Liberating The NHS: Legislative Framework And Next Steps

PCT allocations for 2011-12 (look at all the red ink)

The 2011-12 NHS Operating Framework

David Nicholson's letter on the OF 2011-12

"Dear Colleague

Policy-wise, today’s announcements could be among the most politically significant for the NHS since a certain third party leader stormed the first of the three televised ‘leaders’ debates.

The NHS is central to the UK’s political narrative. That is an interesting place for healthcare to be. Money and power are the meat and drink of politics, and they make it interesting to watch.

Health Secretary Andrew Lansley has made a high-stakes gamble in applying homeopathic principles to reforming NHS management: diluting it in order to increase its potency.

Irwin Brown of the Socialist Health Association argues, tongue firmly in cheek, that we should be a little slower to condemn and a little quicker to sympathise with SoS Lansley

Are we getting to the point where we have to show some kind of sympathy for poor LaLa Lansley?

He had six years planning his programme, and expended endless charm on all parts of the NHS - but especially the GPs, and they are now turning against him

If the NHS falls over this winter, the cause is likely to be not policy but influenza.

Swine flu, to be exact.

I have been sent the following document: a report of a teleconference led by the Health Protection Agency.

This is obviously urgent, so would all Health Policy Insight readers please get this message to your local and regional clinical leaders as soon as possible? Thank you.

H1N1 influenza – Report of an HPA-led teleconference 10 December 2010

The executive summary doesn't actually use the word 'heroic' about the assumptions being made on potential efficiency savings in both healthcare and social care by the Coalition Government's policy and financial planning.

However, that is the whole extent of the punch-pulling in this new Report On Public Expenditure.

I have noticed something about 'The £15-20 Billion Man' Sir David Nicholson, chief executive of the NHS.

He’s still here.

This is, in itself, fairly surprising, given the flagrant resurgence of tensions between himself and SoS Lansley that were evident at last week’s health select committee evidence, and as discussed, before that.

Irwin Brown of the Socialist Health Association wonders how a provision-led NHS will cope with a John Lewis future of unlimited choice and competition. Will tastefully-made TV ads be enough?

Could we stop worrying about commissioning for a bit, and worry about what is happening in provider world?

Professor Alan Maynard wonders whether the funding pressures facing the NHS are properly understood by policymakers, whose proposals promise to increase them.

Re-disorganising the NHS is a favourite pastime of all politicians, as witnessed by dozens of structural reforms over many decades. The common characteristic of these reforms has been unbounded political optimism, with very little beneficial effect in the processes of patient care and on users’ outcomes.

Professor Alan Maynard suggests that ‘tis the season for discussion

1) Do specialist hospitals need super-subsidy?
Specialist hospitals are supposed to benefit from economies of scale i.e. because they are big and specialised, surely their unit costs should be lower?

If these economies of scale exist, why are specialist hospitals such as Great Ormond Street Hospital, Alder Hey and the other hospitals in London and other cities given subsidies?

Irwin Brown of the Socialist Health Association reads a requiem for primary care trusts

It appears unlikely that we will see marches and protests to “Save our PCT”. They have few friends, and the few they had are now as passionate about their demise!