involved in new telecare and telehealth applications.

Hospital care will continue when you get home

R. Winnett

Daily Telegraph, June 8th 2010, p. 1 +2

Hospitals will be penalised financially if patients have to be readmitted within 30 days because their conditions were not treated properly. They will also be fined for a range of medical errors and safety breaches which have injured patients, such as contracting an infection and bungled surgery. New legislation will also scrap many hospital targets introduced by New Labour, which health secretary Lansley believes have led to perverse decisions being taken by the NHS.

(See also Guardian, June 8th 2010, p. 8)

Hospital death rate inquiry call for families

S. Boseley

The Guardian, Jun. 15th 2010, p.4

Peter Walsh, the chief executive of Action against Medical Accidents, has proposed that the families of patients who died after surgery at a hospital with an exceptionally high death rate should be entitled to an investigation. Mr Walsh made these comments following an investigation by the Guardian which revealed that there were wide disparities in death rates at hospitals offering vascular surgery.

Increasing efficiency

D. Carlisle (editor)

Health Service Journal, June 17th 2010, Supplement, 20p.

In the context of looming spending cuts, this supplement offers: the views of seven leaders on how they would achieve the savings government requires of the NHS; reflections on the role of the finance director in enabling his board to make sound decisions; a report on savings to be made from tackling smoking, obesity, physical inactivity, and alcohol use; a look at how managers can improve their image; and consideration of the benefits of using external services to support commissioning.

Lansley pledges to come clean on MRSA figures

R. Prince and R. Winnett

Daily Telegraph, June 2nd 2010, p. 4

In the interests of greater transparency, from July 2010 rates of MRSA and C. difficile infection at individual hospitals will be published weekly on the Internet. At present the statistics are published only monthly at NHS trust level.

Managed migration? Nurse recruitment and the consequences of state policy

S. Bach

Industrial Relations Journal, vol.41, 2010, p. 249-266

This article analyses the main trends in nurse migration to the UK, focusing on the National Health Service as the dominant employer of nurses. It highlights the importance of state policy as a major influence shaping employer utilisation of migrant nurses. This analysis is developed further through an examination of shifts in immigration policy, especially the introduction of the points-based system in 2008, and an exploration of the consequences of these policy changes for migrant nurses, employers and trade unions.

New Labour and reform of the English NHS: user views and attitudes

A. Wallace and P. Taylor-Gooby

Health Expectations, vol.13, 2010, p. 208-217

The British National Health Service has undergone significant restructuring in recent years. In England, the New Labour government sought to modernise the NHS through the introduction of market principles such as competition and incentives for service providers and the expansion of choice for patients. This research aimed to explore how users of the NHS perceive and respond to these market reforms. Data were gathered from qualitative interviews using a quota sample of 48 recent NHS users in South East England. Results show that some NHS users are exhibiting an ambivalent or anxious response to aspects of market reform such as patient choice, the use of targets, and service delivery by private contractors. This has resulted in a sense that current reforms are distracting or preventing NHS staff from delivering quality care.

NHS facing brain drain as leaders look for exit

C. Santry

Health Service Journal, June 17th 2010, p. 4-5

A survey of nearly 2,000 NHS managers has shown that overall 29% were thinking of leaving the health service, rising to 40% of executive directors. The results are being blamed on looming public spending cuts, imminent restructuring and uncertainty about the direction of health policy.

Scottish health boards tap into public spirit

D. Redding

Health Service Journal, June 17th 2010, p. 12-13

In pioneering direct elections in June 2010, 22 members of the public were voted onto two Scottish regional health boards. The Coalition government has promised similar direct elections to the boards of English primary care trusts.

The sensitivity of United Kingdom health-care services to the diverse needs of Chinese origin older people

R.C.M. Chau and S. W.-K. Yu

Ageing and Society, vol. 30, 2010, p. 383-401

This paper is a contribution to the debate on how to make British healthcare services more responsive to the needs of older people who are members of recent immigrant groups. The focus is on Chinese-origin elders, and the objective is to document their diverse migrant histories, cultural backgrounds and attitudes to both 'traditional' and Western healthcare practices. The underlying argument is that if healthcare professionals had a better understanding of the diversity of Chinese older people, this would help to make services more sensitive to their needs and reduce their exclusion from mainstream healthcare.

Thousands of jobs at risk as SHAs face 2012 axe

S. Gainsbury and C. Santry

Health Service Journal, May 27th 2010, p. 4-5

Strategic health authorities will be abolished by 2012, and commissioning will be managed through an independent NHS Board which will allocate resource and provide guidance to GPs who will commission services on behalf of their patients. Providers will be overseen by an expanded Monitor, which will become an economic regulator.

The times they are a changing

N. Edwards

Health Service Journal, June 17th 2010, p. 14-15

The new Coalition government is fully committed to radical reform of the NHS in England. There will be a new NHS board, new roles for the regulators, a new commissioning responsibility for GPs, more performance-related information released to the public, and a move towards 'value based pricing' for the National Institute for Health and Clinical Excellence. The strategic health authorities will be closed down in 2012, and their decision making functions transferred to the board and its regional offices. There will be more independence for providers, but they will be expected to compete for business.

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