Nhs

The coalition is facing more protests today over its plans to abolish Primary Care Trusts. But PCTs are ripe for abolition. Their bureaucracy and management costs have ballooned in recent years and they have been wildly unpopular in some parts of the country for their role in pushing for hospital closures. They have failed to make the NHS more efficient and innovative and they have been responsible for many of the heart-wrenching cases of patients failing to get drugs for conditions like cancer.   In contrast, GPs are one of the most trusted groups in the NHS. Yes, there are examples of poor practice, but generally patients have high respect

More women than ever are having their babies by Caesarian section. Not the old last-resort emergency type, either; the ones where mothers howl for days, to the point of peril for self or child, until mercy descends in a scalpel — life-saving, but adding to existing trauma. No. This marked increase, by as much as 40 per cent in one year at the Liverpool Women’s Hospital, has been among women who elect a Caesarian; those who plan, often months in advance, to be delivered calmly, swiftly and relatively free of pain in a modern, controlled, 21st-century environment. In short: an increase in women who are aware that there is a choice and

Andrew Lansley’s rhetoric is strident: ‘It’s time for politicians to stop telling people to make healthy choices. Rather than lecturing people about their habits we will give them the support they need… we will support leadership from within communities.’ One could be forgiven for thinking that the Health White Paper will inaugurate a completely new dawn. It doesn’t. Many of Lansley’s initiatives are resuscitated Labour policies: taxes on alcohol and tobacco and incentivising healthy living through choice are tried and tested formulas that have had limited past success in every field bar raising revenue. Lansley’s White Paper is not a testament of radicalism, but it is quietly revolutionary nonetheless. Of

Round n in the transparency revolution: Andrew Lansley has welcomed the publication of the latest Dr Foster hospital list, detailing post-operative failures in NHS care. The Observer reports: 1) Almost 10,000 patients suffered an accidental puncture or laceration. 2) More than 2,000 had post-operative intestinal bleeding. 3) More than 13,000 mothers suffered an obstetric tear while giving birth. 4) Some 30,500 patients developed a blood clot. 5) 1,300 patients contracted blood poisoning after surgery. Despite record investment and targets for standards, the NHS still suffers setbacks in the mundane that have severe consequences – according to the report, several hospitals have ‘dangerously high death rates’. A defender of the NHS’

It’s not just the embarrassing and the difficult that will be buried underneath the Wills ‘n’ Kate coverage tomorrow – some good news will be too. Among it is the coalition’s plan to expand the provision of personal budgets. According to the Lib Dem health minister Paul Burstow, speaking today, some one million elderly people will be given control of their own personal care budgets, up from 250,000 now. As I’ve suggested before, this is a worthwhile idea. Personal budgets promise to be one of the most concrete elements of what the Tories used to call their Post-Bureaucratic Age agenda, but has now been stuck with the Big Society label.

The front cover of the Times (£) provides a dreary snapshot of what the coalition can expect once the cuts start to bite. Unison have responded to job losses in the NHS by arguing that the government is “conning” the public over the impact on frontline services. And they’re threatening to all get all litigious about it. As one of the union’s spokeswomen tells the paper, “If we are not happy with the [government’s reply], we are reserving the right to issue urgent judicial review proceedings.” You wonder whether they’d have done the same against Labour’s proposed 20 percent cuts. And this will be just the start of it. As

With this autumn’s Spending Review set to be one of the most important moments in the life of the coalition government, Coffee House has linked up with the think-tank Reform to investigate what could – and should – be in the final document. This first post, by Reform’s director Andrew Haldenby, is the first in a series of “What you need to know” summaries, looking at each of the main policy areas – in this case, health. Other posts will cover specific policies, examples from abroad and Reform events. We’re delighted to get the ball rolling… What is the budget? The NHS is the biggest public service budget in England

It was inevitable that the government’s re-organisation of NHS management would incur a large upfront cost, but I didn’t expect quite such a large figure. £1.7bn has been siphoned off to pay for the re-structuring of NHS commissioning, seven times more than the planned target for management cuts according to the BBC. This is a godsend for the opposition, obviously. Insulating the NHS budget from cuts may have been a political masterstroke in 2007, and ‘I will cut the deficit, not the NHS’ may have been a sharp election slogan. But it is idiotic to ringfence the NHS simply to re-arrange the bureaucratic furniture and destabilise the system. We’ve been

This is amazing. People could scarcely believe it. No less an organism than the Big Society was spotted briefly at PMQs today. Angie Bray, Tory member for South Acton, asked David Cameron to praise a voluntary programme which enables her constituents to share skills and expertise with their neighbours. ‘This is what the Big Society is all about,’ declared Bray, (with the quietly jubilant tone of one who knows her elevation to government will not be long delayed.) Cameron’s delight was palpable. He beamed at everyone. Then his eager ears picked up the groan of a Labour cynic opposite and he instantly switched into a mode of preachy dismay which

Quite why people are surprised that Andrew Lansley has stuck to his plans to introduce GP Commissioning is a mystery.  I’m struggling to recall one of his speeches or policy documents in recent years where it wasn’t mentioned. Anyway, let’s be clear, widespread control of commissioning budgets by GPs was where the NHS was headed until Frank Dobson took over in 1997 and unravelled a decade’s worth of market based reforms.  Rebuilding that position has taken another decade of circular re-organisations to fix.  No wonder the NHS is ambivalent about reorganisation.   These proposals are, of course, radical.  But they are needed to address the fundamental flaws in the NHS

Rachel Sylvester is on top form in the Times today, and I’d urge CoffeeHousers to delve behind the paywall (or borrow someone’s copy of the paper) to read her column.  Its central point?  That ministers are discovering ingenious ways to exploit and undermine the ringfenced health and international development budgets.  The Home Office is saying that drug rehab programmes should fall under health spending.  The Foreign Office is trying to pass off some of their spending as development, and so on.  And, crucially, the Treasury seems to be going along with it: “The Treasury seems to be tacitly endorsing this approach, with officials emphasising that departmental boundaries are artificial.” As

I think we all expected this election campaign to be fought a few inches below the belt.  But, as Iain Dale and Dizzy say, Labour’s tactic of mailing scaremongering leaflets to cancer sufferers is some new kind of low.  I mean, just imagine how it would feel to receive, as a cancer patient or an immediate family member, a leaflet which politicises the problem to the point of suggesting that your care would be jeapordised by voting for another party.  And then imagine how it would feel if you have been specifically targeted because of your connections with the illness, as seems to have been the case here.  Well, it

Labour’s plans for a national care service aren’t looking too sharp this morning.  Andy Burnham is expected to announce a cap on residential costs for the elderly later today – to be funded by freezing inheritance tax bands, raising the statutory retirement age, and (lo!) efficiency savings.  But the full, free-for-everyone-at-the-point-of-use service will have to wait some time – or at least until a new independent commission has decided on how it can be funded in the long-term.  In other words, the government has decided to park the death tax issue until well after the election. Presentationally speaking, this is proving difficult for the government.  I mean, just rewind to

One story which has been rumbling along in the background of Ashcroft and Chilcot – and, indeed, over the past few months – is the fallout from Andy Burnham’s claim that NHS bodies are now the state’s “preferred provider” of healthcare in this country. With those two words, in a speech last September, the Health Secretary appears to have pulled the process of reform back a few years – as private and voluntary sector providers have tried desperately to back out of a process which they now feel is weighted, impossibly, against then. Anyway, I’d recommend that you check out Nick Timmins’ excellent coverage of the latest develoments over at