Hi there. In a big hurry today, and furthermore it's Friday, so after making one brief point, I will simply nick a few links to other people's good work that might give you a bit of weekend cheer.

My brief point is this: once again, the DH's right hand does not seem to know what its further-right hand is doing. Yesterday, Alan Johnson told HSJ that the capital had too many PCTs (this was covered in www.healthpolicyinsight.com/?q=node/217, with link to the HSJ story). Today the DH issue a press release about an updated 'duty to involve' - 'Real Involvement', which can be downloaded from www.dh.gov.uk/publications. The press release is here: http://nds.coi.gov.uk/environment/fullDetail.asp?ReleaseID=382809&NewsAr...

Right. Now I'm taking a deep breath. Lord Darzi's next-stage review suggested that any changes to NHS services should be transparent, locally-led and for the benefit of patients. All sounds fine, doesn't it?

The slight problem with telling us that "new guidance, published today, will help the public have more say in decisions made by their PCT, enabling them to shape local health services. The strengthened 'Duty to Involve' guidance will also make feedback on public consultations more transparent and accessible" is the extent to which it is cutting across people's experience.

I refer you back to Socialist Health Association supremo Martin Rathfelder's observation to David Nicholson at the recent NHS Alliance conference that "in every one of the the last 18 years, the people running my local NHS care more what you think about them and less what I think about them". Nicholson's reply to Rathfelder was, "you're absolutely right - this is one of our biggest problems". (see www.healthpolicyinsight.com/?q=node/201).

There is a fundamental and seriously worrying disconnection between the rhetoric and the reality here, chaps. And we are staring down the barrel of no longer being able to spend our way out of trouble. If the DH wants localism, then that means freedom - including the freedom to do things the DH may not like - such as keeping PCT coterminousity with London's local councils.

Market signals
Meanwhile, Nick Timmins reports (www.ft.com/cms/s/0/bd02528e-a6d4-11dd-95be-000077b07658.html) in today's FT on Bob Ricketts' speech at the Laing and Buisson conference. The Government have sent Ricketts to speak peace unto the malnourished private sector providers.

And isn't it marvellous news that they're planning to sell off hospital buildings and get the NHS to lease them back? I mean, it's worked so brilliantly for HM Treasury's offices! It's only cost £61 million to bring the PFI for GOGGS (Government Offices, Great George Street, of course!) onto the public sector borrowing requirements. Owning things wholesale, as we used to do with this, is soooHSJ.

You'd all better get looking at this - www.helm.org.uk/upload/doc/The_disposal_of_historic_assets_Feb_08_ 20080225151633.doc - oh, and forming your own property companies. There's a profit to be turned here, ladies and gentlemen.

Pffft. Anyway, those links:
US Presidential election
Who do racial supremacists want as the next president? A fine story from Esquire magazine, spotted on Popbitch - www.esquire.com/the-side/feature/racists-support-obama-061308

Pulling the plug on NHS Connecting For Health?
I can only recommend zipping over to E Health Insider, comfortably the best resource for finding out the weird ways of NHS Connecting For Health and the National Progtamme For IT. Jon Hoeksma and Linda Davidson have done remarkable things making this complex and convoluted narrative accessible to non-tech folk, and EHI must surely be high up the ten essential websites.

Anyway, as the influential Nick Timmins of the FT seems to think CFH's work is grinding to a halt (www.ft.com/cms/s/0/b54a2e1c-a46e-11dd-8104-000077b07658.html), you can find out more at www.e-health-insider.com

The DH has launched its consultanmtion on the Quality And Outcomes framework changes. Let them know what you think here: www.dh.gov.uk/en/Consultations/Liveconsultations/DH_089778