Welfare Reform on the Web (January 2004): National Health Service - Reform - General

BUILDING ON THE BEST: CHOICE, RESPONSIVENESS AND EQUITY IN THE NHS

Department of Health

London: TSO, 2003 (Cm 6079)

The report outlines reforms designed to widen patient choice in the NHS in England. Priority will be given to:

• giving people a bigger say in how they are treated by allowing them to record their preferences in their records;
• giving access to a wider range of services in primary care by encouraging innovative new providers;
• increasing choice of where, when and how patients can get medicines by removing the bureaucracy surrounding repeat prescriptions, expanding the range of medicines pharmacies can provide without prescription, promoting minor ailment schemes where pharmacies can help patients treat conditions like coughs and hayfever, and increasing the range of healthcare professionals who can prescribe;
• enabling people to book appointments at a time that suits them and widening the choice of treatment in maternity and terminal care services;
• ensuring that patients have the information they need to make choices.

CHIEF EXECUTIVE'S REPORT TO THE NHS, DECEMBER 2003

London: Department of Health, 2003

The report claims sustained progress in the last three years with acceleration in the last six months. This has been made possible by increased funding and achieved in part by redesigning services and introducing new ways of working. Services are now delivered more quickly and more conveniently, with more support in the home and in the community. On current trends the NHS is well placed to hit government targets and achieve waiting times of six months for admission and thirteen weeks for outpatients by he end of 2005.

CHOOSING LIFE: WHY THE NHS NEEDS INFORMED PATIENTS

H. Cayton

British Journal of Health Care Management, Vol. 9, No.12, 2003, p.402-405

The article argues that the benefits of investing in health information and allowing patients to make informed decisions about their health and treatment will outweigh the costs.

DEMOCRATIC DEFICITS

T. Travers

Public Finance, Dec. 5th-11th 2003, p.28-29

Trust staff, patients and the public can join foundation hospital trusts as members, with rights to elect the ruling council or board. The success of this policy initiative depends on the ability of trusts to engage with the public. Experience with early public and staff consultation exercises run by trusts applying for foundation status has not been encouraging, as little interest has been shown.

GETTING THE BILL

A. Bell

British Journal of Health Care Management, Vol. 9, No.12, 2003, p.409

The article explores the implications of a last minute amendment to the Health and Social Care Bill, which stated that the first 57 foundation trusts would have to be evaluated before any subsequent entrants were able to make the transition. Although this allows for early lessons to be learned, there are concerns about whether this delay will simply extend the two-tier health service feared by many backbench Labour MPs. The form of the evaluation is also explored.

LAYING DOWN THE LAW

D. Lock

Public Finance, Dec.5th-11th 2003, p.30-31

Discusses a number of legal hazards in the proposals for creating foundation hospitals. There are risks of legal disputes over payments and service levels between the hospitals and commissioning primary care trusts if finances are tight on either side. There are also concerns that trust boards may be dominated by middle class members of the community and pressure groups, leading to distortions in health policy.

MILBURN SECURED THREE STARS FOR PM'S TRUST

A. McLellan

Health Service Journal, vol.113, Dec.18th 2003, p.3-5

Former Health Secretary Alan Milburn personally intervened to ensure that Durham Healthcare Trust received three stars in the 2002 ratings because it serves the Prime Minister's constituency. The three star rating made the trust eligible for a £1 million capital funding grant and gave it significant freedom from government control.

A MINISTER REPLIES TO A FEW CHOICE WORDS

J. Hutton

British Journal of Health Care Management, Vol. 9, 2003, p.393-395

Minister for Health John Hutton defends Labour's reforms, arguing that change is the only way for the NHS to provide the services patients expect in the twenty-first century. He argues that the reforms will benefit patients, allowing them fast and convenient access to healthcare.

REID PRESCRIBES PATIENT POWER

P. Webster

The Times, December 9th 2003, p. 4

The Health Secretary, John Reid, who believes only a cultural revolution can save the heath service from a mass defection to the private sector today announced measures designed to achieve "a personalised health service". These include:

• patients to enter personal details on national health record;
• patients to see doctors' letters about them;
• patients can self-prescribe for long-term conditions;
• nurses to treat more ailments and injuries;
• patients to book appointments online.

SPACE INVADERS

D Fillingham

Health Service Journal, Vol. 113, Dec.11th 2003, p.18-19

Discusses the role of the NHS Modernisation Agency in improving the quality of care, in workforce development and job re-design, and in updating the IT infrastructure.

WHERE THE NHS MEETS EDUCATION: A FUTURE WORKFORCE

J. Gillow, L. Sheldon and D. Humphris

British Journal of Health Care Management, Vol. 9, 2003, p.396-399

The article examines the new foundation degree in health care, developed by the University of Southampton in collaboration with NHS bodies in Hampshire and the Isle of Wight. It is designed to:

• develop a generic health care worker who can support patients through their health care journey;
• equip workers with skills and knowledge to maximise the self-reliance and independence of patients undergoing rehabilitation;
• enable role development across the health and social care boundaries;
• increase access to graduate level health and social care professions.

WHY ONLY THE POSH PUSH FOR HEALTHCARE

S. Halpern

British Journal of Health Care Management, Vol. 9, No.12, 2003, p.390

Equity within the NHS is one of New Labour's core aims. However, despite huge investment of both energy and resources, inequality remains rife. Health Secretary John Reid believes that education and greater patient choice will form the solution. However, the article questions whether this will really help those in the lowest socio-economic groups.

YEAR OF LIVING DANGEROUSLY

L. Whitfield

Health Service Journal, vol.113, Dec.18th 2003, p.14-15

Reports progress on the development of a national "data spine" for the NHS in England. By 2010 all 50 million NHS patients should have their own electronic care record, containing basic details of their medical history. Information in the care record will be accessible to hospitals, GPs and social services, leading to concerns about invasion of privacy.

YOUR RIGHT TO CHOOSE

S Williams

Health Which? December 2003, p16-19

Current government policy aims to give NHS patients choices about where, when and how they are treated. Patients will be able to be treated in private hospitals, in the new diagnostic and treatment centres, and abroad as well as in their local hospital. However, exercise of choice requires access to good information about the options available.