Professor Alan Maynard OBE surveys the impact of the recession on the NHS's chances of survival

The UK economy had two major strengths: its finance industry and North Sea oil. The latter is gradually running out; and the bankers should be run out of town for ruining the prosperity of our country.

Depending on whose forecast you read, the UK economy may shrink by three to five per cent this year. Some pessimists think that we may emulate the Japanese, and lose up to ten per cent of national income.

The new British Social Attitudes Report was published this week. It offers fascinating feedback for the health policy community – for example, that satisfaction with outpatient services is rising while satisfaction with inpatient services is falling.

It reveals surprisingly positive attitudes towards the NHS as a whole and surprisingly strong support for public over private provision. It adds important detail to debate about both.

The surprisingly good news

Tom Smith's Health Policy Today examines what the newly-inaugurated 44th president of the USA's health plans will mean in practice

On Barack Obama's first day in office, both expectations and his in-tray are high.

'As people in the USA lose their jobs, most also lose their healthcare coverage. Rising unemployment is compounding America's healthcare challenge'

Tom Smith's Health Policy Today looks at how a form can help organisational function follow a better path.

One of the most interesting reports from last week involved the World Health Organisation checklist for surgeons, which has resulted in a 40 per cent reduction in inpatient deaths. Though some headlines were slightly mocking, 'Right patient? Right leg?', the study has an important point that was missed by many. It reminds us of the critical importance of supporting teams, and how management can do this by supporting organisational routines.

Tom Smith offers a review of policy trends in the latest instalment of Health Policy Today

On today's Daily Politics the Daily Mirror's political editor Kevin McGuire offered his predictions for the year ahead. “2008 was dominated by the economy and Barack Obama”. His prediction for 2009? “Politics will be dominated by the economy and Barack Obama.”

Professor Alan Maynard OBE celebrates his ascension into the pantheon of the British Empire with a typically pro-Establishment disquisition on the need for NICE to get nastier in the recessionary climate for 2009.

The NHS faces a profound financial “squeeze” due to the global recession and the British Government’s attempts to mitigate the products of lax regulation of the financial sector.

At the same time as the funding capacity of the NHS is being challenged, there are two significant sources of increased demand for care: the elderly, and technological change.

The Christmas message of “goodwill” in the 2009—10 Operating Framework for the NHS is that the hospitals in particular are to be screwed until their pips squeak!

Last week the Government said it could no longer defend a ban on patients receiving NHS care if they paid privately for cancer drugs. Making the announcement quietly on the day of the US election sought to avoid fuss and attention, but has only postponed the inevitable debate, which began to take off again over the weekend. The charge is that the government has pulled the plug on the NHS.

STRONG VIEWS EXPRESSED THAT THE DECISION WILL DESTROY THE NHS IN TIME

Professor Alan Maynard on the need to address clinical revalidation and manage poor performance

A decade after the problems with Shipman in Manchester and Yorkshire, Wisheart at Bristol, Neale at Northallerton and Ledward in Kent, we still have no comprehensive system of revalidating doctors. The practices of these four doctors killed and injured scores of patients. Expensive and expensive public inquiries identified systematic failures in governance processes, and made strong recommendations to change the way in which doctors were licensed to practice.

This time next week, we will know the name of the next president of the United States. Today’s Washington Post provides an update on how health policy is affecting the election.

The crucial difference between the candidates relates to how each would provide for the very ill – those that struggle to find cover. Obama would prevent insurance companies from rejecting this group. McCain would uncouple insurance from employment and create state-run high-risk pools, specifically for those that insurance companies won’t touch.