Professor Alan Maynard OBE proposes changes to the vexed and vexing system of Clinical Excellence Awards.

The NHS is facing severe financial problems and the Department of Health requires the service to save and re-cycle £15-20 billion over the next three years.

At the same time as this edict from the Department of Stealth is being implemented, hospitals and PCTs across the country have been given their annual earmarked funding to finance clinical excellence awards (CEA).

The party’s over: it is time to call it a day. After 60 years, there is a rising tide of attention being paid to changing clinical behaviour and measuring whether healthcare actually benefits the patient.

After a decade of generous indulgence with the Blair bonanza of increased NHS funding, the government has returned to that Thatcherite theme of demonstrable “value for money”. This change is occasioned not only by the recession (which shows little sign of reversing), but also by concerns about public sector productivity.

Professor Alan Maynard OBE reviews the consistency and coherence of recent pronouncements on Conservative health policy.

In a recent speech, leader of the Conservative Party David Cameron spelt out his views on NHS policy. He said:

Professor Alan Maynard OBE dissects the NHS and politicians’ approach to financially straitened times ahead.

The NHS is about to have a severe financial crisis due to bankers undermining the economy. The costs of our banking bail-out continue to escalate. The UK economy remains reluctant to return to 2007-08 levels of national income and growth.

But has the NHS really got this message yet?

Flat cash

Professor Alan Maynard OBE looks through the prism of QIPP at the NHS's task to avoid becoming heir to Royal Mail's strikes preceding privatisation. His solutions include a primary care-led A&E; turning the noun 'collaborator' into a positive; and the Kwik-Fit hospital.

QIPP: the policy announced in David Nicholson's August 2009 “need to know“ letter to Chief Executives as a follow-up to Ara Darzi's “Next Stage Review”: Quality Innovation Productivity and Prevention (or backing all horses in the hope that one will cross the finishing line!)

Professor Alan Maynard OBE reflects on the true crisis in NHS dentistry - PCTs' lack of teeth

Policymaking in Whitehall Village is like watching a crab traverse the beach: it is slow, and you despair of it ever getting there. As you think it is getting there, it is engulfed by a wave of nonsense which sets it back to from where it started.

Professor Alan Maynard OBE suggests a taxing approach to the health problems caused by alcohol and sugary foods. Minimum pricing per unit of alcohol and new taxes on highly-fattening processed foods could help change habits and raise revenues.

This time next year, the Conservatives will be in power and the NHS will be facing significant reductions in resourcing.

Typically, such parsimony is accompanied by Ministers lauding the merits of health promotion and non-NHS investments which affect health.

Professor Alan Maynard OBE looks at the progress and pitfalls of healthcare reform in the USA

Winston Churchill is alleged to have said that Americans will try everything and eventually they get it right! Will this be the case with Obama’s hopes for health care reform?

Professor Alan Maynard OBE offers some ‘black sky thinking’ about how the NHS could react to cope with recessionary economics.

It is time for NHS purchasers and providers to confess their failings and mitigate their inefficiencies. Unless they ‘bring out their dead’, their capacity to weather the storms of recession funding will be inadequate and they will join the redundant throngs produced by mischief of the bankers.

Professor Alan Maynard OBE considers how a potential Conservative administration might go about dealing with the NHS. Integration, evidence, less PCTs and reforms to QOF (including a pay-related one for secondary care teams) all crop up – as do the possibility of public sector pay cuts.

The outcome of the 2010 general election remains very uncertain after the Labour meltdown and the Tories failing to take a significant lead in the recent June elections.

Nevertheless, the pundits all expect a Tory victory next year. If and when this transpires, what should they do with the NHS?