The report of an official advisory group said that the reaction of patients, the public, staff, and major stakeholders to the concept of a National Health Service constitution was 'overwhelmingly positive'.
Source: The National Health Service Constitution: Report of the Constitutional Advisory Forum to the Secretary of State for Health, Department of Health (08701 555455)
Links: Report
Date: 2008-Dec
The government announced (in the Queen's Speech) plans for a Health Bill. The Bill would establish a National Health Service constitution, setting out the rights and responsibilities of patients and staff. It extended the remit of the Local Government Ombudsman to look at complaints from people who had arranged their own adult social care.
Source: House of Commons Hansard, Debate 3 December 2008, columns 8-9, TSO (0870 600 5522)
Links: Hansard | Kings Fund press release | Help the Aged press release | NHS Confederation press release | BMA press release | RCP press release | RCN press release | EDCM press release | ASH press release | Guardian report | BBC report | Pulse report
Date: 2008-Dec
A new book examined the development of health policy. It said that attempts to reform the National Health Service could only be understood by reference to the wider social and political contexts, and to the organizational and 'ideational' legacies present within the NHS itself.
Source: Ian Greener, Healthcare in the UK: Understanding continuity and change, Policy Press, available from Marston Book Services (01235 465500)
Links: Summary
Date: 2008-Nov
A think-tank report provided an overview of the main themes in the planning, financing, organization, and reform of the National Health Service.
Source: David Furness et al., An Overview of Health Systems Reform and the NHS, Social Market Foundation (020 7222 7060)
Links: Report
Date: 2008-Oct
A new book examined contemporary debates concerning health systems, and how they had shaped the way the evolution of healthcare. The National Health Service had evolved into a 'sickness system' primarily designed to repair those who fell ill and doing little to promote or improve health.
Source: David Hunter, The Health Debate: Policy and politics in the twenty-first century, Policy Press, available from Marston Book Services (01235 465500)
Links: Summary | Durham University press release
Date: 2008-Sep
The opposition Conservative Party published a plan designed to improve the National Health Service. Central performance targets would be abolished, and measures would be taken to increase the power of patients instead. Patients would be allowed to choose their family doctor, and people with long-term conditions would be enabled to control their care through a personal budget.
Source: NHS Improvement Plan, Conservative Party (020 7222 9000)
Links: Plan | Speech | Conservative Party press release | RCN press release | BBC report | Guardian report
Date: 2008-Sep
A think-tank report proposed a new financial model for the National Health Service – a 'National Health Protection System', under which individuals would be able to invest a tax-funded premium each year to guarantee their healthcare. Competition between private firms and primary care trusts would drive down costs and improve choice. The new model would provide incentives for healthy living; transform the government's role into that of a regulator; give instant access to high-quality information on health conditions and outcomes; and develop a supplementary insurance market to cover rare drugs and luxury items.
Source: Nick Bosanquet et al., Making the NHS the Best Insurance Policy in the World, Reform (020 7799 6699)
Links: Report | BBC report
Date: 2008-Sep
The government published a report setting out responses gathered from patients and public, staff, and other stakeholders during Lord Darzi's review of the National Health Service.
Source: Engagement Analysis: NHS Next Stage Review – What we heard from the 'Our NHS, Our Future' process, Department of Health (08701 555455)
Links: Report
Date: 2008-Jul
A report brought together the views of politicians and retired civil servants about the strengths and weaknesses of the National Health Service, 60 years after its foundation.
Source: Nicholas Timmins (ed.), Rejuvenate or Retire? Views of the NHS at 60, Nuffield Trust (020 631 8450)
Links: Report
Date: 2008-Jul
A report explained the legal and administrative underpinnings of devolution and how they shaped the health policies pursued in England, Scotland, Wales, and Northern Ireland. It identified various kinds of tension building up along administrative and physical borders, and the likelihood of major intergovernmental conflict.
Source: Scott Greer and Alan Trench, Health and Intergovernmental Relations in the Devolved United Kingdom, Nuffield Trust (020 631 8450)
Links: Report
Date: 2008-Jul
The Health Ministers of the four nations of the United Kingdom reaffirmed their commitment to the core principles on which the National Health Service had been founded 60 years previously, including: a comprehensive service, available to all; and access to its services based on clinical need, not an individual's ability to pay.
Source: Press release 3 July 2008, Department of Health (020 7210 4850)
Links: DH press release | Scottish Government press release | Kings Fund press release
Date: 2008-Jul
The government published the final report of a review (conducted by the Health Minister, Lord Darzi) into the future of the National Health Service. The report proposed a shift of emphasis away from increasing the quantity of healthcare to improving its clinical quality. The income of hospitals and family doctors would depend on how much they improved their patients' health. National Health Service trusts would be paid according to the outcome of treatment, using a new set of indicators ranging from surgeons' death rates to surveys of how well patients felt after treatment and patients' views about the quality of service and the compassion of staff. In order to establish greater competition within the NHS, patients would be given enough information to enable them to choose the nearest hospital that could demonstrate superior medical results. A draft NHS constitution was published alongside the report, enshrining in law citizens' access to free treatment, and asserting patients' rights to dignity, privacy, confidentiality, and the opportunity to get a second opinion from another doctor; it also provided a universal right to approved treatments if they were clinically appropriate for individual patients. A separate report was also published alongside the review on the future of the NHS workforce.
Source: High Quality Care For All: NHS Next Stage Review Final Report, Cm 7432, Department of Health, TSO (0870 600 5522)
Links: Report | Summary | Draft NHS constitution | Draft NHS constitution (consultation document) | Workforce report | Hansard | DH press release (1) | DH press release (2) | Kings Fund press release | Picker Institute press release | NHS Alliance press release | Mind press release | SANE press release | SCMH press release | MHF press release | Rethink press release | Turning Point press release | Alzheimers Society press release | PRTC press release | NHS Confederation press release | BMA press release | GMC press release | AOMRC press release | RCN press release | RPSGB press release | CSP press release | NHS Employers press release | CBI press release | Liberal Democrats press release | Guardian report (1) | Guardian report (2) | Guardian report (3) | Guardian report (4) | Guardian report (5) | BBC report (1) | BBC report (2) | Telegraph report (1) | Telegraph report (2) | Telegraph report (3) | Telegraph report (4) | Personnel Today report | Community Care report | FT report
Date: 2008-Jun
A think-tank report said that professionals and managers should be given much greater freedom at the next stage in National Health Service reform: they should be allowed to innovate and develop services that were responsive, cost-effective, and improved the quality of care. Ministers and the Department of Health should focus on setting standards, goals, and priorities for the National Health Service, and on holding local organizations to account for what they delivered. Day-to-day operational matters, and decisions about precisely how those goals were achieved, should become a matter for the local health service. The National Health Service should increasingly become a commissioning rather than a providing organization.
Source: Nicholas Timmins (ed.), Making It Happen: Next steps in NHS reform – Report of an expert working group, King's Fund (020 7307 2591)
Links: Report | King's Fund press release
Date: 2008-Jun
A joint inspectorate report said that patients had yet to see any benefit from market-based National Health Service reforms that had cost about £1 billion to implement since 2000. Many reforms to introduce choice and competition had 'potential': but they remained unproven and needed time to 'bed in'.
Source: Is the Treatment Working? Progress with the NHS system reform programme, Commission for Healthcare Audit and Inspection (020 7448 9200) and Audit Commission
Links: Report | Summary | CHAI press release | Kings Fund press release | Turning Point press release | Liberal Democrats press release | FT report | BBC report | Telegraph report
Date: 2008-Jun
The opposition Conservative Party published a plan designed to improve healthcare outcomes by scrapping 'bureaucratic process targets' and replacing them with outcome measures.
Source: Delivering Some of the Best Health in Europe: Outcomes not targets, Conservative Party (020 7222 9000)
Links: Report | Conservative Party press release | NHS Confederation press release | Kings Fund press release | Help the Aged press release | BBC report
Date: 2008-Jun
A think-tank report said that 'elite opinion' in the media, in political circles, in academia, and in policy think tanks had fallen out of love with the idea of a centrally planned health service provided and financed by government. These groups might in time be effective in promoting a vision of a market in healthcare that was free from government interference and from the 'stifling power' of government-granted professional monopolies.
Source: Helen Evans, Sixty Years On – Who Cares for the NHS?, Institute of Economic Affairs (020 7799 8900)
Date: 2008-Jun
A new book said that creating more opportunities for patient choice would not improve healthcare. Good care was not a matter of making well-argued individual choices, but was something that grew out of collaboration and technological improvements.
Source: Annemarie Mol, The Logic of Care: Health and the problem of patient choice, Routledge (01264 343071)
Links: Summary
Date: 2008-May
The Department of Health published its annual report for 2007-08.
Source: Departmental Report 2008, Cm 7393, Department of Health, TSO (0870 600 5522)
Links: Report
Date: 2008-May
A think-tank report said that existing government policy would leave the National Health Service unprepared to meet the challenge of rising demand. The NHS needed a new, economic constitution which guaranteed value for money and continuing radical reform.
Source: Nick Bosanquet, Andrew Haldenby, Michael Pullinger and Helen Rainbow, Demand for a New Era: The future of health, Reform (020 7799 6699)
Links: Report | Reform press release
Date: 2008-May
The government announced (in the draft Queen's Speech) plans to introduce a National Health Service Reform Bill, designed to take forward those proposals arising from Lord Darzi's review of the NHS in England that would require legislation. Specific measures might include publishing an NHS constitution; enabling and encouraging primary care trusts to be more responsive to their local communities; and providing greater scope for patients to shape the care they received. Hospitals' income would depend on how well they succeeded in treating patients.
Source: Preparing Britain for the Future: The government's draft legislative programme, Cm 7372, Office of the Leader of the House of Commons, TSO (0870 600 5522)
Links: Draft Queens Speech | Amendments | DH press release | NHS Confederation press release | RCN press release | Telegraph report | FT report
Date: 2008-May
A new book examined New Labour 'reforms' which had begun to transform the National Health Service into a European-style social health insurance fund, purchasing services from a variety of private and public sector providers – rather than the alternative of developing a service based on greater accountability and responsiveness to the needs and wishes of local people and those with greatest health needs.
Source: John Lister, The NHS After 60: For patients or profits?, Middlesex University Press (020 8411 5734)
Links: Summary
Date: 2008-Apr
A think-tank report said that greater independence for the National Health Service from government could be of benefit to patients and citizens if a 'public value' approach were applied. This would mean: uniting the NHS to achieve objectives based both on what the public value, and what had greatest impact on the health of society; committing to the 'co-production' of health; recognizing that patients and the public created health, together with their health service – and that the latter should act in partnership with them.
Source: David Levy, NHS Independence: What's in it for patients and citizens?, Picker Institute Europe (01865 208100)
Links: Report | Picker Institute press release
Date: 2008-Mar
A think-tank report said that the performance of the National Health Service was well behind that of other countries' healthcare systems. Improving patient care would need new investment in many areas: but taxpayer funding was (and should be) restricted. Greater productivity was the answer to this strategic challenge. There should be an 'economic constitution' for the NHS which defined duties to 'create value' at all levels of the service.
Source: Nick Bosanquet, Andrew Haldenby and Helen Rainbow, NHS Reform: National mantra, not local reality, Reform (020 7799 6699)
Links:Report | Reform press release | Help the Aged press release | Liberal Democrats press release | Telegraph report
Date: 2008-Feb
The organization representing family doctors proposed a formal constitution for the National Health Service in England, and greater 'independence from party politics'. Health professionals, in consultation with patients, should have much greater involvement in the management of the NHS.
Source: An NHS Constitution for England, British Medical Association (020 7387 4499)
Links: Paper | BMA press release | Telegraph report
Date: 2008-Feb
Health experts suggested new policy approaches for the third term of the National Assembly for Wales.
Source: The Welsh Health Battleground: Policy approaches for the third term, Institute of Welsh Affairs (029 2057 5511)
Links: IWA press release
Date: 2008-Jan
A think-tank report said that there was a case for a National Health Service constitution: but there were also pitfalls to avoid when drafting one. A constitution that set out lines of accountability, as well as the roles and relationships in a more devolved healthcare system, could help clarify what the NHS was designed to do and how it was governed. But a detailed list of patients' rights could become caught up in 'endless legal wrangling'.
Source: Anna Dixon and Arturo Alvarez-Rosete, Governing the NHS: Alternatives to an independent board, King's Fund (020 7307 2591)
Links: Report | King's Fund press release
Date: 2008-Jan
A new book examined the relationship between politics and health policy in the United Kingdom, and how the interests of the medical profession, civil society, and the state were weighed and balanced in the making of health policy.
Source: Alison Hann, Health Policy and Politics, Ashgate Publications (01235 827730)
Links: Summary
Date: 2008-Jan
A report examined the values embedded in the health services and policies of England, Northern Ireland, Scotland, Wales, and the European Union. It highlighted some very different entrenched values, including commitments to: 'collaboration and collectivism' in Scotland; the very similar 'communication and collectivism' in Wales; democratic participation, neutrality, and the new public health in Northern Ireland – 'having a say rather than having a choice'. All stood apart from England in their commitment to communities and participation rather than markets and technical solutions.
Source: Scott Greer and David Rowland (eds.), Devolving Policy, Diverging Values? The values of the United Kingdom's National Health Services, Nuffield Trust (020 631 8450)
Links: Report
Date: 2008-Jan
A report said that the predominant method of National Health Service reform, focusing on either centralized targets or the commercialization of the service, had created a 'cocktail of fears' about health inequalities as well as a host of unintended consequences and inefficiencies. Conversely, the democratization of the NHS, using all the tools of voice, participation, and empowerment, could revolutionize the experience of the patient and the efficiency of workers. In addition it could establish an even more popular basis for future support and funding of the service.
Source: Neal Lawson, Machines, Markets and Morals: The new politics of a democratic NHS, Compass (020 7463 0633)
Links: Report | Compass press release
Date: 2008-Jan
A new book examined the politics of healthcare, including issues such as the politics of health professionalism, clinical knowledge, organization and management, and democracy and participation.
Source: Stephen Harrison and Ruth McDonald, Politics of Healthcare in Britain, SAGE Publications Ltd (020 7324 8500)
Links: Summary
Date: 2008-Jan
