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Welfare Reform on the Web (February 2005): National Health Service - Reform - General

ABUSIVE NHS PATIENT JAILED

J. Carvel

The Guardian, Jan. 21st 2005, p.6

A 53-year-old fetishist from York became the first NHS patient to be jailed for harassing medical staff. The conviction was the first since John Reid, the Health Secretary, ordered a crackdown on violence against NHS staff in December 2003. He was responding to a report that 116,000 incidents of physical or verbal abuse against NHS employees over a period of 12 months had resulted in only 50 prosecutions.

CLEARING THE PATH: THE REGULATORY LANDSCAPE AHEAD

B. Moyes

British Journal of Health Care Management, vol.10, 2004, p.361-365

Describes the proposed regime for regulating NHS foundation trusts. Each trust will submit an annual plan to the regulatory body, Monitor. This will assess the risks identified in the plan and assign a risk rating in three areas (finance, governance and mandatory services). It will then track progress against the annual plan. The frequency and depth of in-year monitoring will be determined by the risk rating.

DOCTOR TREATS SHORTAGES WITH FIRST PRIVATE MEDICAL SCHOOL

A. Blair

The Times, Jan. 17th 2005, p.6

A Harley Street doctor is setting up Britain's first independent medical school since the start of the NHS to cater for the increasingly urgent need to train doctors. The Hunter School of Medicine will open in September next year on Brunel University's Uxbridge campus and is aimed primarily at training senior NHS nurses and paramedics to become doctors

DOCTORS SHOULD NOT SHARE CORPORATE RESPONSIBILITY

J. Shapiro and H. Mascie-Taylor

Health Service Journal, vol.115 Jan. 27th 2005, p.18-19

Should doctors always be team players, or should their individuality be harnessed for optimum patient care? On the one hand doctors are trained to take risks and apply their experience to a wide range of complex problems, thinking on their feet. On the other hand the NHS has always had a structural bias, where change is generally seen in terms of organisational arrangement, something that is becoming more marked with the development of foundation trusts and the independent sector. If clinicians get sucked into this culture, the risk is that individual patient care may be forgotten in the rush for corporate efficiency. The article contains opinions from both sides of the debate.

FELLOWS WELL MET

A. Dix

Health Service Journal, vol.115, Jan. 13th 2005, p.28-31

One solution to the problem of restrictions on junior hospital doctors' hours being tried in London is hiring out the services of surgical research fellows to smaller hospitals. Revenue raised can be used to partially fund salaries for research posts, offering more doctors the chance of clinical development. A potential pitfall is the creation of bogus research posts, which in fact simply provide out-of-hours cover

FOUNDATION DIRECTORS HELD TO ACCOUNT, BUT EVER SO GENTLY

T. Shifrin

Health Service Journal, vol. 115, Jan. 13th 2005, p.14-15

Article explores the relationship between foundation hospital boards of directors, which hold executive power, and their governing bodies, which are made up of elected members drawn from staff, patients and the public.

GOOD CORPORATE CITIZENSHIP AND THE NHS: A REGIONAL MAPPING

K. Jochelson with C. Delap and S. Norwood

London: Health Development Agency, 2004

Report summarises the potential for the NHS to contribute as a good corporate citizen to local regeneration and sustainable development through its procurement, capital build, travel and waste management policies. Gives a snapshot of progress across the English regions and provides regional and local case studies on all the above policies.

HEALTH AND HEALTH CARE IN BRITAIN

R. Baggot

Basingstoke, Hants: Palgrave Macmillan, 2004

Present standards of health in Britain are relatively high, not only in comparison with past generations, but also internationally. Britain in the new millennium is a comparatively healthy place in which to be born and to live. However, the focus upon overall standards of health disguises trends and variations within the population. Any judgement about health standards must be based therefore on a careful analysis of these trends and variations, beginning with the concept of health and its measurement. This is followed by an overview of recent trends, an analysis of the key factors which affect health and illness in the UK, and a discussion of variations between different population groups.

HEALTH DEPARTMENT RUSHES TO CREATE SYSTEM TO DEAL WITH FAILURES IN NHS

N. Timmins

Financial Times, Jan. 24th 2005, p.1

The Department of Health is seeking urgent outside help to create a system to deal with financial and clinical failures in the new, more competitive, NHS market that the government has created. A tender to create "a failure regime" has been issued, with the task seen as so urgent that potential bidders were initially given little more than 10 days to respond. The regime is aimed at "identifying the warning signs of failure" and preventing it among primary care trusts, NHS hospitals, the new foundation trusts and the growing number of private providers of NHS operations and services. But the failure regime will also have to set out how the NHS keeps patient services going if a system or financial failure does occur.

HEALTH POLICY IN BRITAIN: THE POLITICS AND ORGANISATION OF THE NATIONAL HEALTH SERVICE. 5TH ED

C. Ham

Basingstoke, Hants: Palgrave Macmillan, 2004

This book provides an introduction to health policy in the United Kingdom covering both the substance of health policy and the process of health policy-making and implementation. Its aim is to introduce the organisation of the National Health Service, its history and development and to show the way in which policies for NHS services are made and implemented in central government and in NHS bodies. The book also examines the auditing and evaluation of health policy, and considers which groups have power over policy-making. The main concern is the politics of health care; who decides, who benefits and who controls health services. The book has been revised and updated to take account of developments in health services and health policy since 1999.

HEALTH SERVICE CHARTS OVERSTATE RISE IN STAFFING LEVELS

S. Briscoe

Financial Times, Jan 5th 2005, p.2

The government has published charts creating a distorted impression of employment in the Department of Health by exaggerating the increase in the number of staff over the past three years. In last year's annual publication of the National Health Service workforce figures, based on 2003 data, about 60,000 workers were dropped from the previous years' figures. As a result, the published bar chart appeared to show a steeper rise in employment than had actually occurred, supporting the government's assertion that the extra resources pouring into the health service were being spent on staffing.

ITC PROCUREMENT

Health Service Journal, vol.115, Jan. 20th 2005, p.5-9

A survey of over 100 NHS trust chief executives has revealed widespread disquiet about the implementation of the independent treatment centre (ITC) procurement programme. There are concerns that the programme will destabilise local hospitals by diverting elective surgery from them to the new ITCs in order to meet central government targets.

MAKE BOARDS WORK BETTER

J. Bevington, P. Stanton and P. Glanfield

Health Service Journal, vol.115, Jan. 6th 2005, p.24-25

Authors have identified five aspects of NHS trust board behaviour that are critical to high performance. These are:

  • having an effective Chair;
  • focusing on core business;
  • having good intelligence about developments outside the Trust;
  • cohesion between executive and non-executive Board members;
  • Board members being willing to challenge one another.

MAKING DIVERSITY A REALITY

J. Camm

Community Practitioner, vol.78, 2005, p.7-8

Presents an overview of a number of initiatives designed to improve levels of recruitment of minority ethnic staff into the NHS and to enhance their career development.

MOVING TO A 21ST CENTURY PENSION SCHEME

NHS Employers

London: 2005

Key reforms include:

  • changing the retirement age from 60 to 65;
  • moving to a higher benefits accrual rate;
  • moving from a final salary to a career average scheme;
  • offering staff an enhanced pension if they work beyond the age of 65;
  • allowing staff to take their pension flexibly while continuing to work.

Changes would apply to new staff from 2006 and to existing staff from 2013.

(For comment see Health Service Journal, vol.115, Jan. 20th 2005, p.14-15)

NHS PLC: THE PRIVATISATION OF OUR HEALTH CARE

A.M. Pollock

London: Verso, 2004

This book is an account of how Britain's National Health Service, which established health care as a right, has been progressively dismantled and privatised by successive governments over the past quarter-century. The story is not unique to Britain. Making health care once again a commodity to be bought, rather than a right, has become the standard prescription of the World Bank, the International Monetary Fund, the World Trade Organisation, and even the World Health Organisation - and, increasingly, the European Commission. This book tries to show what is at stake. The dismantling process and its consequences are profoundly anti-democratic and opaque. The catchphrases of 'public-private partnerships', 'modernisation', 'value for money', 'local ownership' , and the complexity of privatisation mechanisms such as Private Finance Initiative (PFI), conceal the real nature of what is happening. The author demystifies these terms, providing an accessible and powerful analysis of New Labour's 'mixed economy of health care'. Her conclusion is clear: a system which was designed to promote equity and universality is being replaced by a multitude of fragmented and competing providers driven by financial incentives rather than the health needs of the population.

POLICY TARGETS AND ETHICAL TENSIONS: UK NURSE RECRUITMENT

C. Deeming

Social Policy and Administration, vol.38, 2004, p.775-792

In July 2000 the New Labour government set a target of recruiting 20,000 extra nurses for the NHS by 2004. The target was achieved two years ahead of schedule in February 2002, at least partly by poaching nurses from Third World countries. Despite its commitment to ethical foreign policy, the Labour government did not act decisively to prevent this practice.

THE RELATIONSHIP BETWEEN MEDICINE AND THE PUBLIC: THE CHALLENGE OF CONCORDANCE

F. Stevenson and G. Scambler

Health, vol.9, 2005, p.5-21

Concordance is based on the idea that patients and practitioners should work together towards an agreement on treatment choice. Recent policy developments in the UK increase patient involvement in health care decision-making and so provide support for concordance. Unfortunately concordance is being promoted at a time when the trust patients have in their doctors is in decline, making it more difficult to achieve.

TACKLING CANCER IN ENGLAND: SAVING MORE LIVES

Public Accounts Committee

London: TSO, 2005 (House of Commons papers, session 2004/05; HC166)

People in the cities of Northern England are almost twice as likely to die of cancer as those in the affluent south. Their cancer is likely to be more advanced by the time it is diagnosed and they are less likely to survive. The Committee acknowledges substantial progress in the years since the government made cancer one of its health priorities, but the divide between rich and poor areas has widened for most cancers suffered by men and women.

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