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Welfare Reform on the Web (September 2002): National Health Service - Reform - General

BLAIR CREATING A TWO TIER NHS, SAYS KEY ADVISER

A Grice

Independent, June 28th 2002, p.1

In a report to the Prime Minister, Adair Turner, a member of the Forward Strategy Unit, proposes that every NHS treatment should be priced to help GPs and patients shop around for the best deals. However he also proposes that the launch of foundation hospitals should be delayed until capacity in the NHS as a whole is boosted. This should be done by giving staff at all levels more responsibility, with nurses doing some tasks currently performed by doctors.

BREAST CANCER 'TREATED FASTER'

S Boseley

The Guardian, July 8th 2002, p.5

Women with breast cancer are far more likely to get speedy and satisfactory treatment than those who have other tumours, according to the biggest ever survey of cancer patients carried out for the Department of Health. The third national patient survey shows enormous variations in the standards of care across the country in 2000. While there will have been some improvements in hospitals since, the survey shows how much ground needs to be made up to reach the cancer plan targets.

A CAUSE FOR CELEBRATION?

J Higgins

Health Service Journal, vol. 112, July 11th 2002, p.24-29

Article discusses the impact of the NHS Plan. This was the first attempt in the history of the NHS to set out a 10-year strategy and attracted ongoing support and commitment from stakeholders. The plan wisely chose a populist approach to reducing waiting times for treatment, quicker access to GPs, etc. It also sought to preserve the influence that GP fundholders had enjoyed on commissioning through the creation of Primary Care Groups and Trusts. The creation of Strategic Health Authorities should put an end to parochialism in planning, such as the insistence by local leaders that each town must maintain its own district general hospital. However, the plan's piecemeal proposals for older people failed to address the task of providing high quality services for this group.

CHANGE OF HEART

Z Morris

Health Service Journal, vol. 112, July 18th 2002, p.12-13

In August 2001 University College London Hospitals Trust bought out the private Heart Hospital. This has led to a reduction in waiting times for cardiac surgery from 18 to 6 months.

CHIEF EXECUTIVE'S REPORT TO THE NHS APRIL 2001-MARCH 2002

Department of Health

London: 2002

Gives an upbeat assessment of progress in NHS reform and modernisation.

DOCTORING THE USUAL ROLES

A McGauran

Health Service Journal, vol. 112, July 18th 2002, p.14-15

Reports progress on training nurses to take over some specialist roles formerly the preserve of doctors. Points out that delays in implementing pay modernisation mean that specialist nurse practitioners are not being adequately rewarded at present, which may limit the number of nurses motivated to gain the additional skills.

E-NOVATION: MANAGING WITH NEW TECHNOLOGY

Health Service Journal, vol. 112, July 4th 2002, Supplement. 20p

Supplement discusses the possible benefits of information technology for the NHS. Discusses progress in implementing the NHS IT strategy, as well as risks in the light of an IT disaster in Wessex 10 years ago. Focuses on electronic prescribing, possible impact of a broadband internet connection on healthcare in Buckfastleigh, Devon and implementation of Bluetooth, a short range radio system that may be suitable for hospitals.

HALF OF NEW NURSES IN BRITAIN ARE FROM ABROAD

C Hall

Daily Telegraph, July 18th 2002, p.5

Half of nurses newly registered in Britain in 2001/02 came from overseas. At the same time a nursing shortage in America is drawing British nurses to work in the US where they are offered better pay and conditions.

(See also Times, July 18th 2002, p.13)

HAPPY LANDINGS?

A Moore

Health Service Journal, vol. 112, July 11th 2002, p.11-12

Reports progress by acute trusts and strategic health authorities in bringing in foreign clinical teams to carry out operations and NHS patients.

HEALTH SERVICE RECRUITS MAY HAVE TO TAKE HIV TEST

N Pyke

The Guardian, July 22 2002, p.1

New doctors and nurses may be required to take a test for HIV infection under plans being considered by the government as concern grows at the number of infected recruits already working in the NHS.

HEART PATIENTS TO PICK THEIR HOSPITAL

D Chater

The Times, July 1st 2002, p.6

Heart patients worried about waiting lists will now be advised by nurses how to beat the queues for surgery. Patient advisers - usually nurses - will be able to tell any heart patient forced to wait six months how to get immediate treatment elsewhere. From today the NHS will pay for the patient and one companion to travel to the hospital of their choice. Accommodation costs for the patient's companion will also be paid.

HIDDEN FOUNDATIONS

D Carlisle

Health Service Journal, vol. 112, June 27th 2002, p.13-14

It is clear that three star status will be a requirement for an acute NHS trust to be able to apply for foundation status. Other criteria will be strong leadership, a sound financial basis and the backing of commissioners. The Foundation trusts will be freed from Department of Health control but will be held accountable through performance contracts negotiated with their primary care trust. They will be able to borrow money for capital investment, but probably not from the private sector or against property. A new legal vehicle will be required to set up the trusts. This may be the untried model of the public interest company, which does not as yet exist in UK law.

INSPECTORS MOVE IN AT TROUBLE-HIT MATERNITY UNIT

J Carvel

The Guardian, July 12th 2002, p.6

Government inspectors launched an investigation yesterday into the deaths of mothers and babies at an overstretched NHS maternity unit that cannot recruit enough midwives to run staff rosters. After a series of deaths over the past few years the Commission for Health Improvement said it was responding to public concern about the quality of services at St Peter's Hospital in Chertsey, Surrey.

MANAGING FOR THE FUTURE AND SUSTAINABLE NHS

K Jochelson

British Journal of Health Care Management, vol.8, 2002, p.267-269

Article considers various management options to make the NHS a more environmentally friendly system.

MILBURN WANTS TO END NHS PAY BEDS

A Sparrow

Daily Telegraph, July 15th 2002, p. 8

Alan Milburn is encouraging the "nationalisation" of the 3,000 pay beds that survive in NHS hospitals. The Health Secretary believes that managers could find it easier to cut waiting lists if they closed private units in their hospitals and used the beds for health service patients.

NHS PERFORMANCE RATINGS: ACUTE TRUSTS 2000/01

Department of Health

London: 2001

The new "star ratings" represent a high level summary of the overall performance of general hospitals against a number of key targets largely related to the experience of patients. The system is not primarily a commentary on the quality of clinical care.

NHS SUED BY PRIVATE PATIENT FOR REFUND

L Smith

Daily Telegraph, June 28th 2002, p.8

A patient who had surgery in a private hospital is demanding that the NHS refund him the money.

THE NHS WITH A SILVER LINING

A Waters

Daily Telegraph, Monday July 15th 2002, p.14

NHS doctors have launched a cut-price private health insurance policy to help their patients beat hospital waiting lists. The policy, named On-call, offers treatment in both the NHS and the private sector. When waiting lists are too long the policy will provide private assessment and treatment. The patient's GP will help to decide which care route to take.

NURSES TO GET FREE TRAVEL IN PAY DEAL, SAYS MILBURN

M Woolf

Independent, June 28th 2002, p.8

Reports that nurses are to be given free bus and train travel passes as part of a pay package to be announced in April 2003. There are also likely to be regional salary differences with trusts being given more autonomy in how they reward their staff.

OF ZEROS AND HEROES

A Moore

Health Service Journal, vol. 112, July 18th 2002, p.10-11

With publication of the next set of star ratings of hospital trusts imminent, article explores professionals' concerns. These centre on:

  • lack of transparency in relation to how individual performance indicators are aggregated;
  • possibility of political manipulation of the ratings;
  • inclusion of indicators over which trusts have no control;
  • failure to explain to the public that the system rates management performance, not clinical outcomes.

PLANNING, MARKETS AND HOSPITALS

J Mohan

London: Routledge; 2002

This book takes a systematic approach to assessing the strengths and weaknesses of different forms of planning and coordination of hospital development. It discusses and reinterprets previous histories of hospital policy and looks at whether current policies will reconcile competing goals of equity and choice.

PRIVATE PASSIONS

A Moore

Health Service Journal, vol. 112, July 4th 2002, p.12-13

The government is planning to bring in clinical teams from North European countries to carry out elective surgery to reduce NHS waiting lists. They will compete with the UK independent sector, giving commissioners more options and possibly driving down prices.

THE PRIVATE SECTOR WILL ONLY OFFER THE NHS A PLASTER

A Miles

Times, June 26th 2002, p.20

Argues that the private sector has neither the facilities nor the expertise to take over a significant amount of work from the NHS acute sector. New proposals involve allowing American health care providers to run primary care trusts. Author points out that the US providers are more expensive per capita than the NHS, and have the advantage in their own country of choosing not to treat the sickest patients.

PUBLIC PREPARED TO GIVE UP ON NHS AND TRAVEL ABROAD

N Hawkes

The Times, July 1st 2002, p.6

A poll for the British Medical Association shows that the government's plans to provide a "mixed economy" Health Service have won broad support. However patients once loyal to their local hospital and to the NHS now have no alleigances. They just want treatment. They want it quickly - in private hospitals, if necessary - and they are prepared to travel some distance to get it

(See also The Guardian, July 1st 2002, p.10)

REFORM OF THE GENERAL MEDICAL COUNCIL: A PAPER FOR CONSULTATION

Department of Health

London: 2002

The reformed General Medical Council (GMC) will be a slimmed down organisation consisting of about 35 members, mainly doctors. The new GMC will continue to keep the medical register, though probably not in printed form. Concerns about a doctor's conduct, performance or health will increasingly be dealt with at local level by the relevant hospital or primary care trust. Only the most serious cases will be referred to the GMC, and will be considered by a panel of non-members who will include doctors and lay people. Panels will have a number of options when determining cases other than removal from the register. Procedures will be simpler and swifter than now and the over-riding concern will be the protection of the public.

STICKING POINTS

C Ham, R Kipping and H McLeod

Health Service Journal, vol. 112, July 18th 2002, p.22-25

Reports results of a study which tracked progress in booked admissions pilot schemes from 1999 to 2001. Findings show that the proportion of patients with booked appointments for hospital admissions and day-case treatment will have to more than double by 2005 to meet the NHS Plan targets. Most patients with a booked appointment liked the system, but implementation requires considerable commitment from health professionals. The booking targets in the NHS plan will not be achieved without an increase in capacity.

TORIES INSPIRED BY GERMAN HEALTH SERVICE

D Charter

Times, July 10th 2002, p.12

Article outlines current Conservative Party proposals for NHS reform. These rest on the four pillars of:

  • depoliticisation (removing the need for politicians to micromanage the health service);
  • decentralisation (allowing hospitals to set pay and conditions for staff);
  • improved choice (replacing the state-run system with a competitive mix of private, state and charitable hospitals;
  • introduction of social insurance funds to replace funding from general taxation.

US COMPANIES TO RUN GP GROUPS

A Miles

Times, June 26th 2002, p.1 and 2

Reports that government is in discussions with European healthcare providers about their possible contributions to NHS acute services. Talks with US providers Kaiser Permanente and United Healthcare involve their taking over responsibilities at some of the new Primary Care Trusts.

(See also Financial Times, June 26th 2002, p.6; Guardian, June 26th 2002, p.7)

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