A briefing paper summarized the outcome of a series of seminars held to explore the issues involved in the health reform programme in England. The reforms were designed to combine competition in some areas of care and collaboration in others – with more emphasis to date on competition, for example through policies on patient choice and payment by results: but the increasing prevalence of chronic disease, and the need to improve the quality of specialist services, would require not only closer collaboration between providers but also clinical integration between primary and secondary care, and the development of clinical networks.
Source: Chris Ham, Clinically Integrated Systems: The next step in English health reform?, Nuffield Trust (020 631 8450)
Links: Briefing
Date: 2007-Dec
The Department of Health published its 2007 autumn performance report, showing progress against its public service agreement targets.
Source: Autumn Performance Report 2007, Cm 7292, Department of Health, TSO (0870 600 5522)
Links: Report | BBC report | Telegraph report
Date: 2007-Dec
A new book said that patient choice and competition were essential both for improving the existing National Health Service and for creating incentives to use innovation in the future.
Source: Ian Smith, Building a World-Class NHS, Palgrave Macmillan (01256 329242)
Links: Summary
Date: 2007-Nov
A think-tank report said that the gap between the sort of National Health Service treatment that could be expected by those at the top and those at the bottom of society had actually grown under New Labour. The NHS had become a divisive influence on society, standing in the way of social cohesion and favouring wealth and the 'middle-class voice' over the welfare of the poor.
Source: Nick Seddon, Quite Like Heaven? Options for the NHS in a consumer age, Civitas (020 7401 5470)
Links: Civitas press release | Telegraph report | BBC report | Guardian report
Date: 2007-Nov
The opposition Conservative Party proposed a draft Bill which would create an independent board for the National Health Service in order to free it from 'political interference'. The National Institute for Health and Clinical Excellence would became independent, and patients would be given a stronger voice through a new body. The NHS was being 'held back by top down targets and suffocating bureaucracy'.
Source: NHS Autonomy and Accountability: Proposals for legislation, Conservative Party (020 7222 9000)
Links: Report | Guardian report | Telegraph report | FT report | BBC report
Date: 2007-Nov
The interim report was published of an official review (by the Health Minister Lord Darzi) into how to develop a National Health Service which would deliver effective, higher-quality services that were safe, personalized to individual needs, and equally available to all. It said that greater influence should be placed in the hands of local NHS staff and others working in partnership across the service, based on the best available evidence, using the latest technological innovations, and responding to the needs of local communities. It proposed a package to improve the accessibility and availability of family doctors, with the aim that at least half of all family doctor practices would open on Saturday mornings or on one or more evenings each week. Over 100 new family doctor practices would be created in the 25 per cent of primary care trusts with the poorest provision. New resources would be provided to enable primary care trusts to set up 150 health centres, run by family doctors, open 7 days a week, 8am to 8pm, and situated in easily accessible locations.
Source: Lord Darzi, Our NHS, Our Future: NHS Next Stage Review – Interim report, Department of Health (08701 555455)
Links: Report | Summary | DH press release | NHS press release | BMA press release | NHS Confederation press release | Mind press release | Kings Fund press release | IHM press release | DHN press release | ADASS press release | Help the Aged press release | CBI press release | Liberal Democrats press release | Personnel Today report | Community Care report | Guardian report | FT report
Date: 2007-Oct
A think-tank report examined how policy-makers could reconcile high and rising public expectations with the need for a health system that was financially and politically sustainable. Although there should be no sudden move to National Health Service independence, there should be a move to greater local accountability, including the establishment of foundation primary care trusts. There should be greater political and public recognition of the limits to the NHS, including the existence and need for rationing.
Source: Jennifer Rankin and Jessica Allen with Richard Brooks, Great Expectations: Achieving a sustainable health system, Institute for Public Policy Research (020 7470 6100)
Links: Summary | IPPR press release | NHS Confederation press release
Date: 2007-Sep
A new book said that the solution for low-quality delivery in healthcare and education was to offer choice to users and to encourage competition among providers.
Source: Julian Le Grand, The Other Invisible Hand: Delivering public services through choice and competition, Princeton University Press (01993 814500)
Links: Summary
Date: 2007-Sep
An article questioned whether the 'new market' in the National Health Service was fundamentally different from the 'internal market' which the Labour government allegedly abolished in 1997; and whether this new market was steered 'economically' by a visible (facilitating) hand, or managed 'politically' by a fist which would like to remain invisible in order to maintain its power.
Source: Calum Paton, 'Visible hand or invisible fist?: the new market and choice in the English NHS', Health Economics, Policy and Law, Volume 2 Issue 3
Links: Abstract
Date: 2007-Sep
The government announced a review of the National Health Service, to be completed by July 2008, that would advise on how to meet the challenges of delivering healthcare over the next decade. It said that the review was an opportunity to ensure that the future of the NHS was clinically led: it would involve patients, doctors, nurses, and other practitioners, and consider how best to continue delivering improvements across the NHS. It was designed to establish a vision for the health service which was based less on central direction and more on patient control, choice, and local accountability; and which ensured services were responsive to patients and local communities.
Source: House of Commons Hansard, Debate 5 July 2007, columns 961-978, TSO (0870 600 5522)
Links: Hansard | DH press release | Letter to NHS staff | Kings Fund press release | NHS Confederation press release | IHM press release | Conservative Party press release | KONP press release | Consumer Association press release | Guardian report | FT report
Date: 2007-Jul
A report said that the use of history in health policy-making was dependent on political expediency, personal networks, timing, and particular policy situations. Politicians made limited use of the history and historical interpretation available to them, relying instead on 'folk histories' that revolved around familiar individuals, epochs, and interpretations. Policy-makers remained ignorant of, and failed to learn from, important precedents for some key policy issues.
Source: Virginia Berridge, History Matters? History's role in health policymaking, Centre for History in Public Health/London School of Hygiene and Tropical Medicine (020 7636 8636)
Links: Report | LSHTM press release
Date: 2007-Jun
An official review said that the Department of Health had not yet set out a clearly articulated vision for the future of health and social care, and how to get there.
Source: Capability Review of the Department of Health, Cabinet Office (020 7261 8527)
Links: Report
Date: 2007-Jun
A new book examined the processes and institutions used to make health policy.
Source: Rob Baggott, Understanding Health Policy, Policy Press, available from Marston Book Services (01235 465500)
Links: Summary
Date: 2007-Jun
A report by a policy group of the opposition Conservative Party called for less political interference in the day-to-day management of the National Health Service, through the creation of an independent board; greater freedom for individual healthcare professionals, in return for clear accountability for outcomes; and greater emphasis on public health objectives, with a stronger Chief Medical Officer and separate public health budgets.
Source: Public Services Improvement Policy Group, The National Health Service: Delivering our Commitment, Conservative Party (020 7222 9000)
Links: Report | Conservative Party press release | Kings Fund press release | NHS Confederation press release | Health Foundation press release | BMA press release | BBC report | Guardian report | FT report
Date: 2007-Jun
A new book provided a 'comprehensive and up-to-date' analysis of health and social care issues.
Source: Jon Glasby, Understanding Health and Social Care, Policy Press, available from Marston Book Services (01235 465500)
Links: Summary
Date: 2007-Jun
A government minister said that the National Health Service was too large for its running to be handed to an independent board, which would risk turning the service into a '1960s nationalized industry'. But she also said that NHS structures were out of date, and needed to be more 'patient led', financially disciplined, and well regulated, and to have a 'plurality of providers'.
Source: Speech by Patricia Hewitt MP (Secretary of State for Health), 14 June 2007
Links: Text of speech | Guardian report | BBC report
Date: 2007-Jun
A report set out the case for devolving autonomy, and increasing accountability, within the National Health Service. Behavioural change, not more restructuring, was the solution to many of the existing problems in the NHS. An independent board might be part of the answer: but it would not be enough to deliver a truly patient-led service unless it went hand in hand with real devolution of decision-making closer to patients.
Source: From the Ground Up: How autonomy could deliver a better NHS, NHS Confederation (020 7959 7272)
Links: Report | NHS Confederation press release | LGA press release | BBC report
Date: 2007-Jun
Doctors called for radical changes in the way the National Health Service in England was run. They said that the NHS should only provide core services - agreed after a public debate - because resources were limited. They also called for the NHS to be managed by an independent board, to take the day-to-day running of the service away from political control.
Source: A Rational Way Forward for the NHS in England: A discussion paper outlining an alternative approach to health reform, British Medical Association (020 7387 4499)
Links: Report | Summary | BMA press release | Conservative Party press release | BBC report | Guardian report | Telegraph report
Date: 2007-May
The Department of Health published its annual report for 2006-07, showing its performance against public service agreement targets.
Source: Departmental Report 2007, Cm 7093, Department of Health, TSO (0870 600 5522)
Links: Report
Date: 2007-May
A report said that operational control of hospitals and primary care should be passed to an independent corporation, similar to the BBC, operating under a charter that guaranteed a free service to patients.
Source: Brian Edwards, An Independent NHS: A review of the options, Nuffield Trust (020 631 8450)
Links: Report | Guardian report | FT report
Date: 2007-May
A briefing paper examined the performance of the Labour government since 1997 on healthcare. Health spending had moved much closer to the European average, fulfilling a promise made in 2000. Ambitious targets on reducing waiting lists made in the same year had since been achieved.
Source: Ruth Thorlby and Jo Maybin, Health and Ten Years of Labour Government: Achievements and challenges, King?s Fund (020 7307 2591)
Links: Report
Date: 2007-May
A paper said that the National Health Service should be given much greater freedom from government intervention. Instead of being run by the Department of Health, a governing board should be created, composed of health managers, clinicians, patients, and members of the public. A charter similar to that guiding the BBC should also be drawn up.
Source: Chris Ham, Jon Glasby, Edward Peck and Helen Dickinson, Things Can Only Get Better? The argument for NHS independence, Health Services Management Centre/University of Birmingham (0121 414 7050)
Links: Paper | University of Birmingham press release | Guardian report
Date: 2007-Apr
Researchers developed an approach for analyzing the relative scale of benefits of health policies, in order to help assess where money might be spent to greatest effect. Their approach built on the convergence of methodological developments for measuring the impacts of health policy interventions on target populations. It involved analyzing the impacts of a policy intervention in terms of various measures of the existing burden of disease and the burden that was 'avoidable' from the intervention.
Source: Gwyn Bevan, Mara Airoldi, Alec Morton, Monica Oliveira, and Jennifer Smith, Estimating Health and Productivity Gains in England from Selected Interventions, Health Foundation (020 7257 8000)
Date: 2007-Mar
A trade union report said that the policy of giving private sector organizations a greater role within the National Health Service had led to inefficiency, service cuts, and an erosion of the collaborative spirit of the NHS.
Source: In the Interests of Patients? The impact of the creation of a commercial market in the provision of NHS care, Unison (0845 355 0845)
Links: Report | UNISON press release | News report
Date: 2007-Feb
A think-tank report said that if the National Health Service were to cope with lower growth in funding from 2008 onwards, the government needed to take urgent action to reduce widespread variations in hospital performance, improve productivity, and win the support of health staff in its efforts to reform the service.
Source: John Appleby (ed.), Funding Health Care: 2008 and beyond - report from the Leeds Castle summit, King's Fund (020 7307 2591)
Links: Report | King's Fund press release | BBC report
Date: 2007-Feb
Public health directors said that medicine and treatment that people needed for health reasons should be free: but things that people merely wanted, where there was little proof of clinical benefit, ought to have a price tag attached. This would mean that most prescription charges would be scrapped, while some treatments (such as tonsil removal and varicose vein surgery) would be charged for.
Source: Press release 29 January 2007, Association of Directors of Public Health (020 8274 6129)
Links: Doctors for Reform press release | BBC report
Date: 2007-Jan
Campaigners said that the government was carrying out 'patchwork privatization' of the National Health Service, and that the private sector would make £23 billion in profits and interest over the next 30 years by building NHS hospitals.
Source: Alex Nunns, The ?Patchwork Privatisation? of our Health Service: A users? guide, Keep Our NHS Public (07763 607 528)
Links: Report | Summary | KONP press release | BBC report | FT report
Date: 2007-Jan
The opposition Conservative Party said that it would give family doctors responsibility for their own budgets, and for deciding where patients were treated. National 'top-down' targets for the NHS - including waiting times - would be replaced with new objectives that measured the effectiveness of treatment on the health of patients.
Source: Press release 22 January 2007, Conservative Party (020 7222 9000)
Links: Conservative Party press release | BMA press release | Picker Institute press release | Guardian report | FT report
Date: 2007-Jan
A think-tank report said that a failure to tackle rising costs and to invest in modern services meant that the long-term strength of the National Health Service had weakened, despite record spending increases. It proposed a three-year policy programme beginning with a deficit write-off, and then using patient choice and competition to redesign services around the needs of patients.
Source: Nick Bosanquet Henry de Zoete and Andrew Haldenby, NHS Reform: The Empire Strikes Back, Reform (020 7799 6699)
Links: Report | Reform press release | BBC report | Guardian report
Date: 2007-Jan
