From our UK edition
Ministers have described the deal on GP contracts, negotiated by the government and the British Medical Association (BMA), as a return to the days when GPs were family doctors. Certainly, it is a step in that direction. The contract, which will come into force next April, revives the personal link between doctor and patients aged 75 or over, and makes GPs responsible for out of hours care.
From our UK edition
Sir Bruce Keogh’s anticipated review into accident and emergency has been published today to a chorus of praise and boos. The Mail describes it as a ‘sticking plaster’. The Independent is cautious. The Guardian is critical. And the Telegraph and the Sun are more positive. Sir Bruce Keogh gave a masterly performance on the Today programme, which may go some way to calming fears in the press. He said that the current system, which was designed in the 70s for the 70s, is unsustainable. At the root of his analysis is the belief that the present system is inefficient because patients have to go to the NHS to receive attention, rather than the NHS reaching out to patients. So, in short, emergency care has to become more flexible and mobile.
From our UK edition
It's been a while since we had a nice big fat NHS row, but those who enjoy watching Andy Burnham and Jeremy Hunt fight over the 'party of the NHS' crown can rest assured that there's a really bitter one coming up this autumn. NHS England has spent the past few months consulting on a change to the way clinical commissioning groups are funded that could end the current arrangement where more money per capita is spent on patients in deprived areas. The formula currently being considered would make the number of elderly people in an area a more important factor in the size of the grant that each CCG receives. You can probably already guess how this will play out in the political arena, but firstly, here's the argument behind changing the formula.
From our UK edition
On Monday morning, Jeremy Hunt’s diary secretary rang me to arrange a time for me to speak to the Secretary of State over the telephone. I had already received an email from his special adviser the previous week, saying, ‘The two points which the independent research make clear are central to what you’ve been saying for a long time; namely that health tourism is a huge problem with a substantial cost to the NHS and the current system is an unfair burden on frontline staff.’ When Jeremy rang, he was charming, full of praise, and eager to tackle the issue of health tourism — the exploitation of the NHS by ineligible, non-tax contributing patients. Yet for all the Health Secretary’s good intentions, I fear his department is failing to grasp the nettle.
From our UK edition
Remember the name Simon Stevens. He’s is the new chief executive of the NHS in England and is going to be absolutely crucial to whether the government can make its health reforms work. Stevens is a former Labour special adviser. However, he comes from the reformist wing of the party. He used to advise Alan Milburn and Tony Blair on the NHS. But a profile in today’s Guardian reveals just how impressively radical Stevens is. Denis Campbell writes that Stevens favours local pay in the NHS. He is also, Campbell says, keen on the idea of independent GPs competing with existing GP surgeries for patients, in the hope that this competition would drive up standards.
From our UK edition
David Cameron is currently trying to work out what his position on jumpers is after Number 10 was forced to issue an amazing clarification this afternoon. A spokesman said: 'To be clear, it is entirely false to suggest the PM would advise people they should wear jumpers to stay warm. Any suggestion to the contrary is mischief-making. The Prime Minister would point people to a range of things being done to help people with their fuel bills, such as legislating to put everyone on the best tariff for them. He believes Labour's "price freeze" policy is a con - and certainly would not advise people on what they should wear.
From our UK edition
The details of the government reshuffle are currently being hammered out at the 8.30 Downing Street meeting. But as MPs and ministers nervously wait for the call from the Number 10 switchboard, Ed Miliband will be plotting his own changes to his top team for later this week. And as key Shadow Cabinet members such as Liam Byrne look vulnerable, one shadow minister who is holding on with all he's got is Andy Burnham. The Shadow Health Secretary is very popular with the party's grassroots, but he is also politically vulnerable because of his connections to the previous Labour government. But though Ed Miliband failed to publicly back Burnham at the party's conference, his colleague has in the past few days launched an offensive on his detractors that also makes it more difficult to move him.
From our UK edition
Jeremy Hunt has an unusual way of delivering a forceful speech. He pulls a worried, frowny face, and speaks in a special growly sort of voice when he wants to criticise his opponents, but doesn't shout, or indeed really raise his voice at all. Today he delivered a particularly forceful speech to the Conservative conference on why the Tories are the 'party of the NHS'. He used that phrase 'our NHS' that Andy Burnham likes to deploy as part of his emotive pitch to voters on the health service. Hunt used the same emotive pitch today, arguing that Labour placed ideology above what works for patients, and that it failed to address problems. He said: 'Even their own people felt desperately uncomfortable.
From our UK edition
What to do about Ukip is dominating the conversation on the fringe and in the conference bars here in Manchester. But Ukip is only part of the challenge for the Tories. At the next election, they need to hold onto their 2010 supporters and—if they are to win a majority—take votes off Labour. The Tories will only be able to do that if they can reassure these voters on the cost of living and public services. So, this week we’ll see the Tories trying to underscore their commitment to the NHS. There's already been the cancer drugs fund announcement and Jeremy Hunt will, as I said in the Mail on Sunday, announce a pilot that will see GPs’ surgeries open from 8am to 8pm.
From our UK edition
Are David Cameron and Jeremy Hunt going about fixing the NHS in the wrong way? On this week’s View from 22 podcast, former No.10 advisor Sean Worth and director of Reform Andrew Haldenby discuss Dr J Meirion Thomas’s Spectator cover feature on the problems with the Health Secretary's plans to reshape the NHS. Is Dr Thomas right in saying we need more focus on training GPs, and not centralised technological solutions? Will the government's reforms be remembered in 100 years as a landmark moment for the NHS? And do we need more focus on recruiting British doctors, to improve the quality of care? Freddy Gray and the Economist’s Daniel Knowles also debate the plight of the unpaid intern and whether interns should stop moaning about how they are treated.
From our UK edition
Jeremy Hunt, the Health Secretary, is a decent and well-meaning man. He’s genuinely excited about the new, radical reforms planned for the NHS which he announced last weekend. I have been told that Hunt and his old friend David Cameron see this restructuring of the NHS as the next great step, as significant and successful as Gove’s education reform; something the Prime Minister will be remembered for gratefully in 100 years’ time. I’m afraid they’re wrong. If implemented as announced, these plans will be both expensive and ineffective. The main trouble is that Hunt’s NHS revamp will rely on a vast, integrated and enormously complicated IT system.
From our UK edition
Jeremy Hunt’s quiet demeanour is deceptive. The Health Secretary has a bit of what my late grandfather called ‘iron in the soul’ – a measure of self-confidence, calculation and the determination not to let the bastards get you down. ‘Iron in the soul’ came in handy during the Burma campaign in the Second World War. And I imagine that it’s vital if one is to prosper as Secretary of State for Health. Hunt was sent to the Department of Health last year in order to clean up the political mess left by Andrew Lansley. Hunt’s tenure has been beset by scandals beyond his or his predecessor's control – from Mid Staffs to A&E, with numerous others in between (about which Jane Kelly wrote so vividly in the Spectator a few weeks ago).
From our UK edition
One of the many problems that Andy Burnham has encountered this week is that he has had to spend more time defending his record in the last Labour government than scrutinising the current government's changes to the health service. He has performed the first task in a rather emotional manner, and the Conservatives may well feel that politically this week has been rather successful. But now they're going after him on the policy side of things too, perhaps to underline how preoccupied Burnham is with his own reputation. Jeremy Hunt has this afternoon written a letter to Ed Miliband, seen exclusively by Coffee House, which demands to know whether Labour supports the government's new hospital inspection regime.
From our UK edition
Attending the funeral of Margaret Thatcher in April, the Health Secretary, Jeremy Hunt, was much impressed by the bit in the sermon by the Bishop of London about how Mrs Thatcher had replied personally to so many letters. He went back to his department, and asked it to give him each day one letter from a member of the public which recounted particularly shocking problems in the Health Service. He now uses these letters to dive into the problems that patients experience. It is a good idea, but how alarming that it is a novel one. The Department of Health receives more letters than any other part of government except 10 Downing Street. Is it really the case that up till now, officials have never troubled the Secretary of State with the woes of the public?
From our UK edition
Attending the funeral of Margaret Thatcher in April, the Health Secretary, Jeremy Hunt, was much impressed by the bit in the sermon by the Bishop of London about how Mrs Thatcher had replied personally to so many letters. He went back to his department, and asked it to give him each day one letter from a member of the public which recounted particularly shocking problems in the Health Service. He now uses these letters to dive into the problems that patients experience. It is a good idea, but how alarming that it is a novel one. The Department of Health receives more letters than any other part of government except 10 Downing Street. Is it really the case that up till now, officials have never troubled the Secretary of State with the woes of the public?
From our UK edition
Alan Johnson and Stephen Dorrell have just conducted an impressively reasoned debate on the NHS on Radio 4. This was all the more impressive given both their parties have boxed themselves into corners on NHS care scandals, from which they will continue to lash out today at the last PMQs of the summer. Whether or not Andy Burnham bears responsibility for the hospital failings detailed yesterday, his circumstances significantly constrained his ability to scrutinise the policies the government announced. Because he is in the extremely uncomfortable position of shadowing the brief he held in government, Burnham spent more time defending his own record than he did anything else.
From our UK edition
Jeremy Hunt's statement on the Keogh review marked one of the uglier Commons sessions in this parliament. Amid shouting, muttering and angry pointing from the Opposition benches, the Health Secretary announced that 11 of the 14 hospitals in the review would be put into 'special measures', while making clear that he blamed the culture the Labour government had nurtured in the NHS, and pressure from ministers to cover up bad news. Labour MPs hated the last assertion in particular, roaring with disagreement as Hunt said: 'It is never acceptable for the government to put pressure on the NHS to accept bad news because in doing so they make it less likely that poor care will be tackled.' Burnham accused him of being partisan and guilty of 'one of the most cynical spin operations of our time'.
From our UK edition
Labour and the Tories played the first half of NHS political football this morning at health questions. The scrap began with Opposition MPs asking what influence Lynton Crosby had over the decision to drop plain packaging for cigarettes. It is their equivalent of the Tory attack on union influence, and as such has a fair bit of clout. The first question came from Labour's Cathy Jamieson, who asked: 'Given some of the previous pronouncements by the Public Health Minister I think some of us could be forgiven for thinking that the government's policy has changed in relation to this. And I wonder therefore if she could advise the House, who overruled her support for this policy? Was it the Prime Minister? Was it the Health Secretary? Or was it Lynton Crosby?' Ian Austin had a go too.
From our UK edition
One of David Cameron's better lines at Prime Minister's Questions was that the trade unions 'buy the candidates, they buy the policies and they buy the leader'. In his final response to Ed Miliband, he said: 'What is Labour's policy on Royal Mail? It is determined by the Communication Workers Union. What is its policy on health? It is determined by Unison. What is its policy on party funding? It is determined by Unite.' To underline that point, Jeremy Hunt has sent a letter to Andy Burnham this afternoon asking for 'clarification about union influence over Labour health policy'. The letter, which you can read in full here, says Burnham altered Government policy 'in response to union demands'.
From our UK edition
The health service that employs you is under more scrutiny than ever before, with shocking cases of bad care, 'never events' and serious lapses crawling out of the woodwork. The regulator that was supposed to keep an eye on all of this is under attack, not just for missing it, but also for apparently deciding not to publish what details it did know, and then deciding to withhold key names implicated in a 'cover-up'. So what, in its eternal wisdom, does the trade union representing you do? The British Medical Association, which has always managed a veneer of respectability over and above many other public sector unions, today passed a motion of 'no confidence' in Jeremy Hunt as Health Secretary.
