Mark Britnell

Power in the new system – the power to integrate

Power can be used to fossilise relationships and indeed healthcare delivery in mid-20th century, or used to develop relationships in much more generous integrated way. It’s time to use power to integrate.

The finest characteristic of the NHS is the general practice registered list mapping 99.7% of population to a GP. Most countries in the world would pay for that.

Andrew Lansley sends his apologies that he can't be here, and his best wishes for your conference.

This government has two priorities above all others: to restore order to our public finances; and to ensure the health of our nation. Last month, Chancellor George Osborne's budget set out the plan to have debt falling by the end of this Parliament. We need to reduce public spending by £81 billion.

Professor Alan Maynard’s presentation for the NHS Alliance conference today explores the three main challenges confronting primary care in a ‘Liberated’ NHS

Some assert that primary care in the NHS is the “best in the world”. The evidence for this assertion is poor, with limited evidence of good practice accompanied by evidence of poor access and uneven delivery of services.

It is remarkable that primary care remains “data-lite”, with taxpayers paying for variable service quality for over 60 years.

Improving primary care

The 2010 NHS Alliance conference opened with a vigorous address from NHS Alliance chair Dr Michael Dixon, calling the primary care team to arms behind the vision of a primary care-led NHS, despite over a decade of false dawns.

Describing the “last gasps of secondary care-dominated system disconnected from front-line clinicians", Dixon implored delegates, “do not let this chance slip through your hands. if we fail the NHS, we'll be done for”.

Welcome friends and colleagues, old and new, to this year’s NHS Alliance Annual
Conference. Thank you for coming and thank you for coming in such numbers! What a conference this is going to be! The Government says the frontline of primary care is going to be the future. That means the future is here. You…, you are the future!

It’s really important to learn on focusing attention in areas – on the benefits across whole system as we go, and integration of all government activities on health. That cancer journey (referring to previous presentation) shows how quality is systemic. That’s a very important lesson for us

- the journey, history and context of where we are
- the 6 really big challenges
- the people issues

A full-ish report from the NHS Alliance conference will follow later today. Excerpts and bits can be found at www.twitter.com/HPIAndyCowper

For now:

Healthcare inflation, eh? The HSJ Top People List has grown by 100%. in just a year. That's faster than a journalist's expenses claims ... or an A&E attendance growth.

In truth, it is scant surprise. With this much change around, a limit of 50 was always going to be too much to ask.

So, a few thoughts about the 2010 vintage.

1. Never take lists too seriously

Denial. It's not just a river in Cairo. It runs out, eventually.

I was wondering how long Andrew 'Liberatin' Lansley could carry on pretending that his biggest-ever top-down reorganisation of the NHS was in truth an organic, proctologist-pleasing-bottom-up affair.

If you haven't already read Sally Gainsbury's HSJ interview with health select committee chair (and ex-Health Secretary Stephen Dorrell, you should go and do so now.

It contains a big, unmistakable message.

Some will see it as Dorrell explicitly becoming the health policy Yosser Hughes of the Conservative Party: "gizza job ... I can do that" (though in the interview, he denies the ambition).