Paying for retirement – the phrase politicians are afraid to say

The starting gun for the General Election has been fired, with less than 100 days to go before we vote. But, asks John Read, will the parties have the courage to discuss how future governments will pay for workers’ retirement? Financing the state pensions of the next generation of retired workers is a key challenge […]

hospital scene

An unhealthy partnership?

MPs have just had a bitterly divided debate on what the Transatlantic Trade and Investment Partnership will mean for the NHS. Neil Perkins and Jonathan Hammond consider the evidence. The Transatlantic Trade and Investment Partnership (TTIP) is a trade deal currently being negotiated between the European Union  and the United States. If TTIP goes ahead, […]


Changing the ties that bind

Clinical Commissioning Groups were introduced by the 2012 Health and Social Care Act. The role of GPs within the NHS and their relationships with NHS managers are changing as a result, explains Julia Segar.  The NHS is dealing with severe challenges at present, with A&E in crisis and bed blocking preventing the release of some […]

smoking and drinking

New approach needed to tackle ‘lifestyle diseases’

The Change4Life campaign just launched by NHS England is the latest attempt to persuade people to adopt healthier lifestyles.  But, says Dr Stanley Blue, this type of public health campaign is not enough to tackle fast rising rates of ‘lifestyle diseases’. Current public health policy is focussed on getting people to change their eating, drinking […]

Time for better treatment of people with learning disabilities

There is more evidence than needed to prove that many people with learning disabilities are treated badly and without respect in NHS-provided facilities, argues Barbara Perry. A campaign is seeking to provide people with learning disabilities, and their families, with stronger legal rights. Eighteen year old Connor Sparrowhawk was found dead in a bath at Slade […]

To save lives we must rethink our assumptions about good healthcare

A new report in the British Medical Journal on centralising acute stroke services in Greater Manchester and London reveals the revolution in stroke care and treatment over the last twenty years – and it contains vital lessons for patients and policymakers, explains Dr Stephanie Snow. Around 152,000 of us will suffer from stroke in the […]

Open up on costs to improve NHS care

Sharing information on the cost of treatment could help achieve better patient outcomes at a lower cost, says Professor Sue Llewellyn. But, given the current tensions between collaboration and competition in the NHS, some trusts seem unwilling to provide the ‘commercially sensitive’ information to commissioners that would help make this happen. A recent Parliamentary health select committee report urged […]

Challenging the cult of competition in the NHS

Evidence is short that competition leads to improved healthcare performance, says Prof Kieran Walshe. Collaboration and service integration is a better policy goal. For some time – under both this government and its predecessor – there has been a powerful ideological belief that competition leads to improvements in performance in healthcare. It’s a belief unshaken […]


Middle managers hold key public health role

Ignore middle managers at your peril. They may be central to development and implementation of policy, explains Dr Kathryn Oliver Middle managers are more important than people often think – and that is very true when it comes to influencing and implementing public health policy. In fact, middle managers without a professional training in public […]


Reality check-up: is good for our health

Amid the furore over the delayed scheme, the reality is that the storage of pseudoanonymised patient data is already common practice, writes Dr David Springate. He argues that a national primary care database will bring big benefits – and says the risk of individuals’ data being de-anonymised by big pharma companies or criminals is remote. […]