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Welfare Reform on the Web (September 2001): National Health Service - Reform - General

web linkACUTE HOSPITALS REVIEW GROUP REPORT (PDF format)

Department of Health, Social Services and Public Safety, Northern Ireland

Belfast: 2001

Report recommends that Northern Ireland's 18 trusts should be combined into three, with the three health boards replaced by a single strategic health and social services authority. Proposes that the strategic authority should be at arms length from the Department of Health, while the three health systems would integrate acute and primary care and social services. Emergency and maternity services would be provided at nine sites across the province. Smaller local hospitals would offer day surgery, diagnostic services and inpatient care for patients not requiring round-the-clock consultant cover. The plan depends on availability of resources and assumes that Northern Ireland will get a proportionate share of UK health spending.

ADDITION TO TRAFFIC LIGHTS IN BID TO SPARE HIGH-PROFILE BLUSHES

M. Thompson

Health Service Journal, vol.111, July 19th 2001, p.6-7

The Department of Health is to introduce a fourth category into the "traffic light" system for the identification of failing hospital trusts. The fourth category will be used for organisations whose performance is giving some cause for concern, but which are not actually failing.

BEST OF BRITISH

A.Clarke, K. Woodhouse and B. Miller

Community Practitioner, vol.74, 2001, p.246-250

Article examines how the NHS Plan and devolution which are meant to empower staff and local communities are affecting health visitors in England, Northern Ireland, Scotland and Wales.

BLAIR IS GETTING US NEEDLESSLY FRIGHTENED ABOUT THE NHS

P. Toynbee

Guardian, July 4th 2001, p.16

Argues that the government has no plans for extensive privatisation of the health service. Plans are confined to:

  • purchase of operations from the private sector to cut waiting lists;
  • private management of some fast track surgery units.
Moreover, a new key test for giving out contracts includes a provision not to let private providers offer services provided by staff pilfered from the NHS.

CHI OVERHAULS ITS REVIEW PROCESS TO ALLAY CRITICISM

T. Agnew

Health Service Journal, vol.111, July 12th 2001, p.8-9

The Commission for Health Improvement is redesigning its clinical governance review process in a bid to get closer to the "heart" of the hospital patient's experience.

DEPARTMENT OF HEALTH: FOCUSING ON DELIVERY

Department of Health

London: 2001

The reformed Department of Health will focus on five areas: high-priority clinical conditions, primary care, emergency care, waiting times and "looking after people in the right environment in the right way". Plan promises "more regular meetings and networks of clinicians and managers", a "simplification of current monitoring arrangements" and changes "stemming the tide of initiatives".

DOCTORS' LEADER WARNS BLAIR TO END "THE ABUSE"

H. Rumbelow, D. Charter and R. Watson

Times, July 3rd 2001, p.8

The Chairman of the British Medical Association has launched a strong personal attack on Tony Blair. He argued at the BMA annual conference that government has wrecked doctors' morale by using them as scapegoats when its own gimmicky initiatives failed. Delegates also attacked the NHS Plan which they said belonged to Communist Russia rather than modern Britain. They agreed it would not work without a massive increase in the numbers of doctors and nurses.

(See also Daily Telegraph, July 3rd 2001, p.7; Guardian, July 3rd 2001, p.1 + 11; Independent, July 3rd 2001, p.8).

FIGHTING FOR SURVIVAL

M. Benham

Volunteering, no.69, 2001, p.13

Describes the successful campaign against government plans to abolish Community Health Councils.

THE FUTURE PATIENT

L. Kendall

London: Institute for Public Policy Research, 2001.

Report argues that the move to a more consumerist health economy needs to be matched by patients taking responsibility for their own health. Doctor-patient relationships must change, moving towards sharing of information and decision-making. The government should ensure that high-quality healthcare information is available as a core service in the NHS. Every trust, including primary care trusts, should have a senior member of staff responsible for ensuring relevant information is available to patients. A patient support service should be set up as a central point to filter inquiries about a particular illness on to the relevant patient group. NHS performance indicators should be published by an independent organisation. Finally, self-care by patients should be encouraged.

GOING INTO LABOUR

R. Lissauer

Health Service Journal, vol.111, June 28th 2001, p.24-25

Public-private partnerships are one of the government's key policy tools for improving health services. There is little conclusive evidence of the ability of such partnerships to manage hospitals. The government should therefore launch small pilot projects. Managers and the public need to be convinced of the viability and equity of public-private partnerships.

IMPLEMENTING THE NHS PLAN: RECRUITMENT AND RETENTION

Health Service Journal, vol.111, July 5th 2001. Supplement. 12p

Supplement covers NHS staff recruitment initiatives, provision of workplace nurseries, violence against staff, a new pre-registration training programme for nurses, and the drive to recruit more GPs.

LET THE PRIVATE SECTOR TAKE ON MORE OF OUR AILING HEALTH SYSTEM'S DUTIES

J. Le Grand

Independent. Monday Review, June 25th 2001, p.4

Calls for greater private provision of clinical services within the NHS. The NHS would continue to be funded out of taxation and free at the point of use, but services would be provided by a plurality of public, private and voluntary sector organisations.

MUDDLE ON PRIVATE SECTOR ROLE IN NHS

N. Timmins

Financial Times, July 6th 2001, p.2

Latest policy statements by the Department of Health indicate that top performing NHS trusts will be able to compete to run failing trusts. Such teams could then buy in private sector expertise or consultancies. There is no question of private companies being allowed to take over poorly performing trusts.

NEUROLOGIST RESIGNS OVER NHS "CHAOS"

C. Hall

Daily Telegraph, July 5th 2001, p.13

A leading neurologist has resigned from the NHS in protest against poor working conditions, underfunding and the dishonesty of politicians.

(See also Guardian, July 5th 2001, p.5).

NHS MANAGERS MAY BE OFFERED FRANCHISES TO RUN FAILING HOSPITALS

J. Carvel

Guardian, June 26th 2001, p.5

Teams of doctors and managers from top performing hospitals are to be invited to form consortia to bid for franchises to run failing institutions for a fixed period. The franchise winners would receive extra resources and would be able to buy in extra staff from outside the NHS. Individuals leading the consortia would be incentivised through performance related pay, but would not earn profits on the contracts.

(See also Times, June 25th 2001, p.1).

ONLY RADICAL SURGERY WILL STOP THE ROT OF AGES AT THE HEART OF THE NHS

P. Wheatcroft

Times, June 26th 2001, p.16

Proposes a switch to an insurance based system of funding health care in the UK. This would put patients in the role of consumers, with greater freedom of choice, and would address the chronic funding problems faced by the NHS.

ORGANISATIONAL STRATEGIES FOR CHANGING CLINICAL PRACTICE: HOW TRUSTS ARE MEETING THE CHALLENGES OF CLINICAL GOVERNANCE

L.M. Wallace, et al

Quality in Health Care, vol.10, 2001, p.76-82

Paper reports on the use of organisational strategies to improve clinical practice as part of clinical governance implementation. Trusts most often reported using educative methods such as critical appraisal skills training but frequently rated these methods as ineffective. The choice of strategies by trusts reflects past use rather than perceived efficacy. Ambivalence about the anticipated impact of clinical governance may explain why some trusts continue to use low efficacy methods which may give a semblance of purposive activity. Clinical governance leads should show leadership by evaluating the efficacy of strategies to instil a learning culture.

PRIVATE IS BETTER THAN PUBLIC

D. Green

Guardian, July 6th 2001, p.18

Argues that NHS institutions should be privatised under conditions of competition to allow consumers to escape poor service. Also proposes that local hospitals should be run by non-profit-making organisations and become focuses for community service.

PULLING BACK THE SCREENS

J.A. Mulligan and A. Harrison

Health Service Journal, July 12th 2001, p.29

The death rate from breast cancer has been falling in the UK for a decade but it is not clear how various developments in breast cancer interventions (screening and new drug therapies such as tamoxifen) have contributed to this outcome. As we do know much about how specific interventions interact with each other, it is not clear how money should be allocated most usefully between services.

REBUILDING OUR NATIONAL HEALTH SERVICE

NHS Scotland

Edinburgh: Scottish Executive Health Department, 2001

Offers guidance to NHS Chairs and Chief Executives for the implementation of reforms to the NHS in Scotland. Describes the role and composition of the new NHS Boards, new performance assessment and accountability arrangements, the revised financial framework, new planning arrangements, and the role and functions of the Scottish Executive Health Department.

ROOM AT THE TOP

B. Reid and A. Metcalfe

Health Service Journal, vol.111, July 12th 2001, p.24-25

Discusses the development of a set of core competencies by an NHS trust to define the role of the nurse consultant.

SPIN DOCTORS ARE KILLING THE HEALTH SERVICE

N. Timmins

Financial Times, Jul.16th 2001, p.17

Discusses the finance and management of the NHS under Labour. It looks at how money has been spent on clearing deficits and putting the NHS books in order. Labour has also subjected the health service to continuous reorganisation and restructuring. No organisation could thrive under such conditions.

STRESS AMONG WARD SISTERS AND CHARGE NURSES

I. Allen

London: Policy Studies Institute, 2001

Report is based on results of focus groups of ward sisters and charge nurses from nine hospital trusts in London. Their chief cause of stress was difficulty in staffing the ward, followed by bed blocking. This was principally caused by soaring number of elderly patients who had been successfully treated but who had no suitable residential accommodation to return to.

WHAT DOES IT ALL ADD UP TO?

J. Davies

Health Service Journal, vol.111, July 5th 2001, p.28-31

NHS managers have in the past not been seen as part of a valued and defined professional group. Little attention has been paid to their professional development or career structures. Article discusses the role of the NHS Leadership Centre, part of the Modernisation Agency, in promoting managers' professional and career development.

THE WINDSOR CHANGE

P. Smith

Health Service Journal, vol.111, June 28th 2001, p.11-13

The NHS Reform Bill outlined in the Queen's speech at the State Opening of Parliament will:

  • delegate 75% of NHS spending to primary care trusts;
  • reform the General Medical Council and create a new body to regulate doctors;
  • scrap Community Health Councils and create democratically elected committees to scrutinise local health services.
Other health legislation will focus on clinical negligence, while there is concern about lack of any mention of reform of the Mental Health Act.

WOMEN IN HOSPITAL MEDICINE: CAREER CHOICES AND OPPORTUNITIES

C. Black

London: Royal College of Physicians, 2001

Report concludes that women are being held back in the race to become consultants by the long hours culture prevalent in the NHS. Calls for an expansion of opportunities for consultants to work part-time or to job share, for more out-of-hours hospital creches, and an end to the assumption that a medical career requires commitment at the expense of family life.