by Alan Maynard, professor of health economics, University of York

Ninety-nine NHS organisations now have Foundation Trust (FT) status. Most of them are acute trusts, but an increasing number are in mental health and related services. The objective of the FT initiative was to achieve greater efficiency by giving greater autonomy to hospitals within a rigorous framework of financial regulation in particular.

Has this objective been achieved?

Tom Smith on where the top up debate could go next go next.

At the end of a recent HSJ piece, on the political history of the NHS, Julian Le Grand said the remarkable thing is that consensus has held, surviving even three Thatcher reviews. Reading some commentary over the last week would suggest we are seeing the beginning of its end, following the announcement that ‘top ups’ will be reviewed.

Tom Smith on today’s health policy debate.
During David Nicholson’s speech to the NHS Confederation, he talked about a recent visit to his GP surgery where he was asked to sign the BMA petition, ‘save our surgery’. He declined but asked the receptionist how she was kept informed about what was happening to the NHS. “Oh, Dr Soandso tells us about it, and he never lies”. The continuing row over the future of general practice is increasingly becoming a question of trust.

Tom Smith on today’s health policy debate.
Following on from an interview with the Guardian newspaper today, Alan Johnson gave the keynote speech on the first day of the NHS Confederation conference – the biggest they have ever held in terms of numbers registered. The Secretary of State said he could not reveal the contents of Darzi’s Next Steps review, but could show “a bit of leg”. He talked about the importance of “compassion” and said efforts would be made to measure it, as nurses had encouraged him to. Like most days, his speech may get the evening headlines, but the morning papers were concerned with new figures on cancer mortality, suggesting wide health inequalities – a subject Johnson touched upon. The papers also contained reaction to Alan Johnson’s statement yesterday that the ban on co-payments will be reviewed. But before getting to those things, this review starts with the front page of the Times, which was very concerned about the implications for rising inflation on the costs ofthe NHS.

Tom Smith on today’s health policy debate.

Health policy is so widely debated that today saw two themes arise. In the morning, discussion was about the capacity of maternity services to cope as well as questions about why given much higher funding in recent years. The announcement late this afternoon, however, that the government will look again at co-payments in cancer care is likely to capture the evening headlines.

Tom Smith on today’s health policy debate.
The big story of the day is the Healthcare Commission’s warning that NHS trusts have 10 months to get on track with the management of hospital acquired infections or face the consequences of being labelled a failing trust. The weekend’s papers continued to debate polyclinics, making the grounds for disagreement between the government and doctors more clear. Both the FT and the Sunday Times reported that the Government is set to rewrite its rules on allowing co-payments in the NHS.

Tom Smith on today’s health policy debate.

Amongst today’s headlines includes the snappy, ‘super surgeries row rumbles on’ as well as the not so snappy, ‘Gordon Brown accuses doctors of ill founded allegations over polyclinics’. While many people will today be aware that the government has fallen out with doctors, they may still not be clear about why.

Tom Smith on today’s health policy debates.

BMA deliver petition to Downing Street

An Independent article today notes that “a bitter war of words has broken out between government and family doctors over plans for polyclinics across England”. After Health Minister Ben Bradshaw yesterday accused the BMA of “misleading and mendacious” behavior, the BMA will hit back today will a show of popular support.

Tom Smith introduces a new daily analysis of health policy debate that will appear exclusively on Health Policy Insight at teatime each day.

While press summaries give readers a clue about the surface of debate our new summary aims to scratch beneath the surface and make sense of what is being discussed. It aims to set the reports in context and compare commentary across the British print and broadcast media. Each day the press is full of discussion about health policy, partly reflecting the current highly charged political atmosphere, but also a fair amount of uncertainty about the aims of policy, how different elements link together or don’t, and more crucially how policy should be taken forward and by whom.