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Welfare Reform on the Web (April 2006): National Health Service - Reform - General

S. Ward

Public Finance, March 17th-23rd 2006, p.28-30

Opinion is divided as to whether or not Sir Nigel Crisp, the NHS chief executive who resigned in March 2006, has been made a scapegoat for the NHS’ financial difficulties or in fact helped to cause them. It is argued that his dual role as NHS chief executive and as permanent secretary at the Department of Health created a conflict of interest which contributed to his problems.

Health Service Journal, vol.116, Mar. 9th 2006, p.5-9

Comments on the resignation of NHS Chief Executive Sir Nigel Crisp, who has accepted “accountability” for its current financial difficulties. In the interim, the job has been split into two parts with Department of Health acting director of commissioning Sir Ian Carruthers becoming temporary NHS chief executive and Hugh Taylor, currently deputy chief executive, becoming acting permanent secretary.

J. Newman and E. Vidler

Journal of Social Policy, vol.35, 2006, p.193-209

The redefinition of the patient as a consumer of health care has been central to both Conservative and New Labour reforms of the NHS. This article looks at some of the ways in which policy documents present patients as discriminating or demanding consumers, expert patients or responsible healthcare users. These conceptions serve to shift the balance of power both between healthcare users and providers and between government and the healthcare practitioner, with government standing as the champion of consumer power in the face of entrenched producer interests. It goes on to explore ways in which service delivery organisations respond to Labour’s consumerist imperative.

D. Carlisle and others

Health Service Journal, vol.116, Mar. 9th 2006, p.31-37

Reflects on arrangements for contracting out of NHS services to private sector providers, covering success stories, barriers and current legislation.

S. Boseley

Guardian, March 10th 2006, p.4

Professional bodies are calling for a proper study of the success and revision rates of hip and knee replacements as procedures performed in Independent Sector Treatment Centres (ISTCs) include a “too great”, but hard to quantify number of mistakes, including some serious errors. The ISTCs, used by the NHS to help with waiting list targets, have asked surgeons from abroad with inappropriate or insufficient training to perform operations. Consequently NHS trainee surgeons lose the benefits of watching procedures, and of supervised practice on routine procedures.

J. Cairns

Health Policy, vol.76, 2006, p.134-143

There is wide acceptance that cost-effectiveness is a relevant consideration when deciding which treatments to make available in a publicly funded health service. An unresolved issue concerns the timing and extent of such evaluations. The United Kingdom provides examples of two distinct approaches. The Scottish Medicines Consortium provides guidance to the NHS in Scotland based on a rapid, early review of the evidence. The National Institute for Health and Clinical Excellence (NICE) provides guidance to the NHS in England and Wales based on a later, more extensive review of the evidence. The approach followed by NICE is fairly distinctive internationally with its emphasis on detailed external assessment of evidence, whereas the approach followed by the Scottish Medicines Consortium is closer to that used elsewhere in Europe.

Regulating health and social care: a meeting of minds?

D. Platt

British Journal of Health Care Management, vol.12, 2006, p.83-85

With the introduction of competition and patient choice into the NHS, regulation is becoming a key issue. Article explores lessons that can be learned from the regulation of social care. It concludes that a single monitoring body should regulate both economic activity (allowing new providers into the market and driving unacceptable ones out) and provider quality, as does the Commission for Social Care Inspection.

J. I. Baeza

Maidenhead: Open University Press, 2005

The medical profession occupies a dominant position within the British health care system and as such is able to influence the development and implementation of health policy. The main division within the medical profession lies between general practitioners and hospital consultants. What emerges is that the relationship between GPs and consultants is transforming from a collegial to a more managerial one.

S. Ward, D. Rona and E. Forrest

Health Service Journal, vol.116, March 30th 2006, p.29-33

Sharing of back office functions by NHS bodies offers the prospect of cost savings. In April 2005, the Department of Health launched NHS Shared Business Services, a joint venture with the private firm Xansa. SBS guarantees an initial cost saving of 20% and organisations have found that it improves procurement and management. Special report goes on the present a number of case studies of good practice in shared services.

J. Q. Tritter and A. McCallum

Health Policy, vol.76, 2006, p.156-168

The key document that shapes the theoretical framework for user involvement is Arnstein’s A ladder of Citizen Participation published in 1969. Arnstein claims that a redistribution of power is key to the inclusion of citizens in decision-making and describes eight differing degrees of involvement ranging from non-participation to citizen control. Article explores the relevance of Arnstein’s typology of user involvement to current developments in healthcare, particularly within the NHS.

J. Carvel

Guardian, March 22nd 2006, p. 5

Nearly forty per cent of NHS staff have no access to basic hygiene facilities while nearly fifty per cent have still not had training in infection control according to the Healthcare Commission’s Annual Survey. MRSA infection rates are reportedly rising despite tougher standards introduced under Health Secretary Reid.

[See also Times, March 22nd 2006, p.4]

Audit Scotland

Edinburgh: 2006

Report finds that since 2001 the Scottish health service has made good progress in reducing the longest waits for inpatient, day case and outpatient care for people with waiting time guarantees. However, it anticipates that the service will face a major challenge in meeting more ambitious future targets.

N. Edwards and A. Nolan

Health Service Journal, vol.116, March 16th 2006, p.24-27

Looks at how St George’s Healthcare Trust, South Yorkshire Ambulance Service and Eastern Birmingham PCT have approached organisational development and the introduction of cultural change.

D. Martin

Health Service Journal, vol.116, March 30th 2006, p.14-15

Argues that district general hospitals will have to change radically to survive in the new world of competition between NHS service providers and patient choice. On the one hand many areas of elective care such as diagnostics and simple elective surgery will be exposed to open competition between hospitals and unpopular services will close. On the other hand, hospitals will be expected to co-operate to ensure that services needed to support accident and emergency departments and the management of chronic disease are provided somewhere in every locality, though not necessarily on the same site.

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