Click here to skip to content

Welfare Reform on the Web (Summer 2003): National Health Service - Reform - General

BMA HEADS OFF GP REVOLT ON CONTRACTS

D. Batty

The Guardian, June 16th 2003, p.9

The British Medical Association seems to have headed off a rebellion by family doctors against a new contract which will let them provide services traditionally confined to hospitals. According to a Guardian survey more than half of Britain's 120 local medical committees said doctors planned to accept the deal.

CHILD AT HEART

J. Davis

Health Service Journal, Vol. 113, June 19th 2003, p.26-27

Children's services are being given higher priority in the NHS through a range of initiatives centred on the new National Service Framework. The article discusses various approaches to the reconfiguration of children's services. Changes are being driven in part by staff shortages and the new working time directive, putting the focus on job design.

CONSENSUS AND CONTENTION: DOCTORS' AND MANAGERS' PERCEPTIONS OF THE DOCTOR-MANAGER RELATIONSHIP

H.T.O. Davies, C.L. Hodges and T.G. Randall

British Journal of Health Care Management, Vol. 9, 2003, p.202-207

A national survey showed widespread dissatisfaction with the quality of existing doctor-manager relationships in the NHS, and widespread pessimism about any likelihood of improvement. Key areas of concern included:

  • limitations on resources;
  • poor communication;
  • unfairness in decision making;
  • managerial interference with clinical priorities;
  • a lack of confidence in local (clinical and non clinical) leadership.

Key barriers to improved working relationships were seen as both external to NHS trusts (resource constraints and the turbulent policy context) and internal (poor communication, lack of trust and cultural misalignment between doctors and managers).

CONSULTANTS TO BALLOT ON GO-SLOW AFTER REID REBUFF

J. Carvel

The Guardian, June 20th 2003, p.2

The government is heading for an autumn of discontent in the hospitals after consultants voted overwhelmingly to ballot for industrial action.

(See also: The Times, June 20th 2003, p.1)

DEVIL'S ADVOCACY

A. Cole

Health Service Journal, Vol. 113, June 12th 2003, p.26-28

The article describes the process in reforming the complaints procedure in the NHS. The system will be monitored by the new commission for patient and public involvement in Health at the national level and by patient advisory and liaison services and patients' force at trust level. There will also be a new Independent Complaints Advocacy Service which will help members of the public navigate through the complaints system.

DOCTORS TAUGHT THE ART OF WRITING CLEARER NOTES

O. Wright

The Times, June 9th 2003, p.1

Hospitals are spending hundreds of thousands of pounds a year teaching their doctors and nurses to write better patient notes. Concerned by litigation for medical negligence nearly 100 NHS trusts are providing training on note-taking that will stand up in court.

THE FIFTH AMENDMENT

J. Carvel

Guardian Society, June 25th 2003, p.3

The government's little-debated plans to extend patient choice will have a much greater impact on the future of the health service than will the proposals for foundation hospitals, according to a MORI poll on the views of NHS chief executives. Asked which policy would have the greatest impact over the next five years, chief executives ranked foundation hospitals behind patient choice, new staff contracts, information technology and payment by results for hospitals. The article reviews the rest of the poll results.

HEALTH CHIEF SAYS MINISTERIAL IMPATIENCE IS PLACING THE FUTURE OF THE NHS IN GRAVE JEOPARDY

J. Laurance

The Independent, June 6th 2003, p.2

The Head of the Department of Health's Strategy Unit has warned that the impatience of ministers to see results from the billions of pounds of new investment in the NHS is threatening its survival. Professor Chris Ham says that changing large organisations is slow and unglamorous work that can only succeed step by step, but the pressures of the electoral cycle mean ministers are drawn to radical solutions that nearly always fail.

HOSPITALS ARE URGED TO MAKE BEST USE OF EXISTING RESOURCES

N. Timmins

Financial Times, June 19th 2003, p.6

Hospitals should not be given extra resources or new management freedoms unless they demonstrate they are making the best use of what they have, according to the Audit Commission. The spending Watchdog's call came as it revealed wide variations in the efficiency with which NHS hospitals manage outpatients, waiting lists, operating theatres and casualty.

(See also: The Times, June 19th 2003, p.2)

HOSPITALS COMPLAIN INSPECTIONS ARE UNFAIR

O. Wright

The Times, June 11th 2003, p.4

Government reports into the performance of England's 250 acute hospitals are inconsistent, unsubstantial and frequently unfair, according to the NHS federation, which represents hospital managers. Less than half were happy with their reviews, accusing the inspections, carried out by the government-appointed Commission for Health Improvements, of being unsubstantiated by evidence and inconsistent.

HOSPITALS HIT WAITING TARGET - FOR A WEEK

J. Laurance

The Independent, June 4th 2003, p.8

A government target to cut waiting times in accident and emergency departments improved the performance of hospitals - but only during the week in which they were monitored, a survey by the British Medical Association has found.

HOW WAS IT FOR YOU?

L. Donnelly

Health Service Journal, Vol. 113, June 19th 2003, p.12-13

Healthcare professionals comment on the legacy of Alan Milburn following his resignation as Health Secretary. He is praised for securing more resources for the NHS, and for developing a new vision for its future. The development in his thinking from centralised policies and standardisation to devolution and foundation hospitals is traced.

MAN ON A MISSION

S. Boseley

Guardian Society, June 25th 2003, p.2-3

The NHS can be a game of chance both for patients who use it and staff who run it. Now a new regulator, Sir Ian Kennedy, is preparing to take charge, pledged to secure a fairer deal for everyone. The article asks whether the odds are stacked against him?

MANAGEMENT MATTERS: HOW NHS MANAGERS ARE MAKING A DIFFERENCE

NHS Confederation, 2003

Written to counter charges that the NHS is burdened by an army of parasitic administrators, the report points out that only 3% of staff are managers, accounting for 4% of its budget. It argues that good management can improve the health service, focusing on five areas:

  • ensuring the best use of resources;
  • planning for the future;
  • creating an environment where staff can do their best;
  • working with other parts of the NHS and outside bodies;
  • improving patient care.

It outlines changes that would allow the NHS to be managed more effectively, including setting more realistic targets, attracting more clinicians into management, encouraging innovation, and better support for middle managers.

MIDDLE CLASSES WORK THE NHS SYSTEM, SAYS REID

A. Grice

The Independent, June 27th 2003, p.8

Reports the view of John Reid, the Health Secretary, who believes that middle-class parents have been securing better health care from poorer people by "working the system".

MILBURN'S MEDICINE

T. Shifrin, P. Butler and M. Gould

Guardian Society, June 18th 2003, p.2-3

After nearly four years under Alan Milburn, the NHS has received more funds, a larger increase in staff and achieved bigger cuts in the waiting lists than under any of his predecessors as Health Secretary. Even so, professionals in the service are divided about the effectiveness of his remedies. The article includes the views of members of the action teams and task forces that were set up to oversee implementation of the government's NHS plan.

MINISTER OFFERS TO "TWEAK" NHS PAY CONTRACT

N. Timmins

Financial Times, June 30th 2003, p.2

John Reid made his first concession as Health Secretary when offering to "tweak" the contract that consultants in England rejected last year, in an attempt to head off industrial confrontation with the British Medical Association.

MUCH OBLIGED

E. Peck and G. Perri

Health Service Journal, Vol. 113, June 12th 2003, p.12-14

The article discusses the feasibility of imposing sanctions such as refusal of NHS treatment on people who wilfully endanger their health by smoking, excessive drinking, or eating fatty foods. Such sanctions would bear hardest on socially excluded people and would be politically very difficult for a Labour government to impose.

NASTY OR NICE? THE NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE AND TECHNOLOGY ASSESSMENT

M. Duckenfield

International Journal of Non-profit and Voluntary Sector Marketing, Vol. 8, 2003, p.122-133

The paper uses theories of political marketing to explain the behaviour of the National Institute for Clinical Excellence (NICE) in the technology appraisal process as the result of pursuing different marketing strategies. It finds that NICE follows multiple strategies to sell its policies, depending on the identity of its target audience. NICE engages in a consultation process involving patients and the pharmaceutical industry which acts as a kind of market research to enable it to design policies that are attractive to those sectors. Furthermore, its appeals process acts as a mechanism to ascertaining whether NICE's policy outputs are acceptable to stakeholders.

NHS GOES PUBLIC ABOUT GOING PRIVATE

S. Brown

Primary Care Report, Vol. 5, May 29th 2003, p.8-13

Numbers of NHS patients treated in private hospitals could rise significantly with the implementation of long term contracts and patient choice schemes. The private sector has the capacity to double its NHS activity without any new facilities and see at least 150,000 patients a year.

NICE TO SEE YOU…

N. Brosanquet

Health Service Journal, Vol. 113, June 19th 2003, p.30-31

The National Institute for Clinical Excellence (NICE) has published 62 technology appraisal reports in three years. Many reports refer to complex, specialist topics and affect only small numbers of patients. Some opportunities to give clear guidelines have been missed. There is scope for reports designed to maximise existing NHS resources, and to assess the role of prevention, care integration and other ways to cut long-term costs.

OUT OF SIGHT

G. Clews

Health Service Journal, Vol. 113, June 19th 2003, p.14-15

The article presents views of Emergency Access Czar Professor George Alberti on the achievability and sustainability of A&E waiting time targets, NHS funding, the new GP contract and IT systems.

PIECING TOGETHER THE POLICY JIGSAW

N. Edwards

NHS Conference, 2003

The paper identifies a range of significant policy initiatives that will change the NHS out of all recognition over the next five years. A raft of policies aimed at changing the way patients use the service are running alongside a range of policies designed to change the ways in which services are provided. The government wants to foster greater diversity in provision, and is setting up regulatory machinery to deal with a range of independent providers. Through foundation trusts, there is also a push to devolve power and accountability.

PLEASED TO MEET YOU? HEALTH AND EDUCATION GET ACQUAINTED

N. Bostock

Primary Care Report, Vol. 5, June 11th 2003, p.10-14

The article introduces Health and Education Strategic Partnerships. There will be one of these new forums per strategic health authority. Each will be a partnership of local health and education sector bodies, charged with looking at issues involving learning and research in health and social care.

POSITION OF TRUST

M. Wainwright

Guardian Society, June 25th 2003, p.4-5

The article asks if the new foundation hospitals will wreak co-ordination of local health and social care provision?

PRIVATE PRACTICE

F. Blunden

Health Which? June 2003, p.22-25

The article discusses the role of the National Care Standards Commission in regulating and inspecting private hospitals and doctors. It points out that there are still significant gaps in regulation which leave consumers at risk.

THE QUIET STORM

J. Trueland

Health Service Journal, Vol. 113, June 19th 2003, p.14-15

The Scottish Executive has recently issued proposals for balancing patient's rights and responsibilities in the NHS. Proposed responsibilities include keeping appointments, eating a balanced diet, and taking exercise. In return, the NHS will treat them within guaranteed waiting times and provide access to services based on individual need, and, where possible, choice. This proposed patient-NHS contract has attracted little comment or interest.

RESIGNATION OF MILBURN PROVES BIGGEST SURPRISE

J. Blitz

Financial Times, June 13th 2003, p.1

Tony Blair's campaign to overhaul Britain's public services was dealt a dramatic blow when Alan Milburn, the Health Secretary, unexpectedly resigned from the cabinet. Mr. Milburn was replaced by John Reid.

(See also: The Guardian, June 13th 2003, p.1; The Independent, June 13th 2003, p.5; The Daily Telegraph, June 13th 2003, p.5; The Times, June 13th 2003, p.5)

SETTING PATIENTS FREE

Conservative Party

[London]: [2003]

The report proposes the introduction of a Patient's Passport, which would enable patients to choose from a wide range of healthcare providers (NHS, not-for-profit, voluntary and independent). Under these proposals, patients would be able to move freely around the NHS, with the finance for their treatment automatically following them. Patients will also be able to choose to be treated in private or voluntary hospitals, taking finance with them.

SEXUAL HEALTH

Health Committee

London: TSO, 2003 (House of Commons Papers, session 2002/03; HC69)

Due to the dramatic decline in the nation's sexual health, this is an area in desperate need of prioritisation. Sexual health must be tackled immediately as a public health priority at strategic health authority level. Government needs to introduce a national service framework for sexual health services with challenging targets. Other recommendations include more emphasis on hiring sexual health consultants, a national screening programme for Chlamydia and increased prioritisation for contraceptive services.

SHAPE UP OR SHIP OUT

A. Moore

Health Service Journal, Vol. 113, June 12th 2003, p.12-13

The article discusses the emerging debate about the need to balance patients' rights with equal responsibilities to keep appointments, take medicine, and adopt a healthy lifestyle. There could be patient-doctor agreements which would outline the "duty" the patient owes the health service and the "responsibilities" the health service has to the patient.

SMOKERS TO SIGN PLEDGE WITH DOCTORS

N. Watt

The Guardian, June 4th 2003, p.8

Smokers and overweight people will be asked to sign contracts with their doctors to agree a programme to quit smoking and loose weight under radical plans being drawn out by the government.

STAMP OF GREATNESS

B. Alimo-Metcalfe and J. Alban-Metcalfe

Health Service Journal, Vol. 113, June 26th, p.28-31

New research into leadership shows how NHS managers compare to those in other public services and the private sector. They tend to be better at hard skills than at empathy with their staff. The single biggest leadership determinant of staff satisfaction, "showing genuine concern", is a weakness for NHS managers.

SURVIVAL SPECIAL

J. Trueland

Health Service Journal, Vol. 113, June 26th 2003, p.22-23

The article discusses health policy in Scotland with Minister Malcolm Chisholm. It emphasises parallels between NHS reforms in England and Scotland, including a push towards decentralisation in both countries, empowering government to intervene in failing health systems, and the emphasis on reducing waiting lists and times.

SWEET AND SOUR

L. Whitfield

Health Service Journal, Vol. 113, June 19th 2003, p.20-21

A report of an interview with NHS Chief Executive Nigel Crisp. He is concerned that the media focus on negative reports about the NHS, such as allegations that it is wasting money on meaningless management tasks, while ignoring solid improvements. It goes on to discuss changes in the NHS inspection regime. Finally, it predicts that the NHS will hit more and more of its targets, that more work will be done in Primary care, and that modernisation will continue.

TORIES PLAN "SHOP AROUND" NHS

C. Newman

Financial Times, June 5th 2003, p.3

A shake up of the NHS, that would allow patients to ship around for the best treatment, will be proposed by the Conservatives today. The Patients' Passport scheme will give people a lump sum to buy health treatment at a public or private hospital of their choice.

(See also: The Times, June 5th 2003, p.10)

WILL CPPIH REALLY BE DEMOCRATIC DIVERSE?

B. Sang and C. Dalls

British Journal of Health Care Management, Vol. 9, 2003, p.210-211

The paper presents a vision of the new Commission for Public and Patient Involvement in Health facilitating the involvement of local citizens (not patients) in health care decision-making, governance and scrutiny.

Search Welfare Reform on the Web