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: Care.data is good for our health
Amid the furore over the delayed Care.data 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. […]

Power, money, but little accountability; the rise of the New Corporate State
Contracting out has become the ‘new normal’, writes Professor Stephen Wilks, with around half of all UK government spending now ending up in the pockets of private sector companies. But while public servants must operate within a robust constitutional framework, the same safeguards do not apply to the Public Services Industry. Which is the largest […]

Public health: is the glass half full or half empty?
Dr Julia Segar was one of those out in force during Manchester Policy Week to hear Durham University’s Professor David Hunter and Manchester’s own Professor Steve Harrison ponder whether optimism or pessimism should prevail in the light of recent changes to the way public health is organised. The recent healthcare reforms have seen public health […]

A ‘National’ Health Service? It would be a good idea
The NHS is seen as a fundamentally British institution and even a symbol of national identity. But, writes Dr Julian Simpson, it might make more sense to call it an ‘International’ Health Service. And while ‘health tourism’ and migrant doctors’ language skills make headlines, the real issue is whether it should remain dependent on an […]

Learning to live with the Frankenstein’s Monster that is modern nursing
Today’s nurses have been accused of being “too posh to wash” and lacking compassion, writes Stuart Butler. But unless policymakers are willing to free up their time through further recruitment, or abandon their obsession with targets, they should learn to live with the professionalized work-force that is entirely of their own making. Rather uniquely […]
Quality Performance Data – for the NHS and everyone else too?
A new Audit Commission report published today assesses progress in improving data quality – especially performance data – in the NHS. It reports on-going problems with embedding a culture of good data quality into NHS organisations.
Damned Targets?
“On Tuesday, the Healthcare Commission report revealed that between 2005 and 2008 there were 400 excess deaths at [Stafford] hospital – although it was impossible to say whether these had all been caused by bad care. The report said there were deficiencies at “virtually every stage” of emergency care and managers pursued targets to the […]
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