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

BREAK EVEN

A. Moore

Health Service Journal, vol.115, Apr.21st 2005, p.28-31

The national orthopaedic project was formed to help the speciality hit government maximum wait targets. It has employed an approach of targeted support for the most challenged hospital trusts. The project sends in a team of experts that helps diagnose the problem and find solutions that will work locally.

BUREAUCRAT BASHER WHO "BELIEVES" IN THE NHS

D. Martin

Health Service Journal, vol.115, Apr.7th 2005, p.18-19

Report of an interview with shadow Health Secretary Andrew Lansley in which he states that the Conservatives remain committed to an NHS funded out of general taxation and offering treatment free at the point of use. They would, however, relieve the pressure on the NHS by subsidising patients using the private sector, and cut costs by reducing the number of administrators.

CHARGE OF THE FIRE BRIGADE

D. Martin

Health Service Journal, vol.115, Apr. 28th 2005, p.20-21

Report of an interview with Health Secretary John Reid in which he attacks Conservative plans to use NHS money to subsidise patients paying for private treatment. Goes on to discuss his plans for downsizing the Department of Health and for new targets to speed up the delivery of cervical smear test results and the time it takes for "non-urgent" breast and bowel cancer patients to see a specialist.

CLEANING UP THEIR ACT?

S. Ward

Public Finance, Mar.25th-31st 2005, p.20-23

The prevalence of MRSA infections in hospitals is alarming the public and the author predicts that it will become an issue in the 2005 general election. He argues that figures showing a drop in cases in 2004 may be due to under-reporting rather than to improvements in cleanliness prompted by government campaigns. High bed occupancy rates increase the presence of MRSA bacteria, and the author concludes that the NHS cannot both reduce waiting lists by increasing throughput and tackle the scourge of MRSA.

CRUNCH TIME FOR MANAGERS

D. Martin

Health Service Journal, vol.115, Apr.21st 2005, p.18-19

Report of an interview with Liberal Democrat health spokesman Paul Burstow in which he outlines his party's policies for abolishing strategic health authorities, making local authorities responsible for commissioning healthcare, replacing performance targets with evidence-based minimum standards and investing in diagnostics to reduce waits.

DELIVERING THE NHS CANCER PLAN

C. Blanco-Criado

British Journal of Health Care Management, vol.11, 2005, p.116-120

Increasing workloads and staff shortages in hospital pharmacy services threaten to restrict oncology pharmacists' activity and hinder the improvements to cancer services set out in the NHS cancer plan. Article investigates the causes of the problem and illustrates how switching from intravenous to oral chemotherapy in advanced colorectal cancer could help trusts to meet the government's ambitious treatment targets.

"ENTERTAINMENT ADVISORS" UNDER ATTACK

I. Lloyd

Health Service Journal, vol.115, Apr.14th 2005, p.7

Patient organisations have expressed concern over the recruitment of "entertainment advisors" to market TV, video and Internet consoles provided by private companies for hire by patients in NHS hospitals. The consoles are being rolled out across the NHS under the Patient Power project.

HEALTH CARE UNDER NEW LABOUR: REBUILDING OR DISMANTLING THE NHS?

K. Walshe

British Journal of Health Care Management, vol.11, 2005, p.73-76

Seeing that massively increased public investment in the NHS had failed to improve its performance, the New Labour government in its second term in office introduced radical reform. It reintroduced local control of the NHS through the establishment of foundation trusts and local authority scrutiny committees and set up structures whereby NHS bodies and private providers compete for patients. There are concerns that this mixed economy of health care could threaten the founding principles of the NHS which was intended to offer tax funded universal care free at the point of use.

HOW DO PEOPLE SEE THE PROGRESS OF NHS REFORM?

A. Cowper (editor)

British Journal of Health Care Management, vol.11, 2005, p.77-80

A range of members of the health management community give their views on the progress of NHS reform.

IS THE NHS GETTING BETTER OR WORSE? AN IN-DEPTH LOOK AT THE VIEWS OF NEARLY A MILLION PATIENTS BETWEEN 1998 AND 2004

Picker Institute Europe

Oxford: 2005

Report finds that priority areas which have been the focus of co-ordinated action and investment, such as waiting times, cancer care, and coronary heart disease, have seen major improvements, but patient-centred care in not the norm in many other fields. Patients still want more information, more involvement in decisions about their care, more help when transferring from hospital to home, and easier access to their GP, with appointments at more convenient times.

LABOUR'S MANIFESTO HINTS AT THE SHAPE OF THINGS TO COME

L. Donnelly

Health Service Journal, vol.115, Apr.21st 2005, p.12-15

Argues that under a third term Labour government the number of strategic health authorities will probably decrease as their role in managing the performance of trusts in their area is reduced in a health economy where foundation status is the norm. At the same time the number of primary care trusts may decrease as they move to a strategic role with the introduction of practice-based commissioning.

LAY PERCEPTIONS OF HEALTH AND HEALTH NEEDS

R. Grant

Community Practitioner, vol.78, 2005, p.133-139

There is evidence that individuals in a community hold knowledge that can effectively influence policy development and service provision. Article describes how Community Participatory Appraisal methodology was used to elicit lay perceptions of the health needs of a rural English village.

LOST IN TRANSLATION? HEALTH SYSTEMS IN THE US AND THE UK

C. Ham

Social Policy and Administration, vol.39, 2005, p.192-209

Describes how the NHS has sought to apply and adapt some of the managed care techniques used in the Kaiser Permanente health maintenance organisation in California to the UK context, with a view to reducing inappropriate use of hospital beds by older patients.

MAKING THINGS BETTER? A REPORT ON REFORM OF THE NHS COMPLAINTS PROCEDURE IN ENGLAND

Health Service Ombudsman for England

London: TSO, 2005 (House of Commons papers, session 2004/05; HC413)

Report highlights problems with the current complaints system including fragmentation, failure to focus on patients' needs, poor leadership, and lack of capacity and competence in complaint handling. The Department of Health needs to demonstrate leadership and its commitment to reform by creating a core standard for complaints handling and by investing in trained staff who can treat complaints positively and learn from them. The present system focuses on process rather than outcomes and on meeting deadlines rather than on delivering a quality service.

NHS FACES RECRUITMENT CRISIS AS NURSES RETIRE

M. Firth

The Independent, April 25th 2005, p.6

The number of new nurses joining the NHS needs to double within 10 years just to keep staff figures stable, it has been claimed. With 25 per cent of nurses due to retire within the next decade and new entrants to the register stalling, the Royal College of Nursing warned of a growing crisis in the profession.

NPFIT TO LPFIT: WHY THE NHS NEEDS TO MOVE FROM CENTRALISED TO DISTRIBUTED SYSTEMS FOR IT

B. Sang

British Journal of Health Care Management, vol.11, 2005, p.83-84

There is evidence that the successful implementation of new IT systems requires:

  • that the benefits should outweigh the costs;
  • that users should see benefits for their day-to-day work;
  • skilled facilitation to reduce resistance to change and address the issues of legacy systems.

The author discusses the implications for the NHS and asks how local ownership of the new systems introduced under the National Programme for IT can be achieved. The question of whether these centrally imposed systems will meet NHS core business needs is also explored.

NPFIT'S PROGRESS

M. Cross

British Journal of Health Care Management, vol.11, 2005, p.90-91

Article discusses progress in the implementation of the three systems at the heart of the NHS National Programme for IT: electronic appointment booking, the electronic transmission of prescriptions and the care records service.

POSITIVE ACTION AND THE PROBLEM OF MERIT: EMPLOYMENT POLICIES IN THE NATIONAL HEALTH SERVICE

N. Johns

Critical Social Policy, vol.25, 2005, p.139-163

Since its election in 1997, the Labour government has emphasized the need for greater ethnic diversity in the public sector. One of the main means of achieving this has been the use of positive action within a framework of race equality and mainstreaming. This article, based on a national mail survey and supporting interviews, suggests that this approach may fail in the NHS due to the suspicion that positive action naturally leads to positive discrimination.

POST-ELECTION PRIORITIES

S. Stevens

Health Service Journal, vol.115, Apr.28th 2005, p.19

Article celebrates the achievements of centrally driven "performance management" in raising standards in the NHS. Argues that in the next phase of the reform, alignment of incentives will be the most effective lever for increasing efficiency.

THE PUBLIC AND POLITICIANS CAN LEARN TO VALUE NHS MANAGERS

G. Morgan and A. Maynard

Health Service Journal, vol.115, Apr. 28th 2005, p.22-23

Morgan argues that the public dislike of NHS managers as useless bureaucrats stems from media hype. Maynard responds that managers in the NHS are not respected because they are unable to effectively control clinicians. Until they can do so, waste and inefficiency will not be rooted out.

READY OR NOT

A. Nolan

Health Services Journal, vol.115, Apr.7th 2005, p.30-32

Practice-based commissioning in now under way. From April 2005, GP practices have been able to request indicative budgets for the services to which they refer patients. This is the first step towards linking the referral decisions of GPs to the finances needed to buy the services. The underlying aim is to encourage GPs to find cheaper alternatives to hospital referral. Article reports results of a survey of 140 decision-makers in primary care trusts and practices on progress to date.

SURGEONS CRITICISE PRIVATISATION

J. Carvel and H. Tomlinson

The Guardian, April 21st 2005, p.2

Britain's general surgeons have accused the government of betraying the principles of the NHS by spending billions on contracting out standard operations to the private sector, leaving NHS hospitals ill-equipped to handle the harder cases.

WHOM SHOULD WE TREAT?: RIGHTS, RATIONING, AND RESOURCES IN THE NHS

C. Newdick

Oxford: Oxford University Press, 2005

This book puts patients' rights into their political, economic, and managerial contexts. It considers the implications of the Bristol Inquiry and the rhetoric of patients as 'consumers' of care. In balancing the rights of individuals with those of the community as a whole, it deals with one of the most pressing problems in contemporary society. Amongst the importatnt questions raised are:

  • why does demand for health care consistently exceed supply and how should the Government manage the problem?
  • there is a grave danger that improved rights for the strong and articulate will ignore less visible, or unpopular interests. How should the rights of elderly patients, children, or those with terminal illnesses be balanced?
  • who should decide: Government, doctors, NHS managers, citizens or the courts?
  • how should decision-makers be held accountable, and by whom?
  • how should governance regulate the NHS?
  • as patients become 'consumers' of medical care, what choice do they have as to how, where, and when they will be treated; and should this include hospitals abroad?
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