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Welfare Reform on the Web (June 2006): National Health Service - reform - general

18 weeks waiting: achievable and/or desirable?

A. Cowper

British Journal of Health Care Management, vol.12, 2006, p.148-150

The next major government target looming over the NHS is the requirement to reduce the waiting time for elective treatment to 18 weeks from referral by 2008. Achieving this target will, however, not help with the management of people with mental health problems or long-term medical conditions in the community.

Andrew Foster

A. Cowper

British Journal of Health Care Management, vol.12, 2006, p.137-140

Report of an interview with Andrew Foster, Director of Workforce at the Department of Health from 2000 to 2006 in which he discusses NHS job cuts and the impact of Agenda for Change and the new GP and consultants’ contracts.

Angry nurses drown out minister

C. Hall

Daily Telegraph, April 27th 2006, p.5

Nurses showed unprecedented anger towards Health Secretary Patricia Hewitt at the Royal College of Nursing conference, where the minister’s speech and attempt at conciliation were drowned out and derided. The article reports individual questions put to the minister by nurses and the college general secretary who called for “long-term planning not short-term cuts”.

[See also Independent, April 27th 2006, p.3; Guardian, April 27th 2006, p.5; Times, April 27th, 2006, p. 30]

Compensation culture: NHS Redress Bill

Constitutional Affairs Committee

London: TSO, 2006 (House of Commons papers, session 2005/06; HC1009)

The report deals with areas of concern relating to the NHS Redress Bill:

  1. Whether the Department of Health has a current list of medical experts who are able to provide medical reports.
  2. Whether doctors and lawyers would be willing to work for fixed fees and the proposed level of those fees;
  3. The expected number of additional claimants under the Redress procedure.

Doctors in revolt over legalising euthanasia

N. Hawkes, F. Gibb, D. Charter

The Times, May 10th 2006, p.1

Doctors have revolted against a bill introducing assisted death for the terminally ill.

(See also, The Daily Telegraph, May 8th 2006, p.8, May 9th 2006, p.1, Guardian 10th May 2006, p.12, The Times May 11th 2006, p.21)

From partition to partnership: managing collaboration within a curative framework for NHS care

R. McMurray

International Journal of Public Sector Management, vol.19, 2006, p.238-249

Despite action to remove many of the financial and structural barriers to integrated health and social care, twenty years of policy prescription and service reorganisation have failed to deliver inter-organisational collaboration. The paper attributes this problem to the dominance of the medical model of health and illness within the NHS. The bio-medical model of health sees patients as collections of body parts in need of repair and is concerned with disease and cure. It is incompatible with the more inclusive social model, which emphasises the promotion of health enablement and the maintenance of the well-being of the whole person. Furthermore, policies emphasising patient throughput, speed of treatment and the primacy of hospitals encourage health professionals to withdraw from cross-boundary working in line with the isolationist tendencies of the medical model.

Health scrutiny, democracy and integration: part of the same jigsaw?

A. Coleman

Local Government Studies, vol.32, 2006, p.123-138

This article examines emerging practice in the implementation of local authority health scrutiny. Against the background of public service modernisation, two ways of conceptually describing local authority health scrutiny are suggested and illustrated with the results from the first phase of a three-year project evaluating its implementation and development. Health scrutiny can be seen as a process to increase local democratic input and as a form of integration across different organisations from different parts of the public sector.

Hospitals told to embrace reforms

N. Timmins

Financial Times, May 1st 2006, p.1

Reports that minister for NHS reform Lord Warner has called on local hospitals to reconfigure their services in the light of new moves to provide more care in the community, the introduction of patient choice and the entry of private providers into the NHS market.

How to find “frequent flyers”

A. Cole

Health Service Journal, vol.116, May 4th 2006, p.20-22

People with long term conditions who are serial users of hospital emergency services because their illnesses are not well managed are costing the health service money it can no longer afford. An intensive case management approach is key to keeping such patients out of hospital. Recent work in Manchester suggests that mental health problems and social deprivation rather than age may be the best indicators for the identification of patients for inclusion in case management schemes.

HSJ intelligence

A. Nolan (editor)

Health Service Journal, vol.116, May 18th 2006, supplement, 12p.

Supplement on IT developments in the NHS covers:

  1. Capacity management systems which provide overviews of hospital emergency capacity, and can direct ambulance crews from busy to quieter hospitals.
  2. An innovative approach to provision of hospital out-of-hours care
  3. Introduction of an electronic appointment booking system at the Dudley Group hospitals trust

I’d like to die with dignity. And I don’t want the medieval brigade interfering

C. Cavendish

The Times May 11th, 2006, p.21

This author’s opinion piece describes the arguments from those who are against the proposed Assisted Dying for the Terminally Ill Bill, as well intentioned but based on religious beliefs or from the medical establishment’s viewpoint. She insists that all arguments must take into account the views of terminally ill people

The jobs clear-out that will hit the NHS where it hurts

A. Moore

Health Service Journal, vol.116, May 11th 2006, p.14-15

Managerial jobs are being lost across the NHS in the face of financial pressures and health authority and primary care trust mergers. Middle managers in primary care trusts are most at risk.

Local involvement networks set to replace PPI forums

HSJ Reporters

Health Service Journal, vol.116, May 18th 2006, p.5

The Department of Health is set to replace NHS public and patient involvement forums with “local involvement networks” covering a geographic primary care trust area instead of being linked to particular organisations. The new networks would be voluntary organisations with directly provided budgets of around £150,000 per year to maintain an office and staff.

Lords vote against ‘right to die’ Bill after impassioned debate

B. Russell

The Independent, May 13th, 2006,p.6

Peers at the House of Lords have voted 148 to 100 to carry an amendment delaying debate on the Assisted-Dying for the Terminally Ill Bill for six months.

(See also The Daily Telegraph, May 13th 2006, p.10)

Ministers cling to the belief that trust deficits can be cut with little pain

J. Eagelsham & J. Blitz

Financial Times, April 25th 2006, p.4

While some criticisms of NHS reforms “appear wide of the mark” according to the article, Blair’s claim of more than 250,000 new staff since 1997 and dramatically reduced waiting lists do not negate significant further problems in the NHS. While ministers look to efficiency savings such as out of hospital rehabilitation to reduce deficits, they should take responsibility for the misalignment of productivity and pay rises according to experts reported here. The article also lists job cut figures proposed in the last two months.

Nurse prescribing

B. Stuttle

Community Practitioner, vol.79 2006, p.147

From May 2006, independent extended nurse prescribers can prescribe from the whole British National Formulary (BNF) apart from unlicensed medicines and controlled drugs. Education and training will continue to be delivered in 25 taught days within a higher education institution with 12 days mentoring by a medical practitioner.

Overhaul of regulation needed for “new” NHS to work, warns minister

N. Timmins

Financial Times, April 28th 2006, p. 4

Although final decisions have not been made Lord Warner has hinted that a combined quality and financial regulatory response to the health service market and other reforms is favoured by government. The article provides comments on both split and combined proposals.

Patients win right to faster surgery abroad

J. Carvel, C. Dyer

The Guardian, May 17th 2006, p.19

A European court has ruled that the NHS must pay for treatment abroad for patients who face “undue delay” in their treatment at home. The ruling was made in a case of a woman who needed a hip replacement. The Department of Health argued that waiting list priorities will be disrupted when this ruling is enforced. A Department of Health spokesperson said that this avenue of treatment would still have to be authorised by the local health commissioner of the patient requiring surgery.

(See also The Times, May 17th, 2006, p.4. + p.19)

Stop trying to kill us off

J. Campbell
The Guardian, May 9th 2006, p.32

The author of this comment piece believes that Lord Joffe’s private members bill, Assisted Dying for the Terminally Ill would effectively legalise the killing of disabled and terminally ill people if it becomes law. Although the bill has the backing of pro-euthanasia groups, no charities for the disabled have been consulted and it has been attacked by them. The author argues that the bill chooses to ignore the role played by medical and social services in improving the quality of life of disabled and terminally ill people. The legalisation of voluntary euthanasia could have a negative effect on existing medical services for the disabled.

(See also The Daily Telegraph, May 8th 2006, p.8, May 9th 2006, p.1)

Tackling cancer: improving the patient journey

Committee of Public Accounts

London: TSO, 2006 (House of Commons papers, session 2005/06; HC790)

The report looks at changes in cancer patient experiences since the introduction of the Cancer Plan. Additional funding of more than £1 billion has been provided in the last four years and the Department of Health and the NHS have introduced a range of measures to improve access. According to a follow up survey by the National Audit Office patients were broadly positive about their experiences and progress had been made in improving most aspects of the patient experience since 2000, though less so for prostate cancer patients. Some elements of the patient experience, such as communicating information, symptom relief and the lack of options for some patients in their last days, were still not as good as they might be. In particular, terminally ill patients were often not made aware of non-means tested disability benefits that they could have claimed.

Three trusts fail to reveal heart death figures

J. Carvel & S. Boseley

Guardian, April 26th 2006, p.4

Data for a new website and central cardiac audit database intended to inform patient decision making about surgery have been supplied to the Healthcare Commission by all UK hospitals but three. The article looks at the slow response to original 2002 demands for the data, the Commission’s reasons for publishing surgeons’ death rate information, and at the three trusts which risk being downgraded.

Why the NHS is on the ballot paper

A. Moore

Health Service Journal, vol.116, May 4th 2006, p.12-13

Council oversight and scrutiny committees are having an increasing impact on local health services and are increasing the democratic accountability of the NHS. Article looks at their functioning and the likely impact of health service redesign issues on local elections in England.

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