In a recent HSJ poll, NHS managers suggested they are more comfortable with what they know, when asked their preferred secretary of state. With the government behind in the polls and change looming, it has not been a great conference season for senior local authority or PCT managers listening to the opposition set out their plans.

Professor Alan Maynard discusses the need for efficient systems to address poorly-performing consultants and redundant managers.

The Department of Health management team are increasing their carbon footprint by touring the country and encouraging SHAs and PCTs to lead the revolution outlined in the Darzi report.

Whilst greater attention to outcome measurement and the reduction of unacceptable clinical practice variations is most welcome albeit very late, some fundamental issues are being ignored - in particular, job tenure of clinicians and senior managers.

A new report from Which? is based on an ‘undercover investigation’ into advice dispensed from pharmacies . Which? researchers posing as patients asked questions about emergency contraception, migraines and traveler’s diarrhoea.

They received ‘unsatisfactory advice in 48% of independent pharmacies, 28% of national and regional changes and in 26% of the biggest supermarkets. The results do not bode well for plans to pass more clinical work to pharmacies from GPs.

Reports that Gordon Brown’s speech saved the day are wide of the mark. It was not brilliant rhetoric or piercing analysis that has staved off a challenge to his premiership, but the shift in global economics giving him the opportunity to take a political lead in uncertain times. Having pleased everyone from the Mail to the Mirror , Brown must now set out the substance of the tough choices he talked about - by elucidating what these are.

TALKING THE WALK ON TOUGH CHOICES

In recent weeks and months, much of the media has formed a conclusion that Gordon Brown is unsuited to modern politics. Last week’s economic events may mean, however, that in the last week politics has changed to suit Gordon Brown.

THE ECONOMIC TIDE CHANGES, AND GORDON BROWN FINDS HIMSELF ON MORE FAMILIAR SHORES

The Labour Party want to devolve power in the health service to those best placed to make decisions. The Conservatives criticise the centralizing tendencies of the government and favour greater localism. The Liberal Democrats remain strong advocates of local accountability and decisions made locally.

Today’s HPT wonders, what are we all arguing about? All united in a common desire to empower local people, it should be straightforward to achieve. No? Just what do the parties mean by achieving greater local accountability and is it the same thing?

Tom Smith returns with a discussion of the day's political and policy vogue.

The NHS is like a large sow with many teats, from which provider piglets draw succour. One of the most robust piglets in the sty is the pharmaceutical industry.

Take, for instance, the current debate about 'co-payments' for cancer patients. With NICE declining some products of marginal cost-effectiveness, industry is encouraging its compatriots in the medical profession and elsewhere to demand that where patients buy treatments declined by NICE, the administration of the drugs should be provided by the NHS.

In Tom Smith's temporary absence, Health Policy Today is a somewhat less full round-up than usual, but one story stuck out so much this had to appear.

Taxpayers' Alliance want NHS wages policy on managers' pay: Health Policy Today, 11th September 2008

It may seem strange, but it’s true. Today’s Daily Telegraph reports that the Taxpayers’ Alliance (slogan: campaigning for lower taxes and better government) have both been hiding their statist light under a highly convincing pro-market bushel.

The magazine edited by David Walker, Public landed on my doormat this morning. An article on ‘engagement’ by local authorities caught my eye. The obligation to respond to petitions could lead to an expensive exercise that does nothing to engage.

RESPONDING TO LOCAL HEALTH PETITIONS