The most entertaining NHS story of day appeared in www.publicservice.co.uk. It reports that a public meeting held in north Yorkshire to discuss local views on the health service failed to attract a single member of the public. To develop services, and public involvement, it is time for the NHS to focus on ways to bring together patients and professionals.

DISAPPOINTING TURNOUT TO NHS PUBLIC MEETING

Professor Alan Maynard welcomes greater attention to costs and quality, but warns that doing the right thing brings a fresh set of dilemmas along with it.

The NHS budget is set to stabilise. Indeed with a Darzi-enhanced NICE and the impact of ageing on NHS demand, the real rate of growth of NHS budgets over the next five years may be negative.

The world’s first Health Tourism show was held this weekend at London’s Kensington Olympia. It promised that those keen to combine their heart operation with ‘a dream holiday abroad’ can go along and choose from clinics from over 20 countries, from Malaysia to Portugal and India.

WHAT’S ON AT THE SHOW
The 2008 Health Tourism Show offered showcase clinics that offer everything from heart surgery to breast enlargement and dental work.

The chief executive of Astra Zeneca, David Brennan was a guest on BBC Radio 4’s The Bottom Line this week. The questions he was asked and the answers he gave drew a clear picture of the position the pharmaceutical industry is in today. Breakthroughs from the 1990s have been exhausted, with licenses coming to an end, and despite increased spending on R&D, fewer products are coming to the market, driving a cash-rich industry to buy up biotech firms and sources of new products.

The theme of the BMJ this week is, ‘where are we in the rationing debate?’ and features contributions from US academics and policy makers, English economists and Norwegian doctors. The real theme is that it is critical to involve the public in rationing decisions and the central question, can it be done?

LESSONS FROM OREGON

It is 20 years since the Oregon Health Plan first attempted to involve citizens in setting priorities. Vidhya Alakeson, a policy adviser at the Department of Health and Human Services in the US, looks back at the plan in this week's BMJ.

The big news today is that the Government plans to come out spending as it employs the economic thinking of John Maynard Keynes to counter the contracting tendencies of the banking crisis. Today’s FT says ‘the chancellor is to call on departments to bring forward billions of pounds of capital expenditure to reinvigorate the economy ahead of an expected recession’. The NHS is a potential beneficiary, as the construction sector could be given the task of building new primary care facilities.

DARLING TO ANNOUNCE NEW MONEY FOR POLYCLINICS?

Whether or not they are commensurate with increased levels of funding, there have been improvements in the NHS in recent years. But one area in which the NHS has gone backwards is in engaging patients.

There are pockets of excellence, but being responsive to patients’ complaints, for example, has become less of a real priority across the service over the last ten years. In response to these continued failings, new ways are emerging for patients to express their views on services

WILL NEW WAYS EMERGE FOR PATIENTS TO FEEDBACK ON SERVICES?

The economic crisis has stifled health policy debate for a week or two – including the regular updating of this summary – but with the worst of the emergency seemingly now over, we can look ahead to a more steady tumble into recession.

We are not going back to normal times, but instead entering a new period, what the BBC’s political editor Nick Robinson calls the politics of recession. After a fortnight we will never forget, where are we with health policy?

THE NEW POLITICAL SETTLEMENT IS STILL TAKING SHAPE

Professor Alan Maynard considers the costs and benefits of new incentives for quality

After splurging billions of additional spending on the NHS, even the politicians have now begun to question the value for money of their generosity.

In 27 days time, voters in the US will decide between Barack Obama and John McCain in an election that will have ramifications for the rest of the world. Drawing on recent analysis in the BMJ and this week’s Economist, this issue looks at the two candidates’ positions on healthcare, an issue that 44% of US voters place among their top three concerns.